Arsenic: A Perspective on Its Effect on Pioglitazone Bioavailability.

Arsenic (As) is a common contaminant in drinking water in northeastern Mexico, which reduces the expression of cytochrome P450 (CYP 450). This enzyme group metabolizes numerous drugs, such as oral antidiabetic drugs such as pioglitazone (61% CYP 3A4, 49% CYP 2C8). When CYP 450's function is inadequate, it has decreased therapeutic activity in type 2 diabetes mellitus (T2DM). This study aimed to establish the effect of As on pioglitazone metabolism in patients with T2DM. METHODOLOGY: Urine, water, and plasma samples from a healthy population (n = 11) and a population with T2DM (n = 20) were obtained. Samples were analyzed by fluorescence spectroscopy/hydride generation (As) and HPLC (pioglitazone). Additionally, CYP 3A4 and CYP 2C8 were studied by density functional theory (DFT). RESULTS: The healthy and T2DM groups were exposed via drinking water to >0.010 ppm, Ka values with a factor of 4.7 higher, Cl 1.42 lower, and ABCt 1.26 times higher concerning the healthy group. In silico analysis (DFT) of CYP 3A4 and CYP 2C8 isoforms showed the substitution of the iron atom by As in the active sites of the enzymes. CONCLUSIONS: The results indicate that the substitution of Fe for As modifies the enzymatic function of CYP 3A4 and CYP 2C8 isoforms, altering the metabolic process of CYP 2D6 and CYP 3A4 in patients with T2DM. Consequently, the variation in metabolism alters the bioavailability of pioglitazone and the expected final effect.

Clinical Management of Intra-Pulp Canal Broken Endodontic Files in Primary Teeth: Literature Review / Manejo clínico de las limas endodónticas fracturadas dentro del conducto pulpar en dientes primarios: Revisión de la literatura

ABSTRACT: Fracture of an endodontic file inside a primary root canal is a rare but critical complication during the pulpectomy treatment, because the mechanical obstruction impedes the optimal cleaning and obturation of the pulp canal, compromising seriously the clinical outcome. This accidental event is mainly associated with over-use and excessive torque of intracanal files. Most clinicians opt to proceed with the extraction of the affected tooth followed by a space maintainer placement. Other practitioners attempt the non-surgical retrieval of the separated fragment through available proven techniques in permanent teeth; however, these methods may involve significant damage to the tooth and surround tissues. On the other hand, preservation of the metallic fragment might affect the treatment prognosis and interfere with the physiological root resorption.

RESUMEN: La fractura de una lima endodóntica dentro de un conducto radicular primario es una complicación rara aunque critica durante el tratamiento de pulpectomía, debido a que la obstrucción mecánica impide la limpieza y obturación óptimas del conducto pulpar, comprometiendo seriamente el resultado clínico. Este evento accidental está principalmente asociado con el sobreuso y torque excesivo de las limas dentro del conducto. La mayoría de los clínicos optan por realizar la extracción del diente afectado, seguido por la colocación de un mantenedor de espacio. Otros practicantes intentan la remoción no quirúrgica del fragmento separado a través de técnicas disponibles probadas en dientes permanentes; sin embargo, estos métodos pueden causar daños significativos al diente y tejidos circundantes. Por otra parte, la preservación del fragmento metálico puede afectar el pronóstico del tratamiento e interferir con el proceso de reabsorción radicular fisiológico.

Synthesis of a PVA drug delivery system for controlled release of a Tramadol-Dexketoprofen combination.

The local administration of analgesic combinations by means of degradable polymeric drug delivery systems is an alternative for the management of postoperative pain. We formulated a Tramadol-Dexketoprofen combination (TDC) loaded in poly(vinyl alcohol) (PVA) film. Films were prepared by the solvent casting method using three different molecular weights of PVA and crosslinking those films with citric acid, with the objective of controlling the drug release rate, which was evaluated by UV-vis spectrometry. Non-crosslinked PVA films were also evaluated in the experiments. Differential scanning calorimetry (DSC) analysis of samples corroborated the crosslinking of PVA by the citric acid. Blank and loaded PVA films were tested in vitro for its impact on blood coagulation prothrombin time (PT) and partial thromboplastin time (PTT). The swelling capacity was also evaluated. Crosslinked PVA films of higher-molecular weight showed a prolonged release rate compared with that of the lower-molecular-weight films tested. Non-crosslinked PVA films released 11-14% of TDC. Crosslinked PVA films released 80% of the TDC loaded (p < 0.05). This suggests that crosslinking films can modify the drug release rate. The blank and loaded PVA films induced PT and PTT in the normal range. The results showed that the polymeric films evaluated here have the appropriate properties to allow films to be placed directly on surgical wounds and have the capacity for controlled drug release to promote local analgesia for the control of postoperative pain.

