Maxillary mucormycosis and aspergillosis in post-COVID-19 patients in Mexico: A case series.

BACKGROUND: Fungal infections, during or as a consequence of SARS-CoV-2 infection, associated with uncontrolled diabetes mellitus and indiscriminate use of corticosteroids have been reported. In the jaw, mostly mucormycosis has been diagnosed in hospitals. METHODS: A retrospective, cross-sectional, descriptive study of the clinical, imaging, and histopathologic characteristics of maxillary invasive fungal infection in post-COVID-19 patients diagnosed in a private non-hospital oral pathology service in Mexico during 2020-2022 was conducted. RESULTS: We found 20 cases of maxillary invasive fungal infections in post-COVID-19 patients, 75% including a diagnosis of mucormycosis and 25% diagnosed as probable aspergillosis. The most common signs and symptoms were exposed necrotic bone followed by tooth mobility, discharge, and pain. On imaging, unilateral maxillary sinus involvement was observed in 6 cases (30%), and bilateral maxillary sinus involvement was observed in 3 cases (15%). CONCLUSIONS: It is essential to consider the association of osteonecrosis of the jaw in post-COVID-19 patients, with aspergillosis, not only mucormycosis, for early diagnosis and appropriate treatment.

Influence of dairy products consumption on oral cancer risk: A meta-analysis.

Background: The role of dairy product consumption on oral cancer risk is not yet fully clarified. Some studies have observed an inverse association between dairy consumption and oral cancer risk. This study aimed to determine the influence of dairy product consumption (milk, cheese, yogurt, butter) on oral cancer risk. Methods: A search for studies on dairy products and oral cancer was conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Scopus. The estimation of the odds ratio (OR) effect was performed with the generic inverse variance method using the logarithm of the effect with the standard error (SE) and 95% confidence intervals. Results: Twenty-one studies with 59271 participants (8,300 oral cancer patients and 50971 controls) were included in this meta-analysis. All dairy products significantly reduced oral cancer risk except butter (P=0.16). Milk intake reduced oral cancer risk by 27% (OR: 0.73; P<0.001); yogurt consumption by 25% (OR: 0.75; P<0.001), and cheese consumption by 21% (OR:0.79; P<0.01). Conclusion: Regular consumption of dairy products reduces oral cancer risk between 21% and 27%.

Intraoral exophytic lesion in an adolescent: A case report of myoepithelioma with unique clinical presentation.

Myoepithelioma is an infrequent benign tumor of the salivary glands, characterized by its composition of myoepithelial cells which can show different shapes and be arranged in various patterns with a well-circumscribed or encapsulated growth. This tumor commonly presents in adults as an asymptomatic swelling of the parotid gland, very rarely in minor salivary glands of children or adolescents, and even rarer in the buccal mucosa, with only six cases reported to date and only one of them presented in an adolescent. We present an additional case of myoepithelioma in the buccal mucosa of a 16-year-old male, with a novel clinical presentation as a non-submucosal exophytic mass. Immunohistochemically, neoplastic cells were positive for CK, S100, p63, and GFAP. The tumour was treated surgically, and the patient showed satisfactory evolution at 1 year of follow-up. The clinical and histopathological characteristics of the reported cases are discussed.

Association of periodontitis with vitamin D and calcium levels: a meta-analysis / Asociación de la periodontitis con los niveles de vitamina D y calcio: un metanálisis

Introduction: Low levels of vitamin D have been linked to raised periodontal inflammation, ahigher concentration of periodontopathogens, greater periodontal destruction, and moresevere periodontitis. This study aimed to assess the influence of vitamin D and calcium levelson periodontitis.Material and methods: A search for studies on vitamin D, calcium, and periodontal diseasewas conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web ofScience (WoS), and Scopus. For continuous outcomes, the estimates of effects of anintervention were expressed as mean differences (MD), using the inverse variance (IV)method with 95% confidence intervals. The meta-analysis was conducted using RevMan 5.4software.Results: Thirty-one studies with 14,340 participants were included in this meta-analysis.Periodontitis patients had mean vitamin D concentrations significantly lower than controlswithout the disease (p<0.001). Likewise, these patients showed significantly lower serumvitamin D concentrations (p<0.001) and higher salivary vitamin D concentrations, althoughwithout reaching statistical significance (p=0.70). Regarding calcium levels, periodontitispatients had significantly higher salivary levels than controls (p<0.001).Conclusions: Low vitamin D and high calcium levels are associated with an increased periodontitis risk. (AU)

