Could Periodontitis Increase the Risk of Suffering from Pancreatic Cancer?-A Systematic Review.

(1) Background: The relationship between periodontitis and systemic pathologies continues to grow. Recently, the presence of periodontal pathogens has been linked to an increased risk of pancreatic cancer (PC) and its mortality. Thus, a systematic review is needed to identify whether an association between the two diseases can be established. The objective of this review is to elucidate the mechanisms responsible for this association. (2) Methods: A systematic review was carried out using three databases (PubMed, Embase and Scopus) with the following keywords "Periodontitis AND pancreatic cancer". A total of 653 articles were retrieved; before selection and screening, the inclusion and exclusion criteria were defined, resulting in a total of 13 articles being included in the review. (3) Results: The increase in low-grade systemic inflammation, pH changes, and the cytotoxicity of certain periodontopathogenic bacteria were found in the scientific literature reviewed as mechanisms linking periodontitis with the risk of PC. (4) Conclusions: Through this systematic review, we have seen how periodontitis can be related to PC and how it worsens its prognosis. Knowing the behavior of periodontopathogenic bacteria and the influence they have on our immune and inflammatory system may help to achieve an interdisciplinary approach to both pathologies.

Surgical difficulty and postoperative course of the third molar extraction under general anesthesia: An intervention trial.

BACKGROUND: Third molar extractions are one of the most common surgical procedures in the area of ​​stomatology. However, we know that even if they are minor surgeries, they can cause a postoperative period with local and systemic repercussions. Thus, the aim of this intervention trial is to determine the relationship between clinical parameters (pain, inflammation and trismus) and serum parameters (C-reactive protein (CRP), IL-6 and fibrinogen) that are modified in the first postoperative week, and the appearance of complications after extraction with general anesthesia, using the Pederson scale. METHODS: The research question was: Can postoperative discomfort after third molar extraction under general anesthesia be predicted using Pederson scale? An interventional trial was carried out of third molar extractions under general anesthesia in Dr. Peset University Hospital. Patient selection was performed randomized using MS Excel. Then were divided into two groups (n = 126): group A (2 complex extractions) and group B (4 extractions: 2 simple and 2 complex). All parameters were collected at the surgery and 7 days after surgery. RESULTS: The clinical postoperative parameters showed significant differences in relation to surgical difficulty. In summary, the degree of surgical difficulty can be predicted with the Pederson scale before extracting mandibular third molars. CRP and fibrinogen levels increase significantly with the degree of surgical difficulty. CONCLUSION: Significant differences (p < 0.001) were observed in all the intraoperative parameters according to surgical difficulty as assessed by the Pederson scale. Therefore, this scale was a good indicator to estimate the patient's postoperative period.

Comparison of three fluids for calibration of the new Periotron® 8010

Background: The aim of the present study was to calibrate the Periotron® model 8010 with volumes of three different fluids (distilled water, serum, and saliva) and to identify which of the three is the most reliable, feasible, and reproducible for routine calibration. Material and Methods: A total of 450 samples of Periopaper® were divided into three groups (150 each per group): distilled water, serum matrix and saliva. A calibration curve was run with 0.25, 0.50, 0.75, 1.00 and 1.25 µl of each of the fluids, and the results were determined in Periotron units (PU). Statistical analysis was performed with oneway ANOVA followed by Bonferroni’s post hoc test and a linear equation. Results: Distilled water presented the lowest levels of PU at all volumes, while serum showed the highest levels at high volumes. Linear regression equations rendered similar slopes for saliva and distilled water, while serum was statistically different. Saliva presented a reproduction percentage of 99.7%, which indicated better accuracy and precision than serum and distilled water. Conclusions: Saliva is more reliable and accurate than water or serum for the purpose of calibration of the Periotron® model 8010, though it shares drawbacks with serum. Distilled water is more easily available and does not require any additional procedure, in addition to producing a similar slope to saliva and a smaller deviation from the media than serum. (AU)

Dental treatment under general anesthesia in mentally disabled patients based on an ambulatory surgery model: A Case-control study.