Evaluation of the Bond Strength and Marginal Seal of Indirect Restorations of Composites Bonded with Preheating Resin.

OBJECTIVE: Preheated resins (PR) are considered a cementing agent option for indirect adhesive restorations of composite inlays and onlays. The objective of this in vitro study was to evaluate the marginal sealing, adhesive interface, and microtensile bond strength of indirect adhesive restorations of composites in terms of dentin cemented with PR. MATERIALS AND METHODS: Standardized Class II preparations were performed on 30 extracted human premolars, impressions were taken, and indirect composite restorations were manufactured. In total, 15 restorations were cemented with PR (ENA HRi, SYNCA), and 15 restorations were cemented with self-adhesive resinous cement (RC) (Relyx U200, 3M ESPE), followed by a thermocycling regime. After that, these were segmented sagittally and longitudinally to evaluate the marginal sealing and the adhesive interface with scanning electron microscopy and confocal microscopy. Microtensile bond strength was assessed with a mechanical device (TA. XT Plus C, Stable Micro System). STATISTICAL ANALYSIS: Statistical analysis was conducted using the two-sample Student's t-test. RESULTS: The results showed that there is no statistically significant difference in the degree of microfiltration using PR or RC; however, microtensile bond strength is greater when the restoration is cemented with RC (278.75 N/cm3) than with PR (144.49 N/cm3), and better adjustment and sealing were observed for composite restorations with PR. CONCLUSION: PR comprise an alternative cementing agent for indirect composite restorations in Class II cavities in premolars.

Correlación entre la edad cronológica y dental con los estadios de maduración vertebral en pacientes de 5 a 15 años / Correlation between the chronological and dental age with the vertebral maturation stages in patients from 5 to 15 years old

El uso de un método rápido y efectivo para la estimación de la maduración esquelética de los pacientes pediátricos es fundamental para la aplicación oportuna de tratamientos ortopédicos/ortodónticos. En Odontología Pediátrica, la toma de una radiografía panorámica, como método diagnóstico de rutina, puede servir para estimar con precisión el estadio de maduración en estos pacientes, mediante el cálculo de la edad dental. El objetivo del presente trabajo fue determinar la correlación entre las edades cronológica y dental con los estadios de maduración esquelética de las vértebras cervicales, a través del método estadístico no paramétrico con Rho de Spearman. Se utilizó un diseño observacional, transversal y analítico. La muestra consistió en 516 expedientes de pacientes entre los 5 y 15 años de edad, sistémicamente sanos, con radiografías panorámica y lateral de cráneo, tomadas en la misma fecha. Se determinó la edad cronológica de cada paciente según su historia clínica. Se realizó el cálculo de la edad dental de cada paciente con el método de Demirjian, y se determinó el estadio de maduración de vértebras cervicales con el método de Lamparski. Se determinó una correlación de 72 % entre la edad cronológica y la maduración ósea vertebral; una correlación del 66 % entre la edad dental y la maduración ósea, y una correlación del 86 % entre la edad cronológica y la dental. De acuerdo con estos resultados, tanto la edad cronológica y dental presentan una alta correlación con la edad de maduración vertebral. Se concluye así que la edad dental y cronológica son indicadores apropiados para estimar el estadio de maduración esquelética de los pacientes pediátricos.