Introducción: Los niveles bajos de vitamina D se han relacionado con una mayor inflamaciónperiodontal, una mayor concentración de periodontopatógenos, una mayor destrucciónperiodontal y una periodontitis más severa. Este estudio tuvo como objetivo evaluar lainfluencia de los niveles de vitamina D y calcio en la periodontitis.Material y métodos: Se realizó una búsqueda de estudios sobre vitamina D, calcio yenfermedad periodontal en las siguientes bases de datos: PubMed (MEDLINE, CochraneLibrary), Web of Science (WoS) y Scopus. Para los resultados continuos, las estimaciones delos efectos de una intervención se expresaron como diferencias de medias (DM), mediante elmétodo de la varianza inversa (IV) con intervalos de confianza del 95%. El metanálisis serealizó con el software RevMan 5.4.Resultados: Treinta y un estudios con 14 340 participantes se incluyeron en este metanálisis.Los pacientes con periodontitis tenían concentraciones medias de vitamina Dsignificativamente más bajas que los controles sin la enfermedad (p<0,001). Asimismo, estospacientes mostraron concentraciones séricas de vitamina D significativamente más bajas(p<0,001) y concentraciones salivales de vitamina D más altas, aunque sin alcanzar lasignificación estadística (p=0,70). Con respecto a los niveles de calcio, los pacientes conperiodontitis tenían niveles salivales significativamente más altos que los controles (p<0,001). (AU)

Candida species colonization in oral lichen planus: A meta-analysis.

Objective: Oral lichen planus (OLP) is a common chronic inflammatory disease that affects 1%-2% of the population. Candida species superinfection can aggravate the symptoms of OLP, especially of the erosive forms, and promote malignant transformation by producing carcinogenics as nitrosamines or acetaldehyde. On the other hand, antifungal treatment of Candida-infected OLPs improves the clinical symptoms of the disease. The objective of this study is to assess the possible influence of Candida species colonization in oral lichen planus. Methods: A search for studies on Candida and oral lichen planus was performed in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Scopus. Data analysis: The estimated prevalence of Candida detection in OLP was calculated according to the DerSimonian and Laird random model. For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratio (OR) using Mantel-Haenszel (M-H) method with 95% confidence intervals. Results: Twenty-four studies were included in this meta-analysis. The estimated prevalence of Candida species detection in oral lichen planus (OLP) lesions was 37.00% (95% CI: 30.52-43.72%). OLP patients were almost 2½ times more likely to be infected by Candida species compared to healthy controls (OR: 2.48, P < 0.001). Likewise, Candida species superinfection was more likely in erosive OLP forms (OR: 2.53, P < 0.001), and by non-albicans Candida species (OR: 2.33, P = 0.02). Conclusions: More than one-third of OLP lesions are infected by Candida species, modifying their biological behavior.

Prevention of Occupational Hazards Due to Asbestos Exposure in Dentistry. A Proposal from a Panel of Experts.

Asbestos in all its forms is a Group 1 material agent with proven carcinogenic effects in the human being since 1977. Exposure to asbestos can be considered unsafe. The use of asbestos in the field of dentistry had a common use in the manufacture of dental prostheses in the 1960s and 1970s. Taking into account the long induction period of this agent and the plausibility for being a risk factor in dentistry, the objective of this study is to propose a plan for the prevention of occupational risks due to asbestos exposure in dentistry by means of the contribution of a panel of experts. An Expert Panel (EP) approach was used in which a group of nine experts identified and documented the use of asbestos in the dental profession. EP was created and followed the protocol in accordance with the EuropeAid Assessment Guidelines. As a result of this study, EP documented the common use and sources of asbestos in dentistry in prosthetic materials, dental dressings, and in the coating of casting cylinders. EP also created a consensus document on the priority measures for the Plan for the Prevention of Risks from Asbestos in Dentistry, based on previous reports from the European Commission Senior Labour Inspectors' Committee. The document concluded that obtainment of information, receiving specific training on the subject and performing epidemiological studies, and the proper risk assessments were the priority measures to adopt.

Efficacy of local antibiotic therapy in the treatment of peri-implantitis: A systematic review and meta-analysis.