BACKGROUND: Mentally disabled patients commonly offer little or no cooperation in dental treatments, and general anesthesia may become necessary in such cases. The present study was to identify the most relevant factors in dental treatment under general anesthesia in disabled patients based on a Major Ambulatory Surgery (MAS) model. The study analyzes anesthetic variables and type of dental procedures carried out for disabled patients compared with controls. MATERIAL AND METHODS: A case-control study was carried out with 574 patients (263 cases and 311 controls) subjected to dental treatment under general anesthesia in the Day Surgery Unit of Dr. Peset University Hospital (Valencia, Spain). Epidemiological, anthropometric and preoperative data (ASA score, Mallampati classification) were collected. RESULTS: Males and obesity were more prevalent among disabled patients than controls. Significant associations were found between longer surgery time, underwent thoot extraction, tartrectomy, fillings and disabled patients treated under general anesthesia. The preoperative risk scores were likewise higher in disabled patients (ASA III-IV). The duration of surgery increased with the ASA score but didn´t influence postoperative stay. Patient condition in the first 24 hours of late postoperative recovery was good in both groups. CONCLUSIONS: Dental treatment based on the MAS in mentally disabled patients is effective and safe, even in individuals with a certain prior risk (ASA III). Key words:Disabled patients, ambulatory surgery, dental treatment, special needs, Major Ambulatory Surgery by general anesthesia.

Adherence to supportive periodontal treatment in relation to patient awareness.

BACKGROUND: To evaluate the risk profile of noncompliant patients in relation to adherence to supportive periodontal therapy in order to identify factors associated with this profile, and be able to prevent the abandonment of periodontal therapy. MATERIAL AND METHODS: This cross-sectional observational and comparative study was carried out on the patients who attended the Periodontics department of a University in Valencia (by a questionnaire and followed-up the periodontal supportive therapy through the medical history.) 220 patients were interviewed and gave their informed consent and data release permission before taking part in the study, which was approved by the Ethics Committee (UCV/2019-2020/048). RESULTS: 48.84% of self-reported patients were regular compliers, in contrast with 10.62% of referred patients. Those with acute symptoms were greater adherent than those patients who didn´t present symptoms. Regarding patients undergoing surgical procedures, significant results were obtained: 69.70% showed adherence, in contrast with 18.67% patients with basic treatment. Results between men and women were similar. However, the age of the non-compliant patients was slightly older. CONCLUSIONS: Self-reported patients presented a significantly higher degree of adherence to periodontal supportive therapy than the referred patients. Patients with acute symptoms presented higher adherence than those without them. Patients who underwent surgery presented a significantly higher degree of adherence than patients who received basic periodontal treatment. No conclusive data have been found regarding sex and age. Key words:Awareness, periodontal disease, compliance, SPT.

COVID-19, A new challenge in the dental practice.

BACKGROUND: This review was conducted in order to learn the latest information about how to prevent cross-infection of COVID-19 in dentistry. The aim of this study is offer a clinical protocol to reduce the risk of infection of COVID-19 in dental settings. MATERIAL AND METHODS: We carried out a review based on the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We used the following three databases: PubMed, Embase and Scopus. The search strategy was performed in the three databases applying the search terms "COVID-19 AND dental", "COVID-19 AND dentistry", selecting human studies published from November 2019 to May 2020. English publications regarding COVID-19 as the central topic of the research were eligible for inclusion, regardless of study design. There are very few published studies on the association between COVID-19 and dentistry, for that reason we also included the English abstract of two studies written in Chinese. The following exclusion criteria were established: animal studies and in vitro studies. RESULTS: The search identified a total of 212 articles, of which 54 were preselected, and 23 were finally included in the review on the basis of the inclusion and exclusion criteria. We collected all the information about routes of general and oral infection, dental patient evaluation and cross-infection control in Dental Clinic in the selected studies. CONCLUSIONS: Cross infection in the dental clinic involve a very important risk due to the return to dental settings after periods of social isolation of the population after the epidemic outbreak of SARS-CoV-2. Therefore, we must take adequate and sufficient security measures to protect the patients and the dental clinic staff. Key words:COVID-19, COVID-19 cross infection risk, COVID-19 prevention in Dentistry, COVID-19 in Dental Clinic.

Effect of Non-Surgical Periodontal Treatment on Oxidative Stress Markers in Leukocytes and Their Interaction with the Endothelium in Obese Subjects with Periodontitis: A Pilot Study.