The use of fast and effective methods for estimating the skeletal maturity for pediatric patients, is fundamental for the opportune application of orthopedic/orthodontic treatments. In pediatric dentistry, the panoramic radiography as a routine diagnostic method, can be used to estimate the stage of maturation in these patients, through the calculation of dental age. The aim of the present study is to determine the correlation between the chronological and dental ages, with the cervical vertebrae stages of skeletal maturity, through the non-parametric Spearman statistical method. An observational, transversal, and analytical design was employed. The sample consisted of 516 records from patients between 5 and 15 years of age, systemically healthy, with panoramic and lateral skull radiographs taken on the same date. The chronological age of each patient was determined according to the clinical history. Dental age of each patient was calculated with the Demirjian approach, and the stage of maturation of cervical vertebrae was determined by means of the Lamparski method. The results showed a correlation of 72 % between chronological age and bone maturation, a correlation of 66 % between dental age and bone maturation, and a correlation of 86 % between chronological and dental age. It is concluded that both chronological and dental age exhibit a high correlation with the correspondent stage of vertebral maturity. Thus, dental and chronological age are appropriate indicators to estimate, with high precision the stage of skeletal maturation in pediatric patients.

Calcium sustained release, pH changes and cell viability induced by chitosan-based pastes for apexification.

We explored chitosan-based sustained release pastes for apexification. The study aimed to formulate chitosan-based pastes loaded with calcium hydroxide (CH) or with calcium chloride (CC), and to evaluate the sustained release of Ca2+ and pH changes in deionized water as well as the effect of the pastes on cell viability. The pastes were formulated by dissolution of the chitosan in 1% or 2% acetic acid (AAC) plus the addition of CH or CC, then were suspended in deionized water for 50 days; the released Ca(II) and pH were measured with an electrode probe. The effect of the pastes on viability of human dental pulp cells was evaluated with a MTS assay. The results showed that the pastes prepared with 1% and 2% AAC and loaded with CH released a 74.9% and a 76.1% of the Ca2+ content, respectively, while the pastes prepared with 1% and 2% AAC loaded with CC released a content of Ca2+ of 90.8% and 76.6%, respectively. A control paste (CH and polyethylene glycol) released a 95.4%; significant statistical differences were found between the percentage of the experimental pastes and the control. The CH-loaded pastes caused an alkaline pH at the starting of the study, but the pH became neutral at the ending. The pH of the CC-loaded pastes was neutral at the starting and was acid at the ending. The pastes no affected on the cell viability. The chitosan-based pastes showed a suitable sustained release profile and cytocompatibility.

Antinociceptive local activity of 4-allyl-1-hydroxy-2-methoxybenzene (eugenol) by the formalin test: an anti-inflammatory effect

Eugenol has been employed for decades as a condiment, an antimycotic, an antibacterial, an antiviral, and an antioxidant, and it is one of the natural analgesics most frequently utilized for pain and inflammation. Our objective was to determine the analgesic/anti-inflammatory effect of eugenol compared with diclofenac, naproxen, and tramadol using the formalin test. The formalin method was used in 6- to 10-week-old Wistar rats (weighing 250 g each) divided into six groups: saline (0.9%); formalin (5%); diclofenac (250 µg/kg); naproxen (400 µg/kg); tramadol (500 µg/kg), and eugenol (1,400 µg/kg), in the intraplantar part of the hind-end trunk of the rats, with n = 5 per group. Eugenol diminished 44.4% of nociceptive behavior in phase 1 and 48% in phase 2 (p ≤0.05 vs formalin). Eugenol was shown to be 1.14 times more effective than diclofenac, but 1.62 and 1.75 times less effective than naproxen and tramadol, respectively, in phase 1 and 1.45 times less effective than diclofenac and naproxen and 1.66 less effective than tramadol in phase 2 (p ≤0.05). These data suggest that eugenol possesses moderate activity in the acute pain phase and greater activity in inflammatory-type pain, and both effects are comparable to those produced by diclofenac and are less than the effects produced by naproxen and tramadol in the formalin test

Prevalencia de Bruxismo y Trastornos Temporomandibulares Asociados en una Población de Escolares de San Luis Potosí, México / Prevalence of Bruxism and Associated Temporomandibular Disorders in a Population of School Children of San Luis Potosí, México