OBJECTIVES: The aim of this systematic review and meta-analysis was to state the efficacy of local administration of antibiotics in the treatment of peri-implantitis in terms of peri-implant probing depth (PPD) and bleeding on probing (BoP) reduction. DATA, SOURCES AND STUDY SELECTION: Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). Due to the encountered heterogeneity between the studies being combined, random-effects models were applied in order to analyze effect sizes. Twelve studies (365 patients and 463 implants) were included in the systematic review. After peri-implantitis treatment with local antibiotics, PPD was reduced 1.40 mm (95% confidence interval: 0.82-1.98). When local antibiotics were applied, a 0.30 mm higher reduction of PPD was obtained than in the control group (95% confidence interval: 0.07-0.53). BoP attained an odds ratio value of 1.82 (95% confidence interval: 1.09-3.04), indicating that the likehood of bleeding is almost two-fold when antibiotics are not locally administrated. Adverse effects were not found after applying local antibiotics. CONCLUSIONS: The local antibiotic administration does reduce, without adverse effects, both peri-implant probing depths and bleeding on probing in patients affected by peri-implantitis, if compared to control groups without local antibiotic application. CLINICAL SIGNIFICANCE: Patients with dental implants frequently suffer from peri-implantitis. Clinical features of peri-implantitis lesions include the presence of bleeding on probing and increased peri-implant probing depths. Both BoP and PPD have become reduced after local administration of antibiotics.

Collagen Matrix vs. Autogenous Connective Tissue Graft for Soft Tissue Augmentation: A Systematic Review and Meta-Analysis.

Soft tissues have been shown to be critical for the maintenance of both teeth and implants. Currently, regenerative soft tissue techniques propose the use of collagen matrices, which can avoid the drawbacks derived from the obtainment of autogenous tissue graft. A systematic review and meta-analysis were conducted to ascertain the efficacy of collagen matrices (CM) compared to autogenous connective tissue graft (CTG) to improve soft tissue dimensions. An electronic and manual literature searches were performed to identify randomized clinical trials (RCT) or controlled clinical trials (CCT) that compared CTG and CM. Pooled data of width of keratinized tissue (KT) and mucosal thickness (MT) were collected and weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. Nineteen studies were included based on the eligibility criteria. When using CTG a higher MT gain (0.32 mm, ranging from 0.49 to 0.16 mm) was obtained than when employing CM. Similar result was obtained for the width of KT gain, that was 0.46 mm higher (ranging from 0.89 to 0.02 mm) when employing CTG. However, it can be stated that, although autogenous CTG achieves higher values, CM are an effective alternative in terms of total width of KT and MT gain.

Periodontal Treatment by Dental Undergraduate Students: Assessment of the Patient's Oral Quality of Life - A Prospective Pilot Study.

PURPOSE: To assess the impact of nonsurgical periodontal treatment, performed by undergraduate dental students, on oral health-related quality of life of patients with periodontitis. MATERIALS AND METHODS: An observational, prospective, single-arm cohort study with pre­post test involving 31 undergraduate dental students was performed. A complete periodontal examination was performed before and after receiving nonsurgical periodontal treatment. The main independent clinical variables assessed were the degree of periodontal inflammation and the number of teeth with periodontitis. Oral health-related quality of life was assessed before and after treatment through the Oral Impacts on Daily Performances (OIDP) questionnaire. The association between the extent of periodontal treatment (measured as number of treated teeth) and final OIDP score was assessed, adjusting for age, sex, and baseline OIDP, in a multiple regression model. RESULTS: Thirty-four patients were enrolled and treated by the undergraduate students. The mean OIDP value (global absolute score), representing the severity and frequency of the impacts, decreased from 26.2 to 12 after treatment. The mean percentage of impact, representing the number dimensions affected by oral health (global percent score), was reduced from 13% to 6%. However, no association between the number of treated teeth and post-treatment OIDP score was observed after adjusting for age, sex, and baseline OIDP score. CONCLUSION: Nonsurgical periodontal treatment performed by undergraduate dental students improved the oral health-related quality of life of periodontal patients, although no statistically significant association was found between the extent of periodontal treatment and the final OIDP score.

Antibiofilm Activity of Diclofenac and Antibiotic Solutions in Endodontic Therapy.