AIM: The primary objective of this pilot study was to evaluate the effect of non-surgical periodontal treatment. The secondary aim was to evaluate the effect of dietary therapy on both parameters of oxidative stress in leukocytes and leukocyte-endothelial cell interactions in an obese population. METHODS: This was a pilot study with a before-and-after design. Forty-nine obese subjects with periodontitis were randomized by means of the minimization method and assigned to one of two groups, one of which underwent dietary therapy while the other did not. All the subjects underwent non-surgical periodontal treatment. We determined periodontal, inflammatory and oxidative stress parameters-total reactive oxygen species (ROS), superoxide production, intracellular Ca2+, mitochondrial membrane potential and superoxide dismutase (SOD) activity. We also evaluated interactions between leukocytes and endothelium cells-velocity, rolling flux and adhesion-at baseline and 12 weeks after intervention. RESULTS: Periodontal treatment improved the periodontal health of all the patients, with a reduction in serum retinol-binding protein 4 (RBP4), total superoxide production and cytosolic Ca2+ in leukocytes. In the patients undergoing dietary therapy, there were less leukocyte adhesion to the endothelium, an effect that was accompanied by a decrease in TNFα, P-selectin and total ROS and an increase in SOD activity. CONCLUSIONS: Whereas non-surgical periodontal treatment induces an improvement in leukocyte homeostasis, dietary therapy as an adjuvant reduces systemic inflammation and increases antioxidant status which, in turn, modulates leukocyte-endothelium dynamics.

Association between Periodontal Diseases and Polycystic Ovary Syndrome: A Systematic Review.

BACKGROUND: A convergent association between polycystic ovary syndrome (PCOS) and periodontal disease, in particular chronic periodontitis (CP), has recently been proposed. The underlying molecular mechanisms of this association are not fully understood, though it is thought that chronic inflammation is responsible. Therefore, the aim of this study was to evaluate the association between periodontal disease-gingivitis and CP-and PCOS. MATERIALS AND METHODS: The PICO (Participants, Intervention, Control, and Outcomes) question was as follows: "Is there an association between PCOS and CP?" A systematic review of three databases-PubMed, Embase and Scopus-was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Original studies in human cohorts carried out in the last 10 years and including a control group were eligible for inclusion. Letters to the editor, case reports, and reviews were not considered. RESULTS: Ten articles met all the selection criteria and provided a positive answer to the PICO question. Our review of these articles revealed an association between CP and PCOS, since periodontal parameters were altered more frequently in patients with these conditions than in healthy young women. This altered periodontal response in PCOS was associated with a proinflammatory status that seemed to increase susceptibility to periodontal disease. CONCLUSION: Patients with PCOS appear to be more susceptible to developing periodontal diseases than women without the pathology.

Oral health knowledge in relation to educational level in an adult population in Spain.

BACKGROUND: To analyze the relationship between oral health knowledge and educational level among an adult population in Spain, and between oral health knowledge and subjects' oral hygiene practices, dietary habits, toxic habits, and oral quality of life. MATERIAL AND METHODS: This transversal study used the Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire to evaluate subjects' knowledge and understanding of oral health, and the World Health Organization oral health questionnaire for adults to evaluate dietary, oral hygiene, toxic habits, and oral quality of life. Participants (n=400) gave their informed consent and data release permission before taking part in the study, which was approved by the University of Valencia Ethics Committee (certificate No.: H145160675341). Statistical analysis was performed using SPSS v22.0 software, applying Student's t-test, ANOVA, and chi2 test, with significance set at p<0.05. RESULTS: Oral health knowledge results were: low 41.5% and high 58.5%. An association was found between educational level and oral health knowledge (Chi2: p=0.000). Oral hygiene habits presenting an association with higher levels of oral health knowledge were dental floss use, a higher number of teeth present, and lower prevalence of partial prostheses. A significant association was found between oral quality of life and oral health knowledge. CONCLUSIONS: Oral health knowledge is associated with the individual subject's educational level. But oral health knowledge is not necessarily reflected in the practice of healthy habits. Key words:Oral health literacy, oral health habits, oral health knowledge, CMOHK.