RESUMEN: El término "Transtornos Temporomandibulares" (TTM) incluye numerosos problemas clínicos asociados con las articulaciones temporomandibulares, músculos de la masticación y otras estructuras asociadas. El bruxismo, un hábito oral parafuncional, consiste en rechinar o apretar de manera rítmica e involuntaria los dientes, lo que puede conducir a trauma oclusal y problemas articulares. El objetivo del estudio fue determinar la frecuencia y prevalencia de signos y síntomas de TTM y bruxismo en niños escolares de 6 a 12 años, en una población de San Luis Potosí, México. Se empleó un diseño transversal descriptivo en una muestra de 314 participantes, estudiantes de una escuela primaria de la ciudad de San Luis Potosí, México. Los participantes fueron seleccionados aleatoriamente en forma estratificada y polietápica. La muestra total consistió en 153 femeninos y 161 masculinos. Los signos y síntomas de TTM más frecuentes fueron la alteración de la función de la ATM (35 %), seguido por los ruidos y chasquido articulares (29,2 %). En los sujetos con diagnóstico de bruxismo, la alteración más frecuente fueron molestias asociadas en la ATM (19,4 %), dolor de cabeza (17,8 %) y atrición dental (16,5 %).

ABSTRACT: The term "Temporomandibular disorders" (TTM) includes numerous clinical problems associated with joint temporomandibular, muscles of mastication and other associated structures. Bruxism, oral parafunctional habit, consists of grinding or clenching of involuntary, rhythmic manner, which can lead to trauma, occlusal and problems joint. The objective of the study was to determine the frequency and prevalence of signs and symptoms of DTM and bruxism in school children aged 6 to 12, in a population of San Luis Potosí, México. A crosssectional descriptive design was used in a sample of 314 participants, students of a primary school in the city of San Luis Potosi, Mexico. The participants were randomly selected in tiered form and conglomerated. The total sample consisted of 153 female and male 161. The signs and symptoms of TMD frequent were alteration of the function of the ATM (35 %), followed by noise and snap joint (29.2 %). In subjects with a diagnosis of bruxism, the most frequent alteration was associated with TMJ discomfort (19.4 %), headache (17.8 %) and dental attrition (16.5 %).

Expression of enamel proteins in rough endoplasmic reticulum and golgi complex in human dental germs / Expresión de proteínas del esmalte en retículo endoplásmico rugoso y complexo golgiensis en gérmenes dentales humanos

Tooth enamel is the hardest tissue in the body. The organic matrix configuration is provided by the main proteins amelogenin, ameloblastin and enamelysin (MMP20), an enzyme that helps to shape the matrix. The aim of this study was to determine by histochemistry the expression of amelogenin and enamelysin through the rough endoplasmic reticulum in the late stages of amelogenesis, and its expression in the Complexus golgiensis (Golgi complex / Golgi apparatus) in the early stages in human fetuses. In early stages a colocalization of both proteins inside the Golgi apparatus was found, being more evident the relationship between Golgi and amelogenin (99.92 %). In the late stage, a colocalization of both proteins and rugged endoplasmic reticulum was found. With enamelysin being more evident in relation with rough endoplasmic reticulum (99.95 %). Our findings demonstrated the presence of amelogenin and enamelysin in odontoblast and ameloblast. However, the presence of these two proteins in odontoblast remains unknown.

El esmalte dental es el tejido más duro del cuerpo. La configuración de la matriz orgánica es proporcionada por las proteínas principales amelogenina, ameloblastina y enamelisina (MMP20), una enzima que ayuda a dar forma a la matriz. El objetivo de este estudio fue determinar mediante histoquímica la expresión de amelogenina y enamelisina a través del retículo endoplasmático rugoso en las últimas etapas de la amelogénesis , y su expresión en el Complexo golgiensis en las primeras etapas de formación en fetos humanos. En las primeras etapas se observó colocalización de ambas proteínas en el interior del Complexo golgiensis, siendo más evidente la relación entre Golgi y amelogenina (99,92 %). En la última etapa, se identificó una colocalización de ambas proteínas y retículo endoplásmico rugoso. Resulto más evidente la enamelisina en relación con el retículo endoplasmático rugoso (99,95 %). Nuestros resultados demostraron la presencia de amelogenina y enamelisina en odontoblastos y ameloblastos, sin embargo se desconoce la presencia de estas dos proteínas en odontoblastos.