INTRODUCTION: The aim of this study was to compare the antibiofilm effects of a triple antibiotic solution (TAS); a double antibiotic solution (DAS); and 5%, 2.5%, and 1.25% diclofenac solutions (DCSs) against Enteroccocus faecalis biofilm. METHODS: Eighty-four sterile radicular dentin blocks were used as biofilm substrate for 3 weeks. The study groups were as follows: (1) 1 mg/mL TAS (minocycline, metronidazole, and ciprofloxacin), (2) 1 mg/mL DAS (metronidazole and ciprofloxacin), (3) 5% DCS, (4) 2.5% DCS, (5) 1.25% DCS, and (6) 0.9% saline solution. The antimicrobial activity was evaluated by bacterial count determinations and confocal laser scanning microscopy. The contact time for the antimicrobial tests was 5 minutes. Bacterial counts were expressed as the reduction percentage of colony-forming units; for the confocal laser scanning microscopic evaluation, the log10 total biovolume and percentage of green population (live cells) were calculated. RESULTS: The colony-forming unit reduction percentage ranged between 62.98 and 98.62, respectively, for TAS and 5% DCS. The DCS showed a concentration-dependent effect.For the confocal laser scanning microscopy, the log10 total biovolume in all groups was very similar and showed a scarce (1.39-1.02) but significant reduction with respect to the control; 5% and 2.5% DCSs gave the lowest viable cell percentage. The TAS and DAS groups showed intermediate values without significant differences between them. CONCLUSIONS: DCSs at 5% and 2.5% have greater antimicrobial effects than TAS and DAS and may be considered a valid alternative for controlling the infection of teeth with apical periodontitis.

Alveolar Bone Ridge Augmentation Using Polymeric Membranes: A Systematic Review and Meta-Analysis.

Alveolar bone ridge resorption occurred after natural teeth loss and it can restrict the possibility of dental implants placement. The use of bone regenerative procedures is frequently required. The existing evidence regarding the efficacy of horizontal bone ridge augmentation trough guided bone regeneration (GBR) using polymeric membranes was stated. A systematic review and meta-analysis were performed. Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase, and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. It was found that the mean of horizontal bone gain was 3.95 mm, ranging from 3.19 to 4.70 mm (confidence interval 95%). Heterogeneity is I2 = 99% (confidence interval 95%) and significance of the random-effects model was p < 0.001. The complications rate was 8.4% and membrane exposure was the most frequent. Through this study, we were able to conclude that the existing scientific evidence suggests that GBR using polymeric membranes is a predictable technique for achieving horizontal bone augmentation, thus, permitting a proper further implant placement.

Candida species oral detection and infection in patients with diabetes mellitus: a meta-analysis

Introduction: Diabetes mellitus is a chronic metabolic disorder that induces elevated plasma glucose levels. Diabetic patients are more susceptible to infections, especially fungal infections. There is a direct relationship between increased blood glucose levels and the number of Candida hyphae in the oral mucosa. This study aimed to evaluate oral candidiasis and the different Candida species found in patients with and without diabetes mellitus. Methods: A search for studies on oral candidiasis and diabetes mellitus was carried out in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS) and Google Scholar. For dichotomous outcomes, the estimates of effects of an intervention were expressed as odds ratios (OR) using the Mantel-Haenszel (M-H) method with 95% confidence intervals. Results: 25 studies were included in this meta-analysis. Diabetes Mellitus patients tripled the probability of being infected by Candida species (OR:3.16, p<0.001). Likewise, Candida species infections were more likely in patients with poor glycemic control (OR:2.94, p<0.001) and with dentures (OR:2.22, p<0.001). In contrast, neither gender nor diabetes mellitus type of diabetes conditioned fungal infections (p>0.05). The most prevalent Candida species in both diabetics and controls were C. albicans and C. tropicalis. Diabetics had significantly fewer C. non-albicans species oral infections than non-diabetics (p=0.04). Conclusions: Diabetics are more prone to oral candidiasis, especially C. albicans infections (AU)

Risk factors for actinic cheilitis: A meta-analysis.

Background. Actinic cheilitis (AC) is a potentially malignant disorder characterized by chronic lip inflammation, especially the lower lip, associated with accumulative exposure to solar radiation. The present study aimed to assess the possible risk factors related to AC. Methods. A search for studies on AC risk factors was conducted in the following databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Google Scholar. For dichotomous outcomes, the estimates of the effects of intervention were expressed as odds ratios (ORs) using Mantel-Haenszel (M-H) method, and for continuous outcomes, the estimates of the effects of intervention were expressed as mean difference (MD) using the inverse variance (IV) method, both with 95% confidence intervals. Results. Twelve studies were considered in this meta-analysis. The factors from the highest to lowest risk of AC were having a low skin phototype (OR: 3.30), age >50 years (OR: 3.01), having high sun exposure, cumulative throughout life (OR: 2.13) as daily (OR: 2.00), being male (OR: 1.78), and being a drinker (OR: 1.56) or smoker (OR: 1.32). However, the use of sunscreen creams and caps/hats to protect against the sun were factors with no significant influence on the AC risk. Conclusion. Chronic sun exposure in subjects with low skin phototypes is the main risk factor for AC.