Manejo estomatológico pediátrico de la hipomelanosis de ito. reporte de un caso / Dental management hypomelanosis of ito. case report

La hipomelanosis de Ito (incontinencia pigmentante acromática o nevo sistmico acrómico) es una enfermedad dermatolgica o sindrome neurocutáneo de ocurrencia rara, que consiste en la presencia de manchas dérmicas hipopigmentadas en varias partes del cuerpo, además de múltiples manifestaciones extracutáneas, principalmente del sistema nerviosocentral (posible retraso mental de diferentes grados), musculo-esqueléticas y oculares. También ha sido asociada con diversas anomalías dentales, como son la hipodoncia y el talón cuspídeo palatino. El propósito del presente artículo es reportar el manejo estomatológico proporcionado a una niña de 2 años y 7 meses de edad con hipomelanosis de Ito, en la clínica del Posgrado en Estomatolog¡a Pediátrica, de la Universidad Autónoma de San Luis Potosi.

Hypomelanosis of Ito (incontinence pigmenting achromic or systemic achromic nevus) is a dermatological disease or neurocutaneous syndrome rare occurrence, with incidence of dermal hypopigmented spots in many parts of the body, and several extracutaneous manifestations, primarily central nervous system (possible mental retardation of variable degrees), optical and musculoskeletal. It has also been associated with various dental anomalies such as hypodontia and the palatal cusp heel. The purpose of this paper is to report dental management provided a girl of 2 years and 7 months old with Hypomelanosis of Ito, at the clinic of Pediatric Dentistry of the Autonomous University of San Luis Potosi.

La sala lúdica: un complemento de la Clínica Dental Pediátrica Universitaria / The playroom: a complement of the University Pediatric Dental Clinic

El presente artículo muestra las diferentes actividades que realiza la salalúdica SALPEP (Especialidad en Estomatología Pediátrica, Facultad deEstomatología, Universidad Autónoma de San Luis Potosí), tanto educativascomo de preparación conductual antes de ingresar a la consulta dental, en los pacientes pediátricos así como en sus padres que acuden a la Clínica Dental Pediátrica del Posgrado. Además, se resaltan los resultados obtenidos en sus primeros doce meses de labor, los beneficios y experiencias logradas que se han refl ejado en el aumento de la calidad de la atención odontológica, en todos los aspectos...

Comprendiendo y combatiendo el fracaso anestésico en odontología / Understanding and combatting anesthetic failures in dentistry

El fracaso anestésico en odontología es un tema de constante investigación, ya que se presenta con frecuencia a la hora de realizar bloqueos del nervio alveolar inferior (BNAI) y en pacientes con pulpitis irreversible o procesos infecciosos. Son múltiples las causas que se han asociado al fracaso, entre las que destacan: factores anatómicos, bioquímicos, fisiológicos, patológicos, psicológicos, operatorios y aquellos relacionados con la solución anestésica per se. Una buena anestesia es un punto crítico a lograr en cualquier tratamiento dental y por eso se han propuesto diversas estrategias clínicas y farmacológicas como uso de técnicas suplementarias, utilización de dispositivos y coadyuvantes anestésicos, empleo de soluciones anestésicas distintas, modifi cación de los anestésicos, utilización de premedicación analgésica e incluso la aplicación local de analgésicos y otro tipo de fármacos; todo con el fin de compensar y tratar de disminuir el fracaso anestésico

Failures in anesthesia in dental practice are a topic of ongoing research due to the fact that these occur frequently when performing an inferior alveolar nerve block (IANB) in patients with irreversible pulpitis or infectious processes. Multiple causes have been associated with this problem, including anatomical, biochemical and physiological, patho-logical, psychological, and operative factors, as well as issues related to the anesthetic solution itself. Good anesthesia is critical in any dental treatment that involves pain, which is why various clinical and pharmacological strategies have been proposed in order to decrease the likelihood of anesthetic failure (such as the use of supplementary techniques, devices and aids, alternative anesthetic solutions, changing anesthetics, analgesic premedication, and even the local application of analgesics and other drugs).