Dentine tubule disinfection by different irrigation protocols.

The purpose of this study was to test the antimicrobial activity and the smear layer removal of different irrigation protocols-sodium hypochlorite (NaOCl), NaOCl followed by ethylenediaminetetraacetic acid (EDTA), and NaOCl combined with etidronic acid (HEBP)-against infected dentine tubules during root canal preparation. Single rooted premolars contaminated with Enterococcus faecalis were chemomechanically prepared. Depending on the irrigation protocols, the roots were divided into the following groups: (1) distilled water during and after instrumentation; (2) 2.5% NaOCl during and after instrumentation; (3) 2.5% NaOCl/9% HEBP during and after instrumentation; and (4) 2.5% NaOCl during instrumentation followed by 17% EDTA after instrumentation. The percentage of dead cells and the biovolume in infected dentine tubules were measured using confocal laser scanning microscopy and the live/dead technique. Smear layer removal on root canal wall surfaces was observed by means of scanning electron microscopy. Results were compared through parametric tests (p < .05). The groups NaOCl, NaOCl/HEBP, and NaOCl+EDTA exerted the highest antimicrobial activity (p > .05), followed by the group irrigated with water. All the irrigation protocols-including water-significantly reduced the bacteria biovolume. No dentine tubules free of smear layer were found in the positive control or the 2.5% NaOCl group. With NaOCl/HEBP and NaOCl+EDTA, respectively, 90.41% ± 7.33 and 76.54% ± 15.30 of dentine tubules were free of smear layer (p = .01). NaOCl/HEBP and NaOCl+EDTA exerted an important antimicrobial activity against bacteria inside dentine tubules, lowering the bacteria biovolume and eliminating a high amount of the smear layer, particularly in the NaOCl/HEBP group.

Clinical study of 200 patients with recurrent aphthous stomatitis. / Estudio clínico de 200 pacientes con estomatitis aftosa recurrente.

Introduction: Recurrent aphthous stomatitis (RAS) affects approximately 20% of the general population. Its etiology is still unknown. Objective: To analyze this entity's clinical features. Method: Data such as age, gender, family history of RAS, age at first episode onset, prodromal symptoms, number, size, morphology and localization of lesions, RAS clinical form, annual rate of recurrence, predisposing factors, symptoms and time for symptoms and lesions disappearance were assessed in 200 patients with RAS. Results: Patients had RAS minor forms. Main clinical characteristics were family history of RAS (89%), first episode at ≥ 10 years of age (69%), prodromal symptoms (66%), one lesion per episode (63%), < 0.5 cm lesions (64%), rounded morphology (55%), localization at the tongue (27%), 3 recurrent episodes per year (36%), stress as predisposing factor (34%), symptom disappearance in 2 days (54%) and healing of lesions in 8 days (40%). Conclusion: Even when RAS is a common disorder of the oral mucosa, there is no curative treatment available. Therapeutic measures seek to reduce the pain and size of lesions, accelerate the time of recovery and decrease the rate of relapses.

Introducción: La estomatitis aftosa recurrente (EAR) afecta aproximadamente a 20 % de la población general. Su etiología aún se desconoce. Objetivo: Analizar las características clínicas de esta entidad. Método: En 200 pacientes con EAR se analizó edad, sexo, historia familiar de EAR, edad de aparición del primer episodio, síntomas prodrómicos, número, tamaño, morfología y localización de las lesiones, forma clínica de EAR, tasa anual de recurrencia, factores predisponentes, sintomatología, tiempo de desaparición de los síntomas y las lesiones. Resultados: Los pacientes tenían formas menores de EAR. Las principales características clínicas fueron historia familiar de EAR (89 %), primer episodio con ≥ 10 años de edad (69 %), síntomas prodrómicos (66 %), lesión por episodio (63 %), lesiones de < 0.5 cm (64 %), morfología redondeada (55 %), localización en lengua (27 %), tres episodios recurrentes anuales (36 %), estrés predisponente (34 %), desaparición de síntomas a los dos días (54 %) y curación de lesiones a los ocho días (40 %). Conclusión: Aun cuando la EAR es un trastorno común de la mucosa bucal, no se dispone de un tratamiento curativo. Las medidas terapéuticas buscan reducir el dolor y tamaño de las lesiones, acelerar el periodo de recuperación y disminuir la recidiva.