La publicación científica en estomatología: un desafío para los investigadores / The scientific publication in stomatology: a challenge for researchers

La publicación de artículos científicos en odontología constituye la forma más apropiada para que un investigador dé a conocer los resultados de su trabajo; este reporte escrito representa la culminación del proceso de un estudio y resume los aspectos más relevantes del trabajo realizado –como son las características de los pacientes incluidos, el diseño empleado para dar respuesta a la pregunta planteada inicialmente, los materiales o procedimientos utilizados, los resultados y conclusiones emanados del estudio– en una forma coherente y estructurada. El propósito del presente artículo es dar a conocer algunos elementos de la definición de la publicación científica, la importancia de publicar en revistas de reconocido prestigio, el proceso de la publicación, la estructura de un artículo científico y los principales lineamientos para la publicación.

In dentistry, publishing scientific papers is the most effective way for researchers to disseminate the results of their work; these written reports represent the culmination of the research process and provide a summary of the most relevant aspects of the work carried out, such as the characteristics of the patients included, the design used to find the answer to the initial question, the materials or procedures used, and the results and conclusions of the study, all presented in a cohe­rent and structured manner. The purpose of this article is to examine the definition of scientific publication in dentistry, the importance of publishing in prestigious journals, the publication process, the structure of a scientific article, and the main guidelines for publication.

Design of a controlled release system of OP-1 and TGF-ß1 based in microparticles of sodium alginate and release characterization by HPLC-UV.

A new system for sustained release of growth factors, such as osteogenic protein 1 (OP-1) and transforming growth factor ß1 (TGF-ß1), intended to repair and promote dental tissue regeneration in rats was designed and characterized in this work. The release system was made with microparticles of sodium alginate, produced by ionic gelling dripping technique. The release profiles of OP-1 and TGF-ß1 from biopolymer matrix were determined by high-performance liquid chromatography (HPLC), and with this purpose, an HPLC-UV method was developed. About 80% of each growth factor was released in the first 24 h, reaching almost 100% in 168 h. The system was tested during the tissue repair in rat molars in comparison with calcium hydroxide and both growth factors not encapsulated. The dentin sialoprotein (DSP) was used as a repair marker. It was detected by immunohistochemistry, after 14- and 28-d post-treatment. X (2) test (p ≤ 0.001) and Fisher exact test (p ≤ 0.05) were applied for assessment of the amount of immunostaining. The treatment with encapsulated OP-1 showed an increased DSP immunostaining after 14 d and did not find any significant difference with the immunostaining observed for calcium hydroxide treatment. Treatment with TGF-ß1 did not show significant difference with calcium hydroxide. Treatment with both factors OP-1 and TGF-ß1 showed higher DSP immunostaining in comparison with calcium hydroxide treatment. In conclusion, the combination of both growth factors encapsulated showed more DSP immunostaining in comparison with each one separated, either encapsulated or not.

Manejo clínico-farmacológico del dolor dental / Clinical and pharmacological management of toothache

En la práctica odontológica es frecuente el tratamiento farmacológico con analgésicos para mitigar el dolor en pacientes que han sido sometidos a algún procedimiento odontológico mayor, con el fin de prevenir o disminuir el dolor provocado con el procedimiento. Sin embargo, a la fecha no se puede hablar de un manejo estandarizado para todo tipo de pacientes y la investigación en la búsqueda del mejor tratamiento farmacológico es continua. Se presentan en esta revisión los aspectos fundamentales del dolor, las características del dolor dental, los diferentes fármacos y estrategias de manejo del dolor que se han utilizado en diferentes estudios clínicos y algunas recomendaciones.

Comparación de la microfiltración utilizando dos técnicas de obturación con amalgama en molares temporales: estudio in vitro / A comparison between two obturation techniques with amalgam in primary molars: an in vitro study

El objetivo del estudio fue evaluar si la obturación de amalgama convencional con dos diferentes adhesivos dentinarios disponibles comercialmente, es más eficaz que cuando estos adhesivos no son empleados en lo referente a la microfiltración. El diseño del estudio fue experimental in vitro. Los resultados obtenidos muestran que la restauración de amalgama adhesiva resultó ser más efectiva en cuanto al grado de reducción de la microfiltración, cuando fue comparada con la restauración de amalgama convencional

Concentración de flúor en jugos de frutas como factor de riesgo adicional a fluorosis dental / Fluoride concentration in fruit juices as an additional risk factor for dental fluorosis

Objetivo: evaluar las concentraciones de flúor en jugos de frutas que se consumen en la ciudad de San Luis Potosí. Material y métodos: se evaluó la concentración de flúor en algunos productos de las 2 compañías de jugos de frutas más populares de México. Se recolectaron muestras de diferentes lotes, sabores y presentaciones de cada producto, con 3 muestras por lote. La determinación de la concentración de flúor se realizó mediante el método del electrodo de ion selectivo. Resultados: la concentración de flúor de los productos de las diferentes compañías tuvo un rango de 0.16 a 2.33 ppm. Al comparar los resultados de las concentraciones de flúor entre los productos de las diferentes compañías, mostraron diferencias estadísticamente significativas (p<0.05). Conclusiones: 33 por ciento de los productos analizados mostraron niveles de flúor por arriba de la norma mexicana (0,7 ppm) y pueden ser un factor de riesgo adicional de fluorosis dental

Analgesic efficacy of tramadol by route of administration in a clinical model of pain.

The objective of this study was to evaluate the analgesic efficacy produced by tramadol given by two different routes of administration in patients experiencing pain after removal of an impacted mandibular third molar under local anesthesia. A double-blind, randomized, placebo-controlled clinical trial was conducted. Patients were assigned into four groups of treatment, twelve subjects per group: Group A, tramadol 50 mg IM one hr before surgery; group B, tramadol 50 mg into the surgical site; group C, tramadol by both routes of administration, 50 mg IM one hr before surgery plus 50 mg into the surgical site; and group D, control. We evaluated intensity of pain and analgesic consumption as was requested. Demographic characteristics and variables describing the difficulty of the surgical procedure were similar between groups. The duration of the anesthetic effect was significantly longer in the groups where tramadol was injected into the surgical site (215 and 252 min). Administration of systemic and local tramadol (50 mg) suppressed the pain intensity values in comparison to the control group (p < 0.05). Also, tramadol in both routes of administration suppressed the pain intensity values in comparison to all groups (p < 0.05). A significant reduction in the consumption of ketorolac was seen in all treatments as compared to the control group. However, only in the route combination group was a significant reduction in the requirement of acetaminophen observed. Nine patients requiring additional medication were treated with ketorolac 30 mg injected intramuscularly; 2 in the systemic group, 2 in the local group, 4 in the control group and only 1 in the combination group. Adverse events were minimal and similar in all groups.

Effectiveness of treatment with carbamide peroxide and hydrogen peroxide in subjects affected by dental fluorosis: a clinical trial.

Dental fluorosis is an endemic dental health problem around the world; so, it is important to develop clinical alternatives that are non-invasive and inexpensive. In this study, nightguard vital bleaching technique (NVBT), using carbamide and hydrogen peroxide as active agents, has shown itself to be effective in whitening teeth affected by dental fluorosis. Carbamide peroxide at 10 and 20% and hydrogen peroxide at 7.5% showed good clinical effectiveness in improving clinical appearence, but it is important to point out that clinical success is only in cases of class 1 to 3 of the Tooth Surface Index of Fluorosis. When comparing 10 and 20% concentrations of carbamide peroxide, there was no difference in the clinical effectiveness (p > 0.05); but when comparing both concentrations of carbamide peroxide against hydrogen peroxide, results showed that carbamide peroxide was more effective in whitening in cases of dental fluorosis, the difference being statistically significant (p < 0.05). NVBT has two advantages: it is a non-invasive technique and the relationship cost/benefit is excellent; only a few patients reported tenderness or mild tooth sensitivity.

Laminados veneer en odontología estética. Caso clínico y revisión de la literatura / Laminate veneers in esthetic dentistry. Clinical case and review of the literature

Se presenta un paciente femenino de 18 años e edad que acude a la Clínica de Medicina Estomatológica UASLP, con fluorosis dental, dos unidades de metal porcelana en los incisivos centrales superiores, existe opacidad en las zonas cervicales y mal ajuste en zonas marginales. Después de haber evaluado y diagnosticado de acuerdo a los principios estéticos, las coronas incorrectas y los problemas periodontales, se llevó a cabo el tratamiento mediante un recontorneado gingival y la colocación de laminados veneer. Se hace una revisión de la literatura