Ensayo clínico aleatorizado sobre la efectividad de tratamientos alternativos en la estomatitis aftosa recurrente / Randomized clinical trial of the effectiveness of complementary therapies for recurrent aphthous stomatitis

Fundamento y objetivo: A pesar de la elevada prevalencia de la estomatitis aftosa recurrente (EAR), su etiología no está del todo aclarada y no existe un tratamiento totalmente curativo. El objetivo de este trabajo fue evaluar la eficacia clínica y la seguridad de 4 tratamientos (nitrato de plata, própolis, ruibarbo y nogal) de la EAR. Pacientes y método: Se realizó un ensayo clínico aleatorizado con 125 pacientes con aftas menores, con 25 pacientes por grupo: cauterización con nitrato de plata, própolis, extracto de ruibarbo, extracto de corteza de nogal y placebo. Resultados y conclusiones: Ningún paciente refirió efectos adversos relacionados con el tratamiento. Hay diferencias significativas (p<0,001) globales en el tiempo hasta la desaparición de los síntomas. El más rápido fue el nitrato de plata (1,16 días), después los 3 tratamientos alternativos (1,60 días con própolis, 1,84 con ruibarbo y 2,00 con nogal, sin diferencias entre ellos), y por último el placebo (4,64 días). En cuanto al tiempo medio de curación de las lesiones, fue estadísticamente mayor (8,96 días) para el placebo que para los 4 tratamientos: nitrato de plata (7,32 días), própolis (6,80), ruibarbo (7,72) y nogal (8,00) (AU)

Background and objective: Despite the high prevalence of recurrent aphthous stomatitis (RAS), its etiology is not yet completely clear and there is no completely remedial treatment available at present. The objective of this study was to evaluate the clinical efficacy and safety of 4 treatments (silver nitrate, propolis, rhubarb and walnut) for RAS. Patients and method: A randomized clinical trial was conducted with 125 patients with minor aphthae, including 25 patients per group: cauterization with silver nitrate, propolis, rhubarb extract, walnut extract and placebo. Results and conclusions: No patient reported adverse effects related to the treatment received. There were significant (P<.001) differences in the time elapsed until symptom resolution. The fastest treatment was silver nitrate (1.16 days), followed by the 3 alternative treatments (1.60 days with propolis, 1.84 with rhubarb and 2.00 with walnut; with no differences between them), and finally the placebo (4.64 days). The mean healing time of the lesions was statistically higher (8.96 days) for the placebo than for the 4 treatments: silver nitrate (7.32 days), propolis (6.80), rhubarb (7.72) and walnut (8.00) (AU)

Randomized clinical trial of the effectiveness of complementary therapies for recurrent aphthous stomatitis. / Ensayo clínico aleatorizado sobre la efectividad de tratamientos alternativos en la estomatitis aftosa recurrente.

BACKGROUND AND OBJECTIVE: Despite the high prevalence of recurrent aphthous stomatitis (RAS), its etiology is not yet completely clear and there is no completely remedial treatment available at present. The objective of this study was to evaluate the clinical efficacy and safety of 4 treatments (silver nitrate, propolis, rhubarb and walnut) for RAS. PATIENTS AND METHOD: A randomized clinical trial was conducted with 125 patients with minor aphthae, including 25 patients per group: cauterization with silver nitrate, propolis, rhubarb extract, walnut extract and placebo. RESULTS AND CONCLUSIONS: No patient reported adverse effects related to the treatment received. There were significant (P<.001) differences in the time elapsed until symptom resolution. The fastest treatment was silver nitrate (1.16 days), followed by the 3 alternative treatments (1.60 days with propolis, 1.84 with rhubarb and 2.00 with walnut; with no differences between them), and finally the placebo (4.64 days). The mean healing time of the lesions was statistically higher (8.96 days) for the placebo than for the 4 treatments: silver nitrate (7.32 days), propolis (6.80), rhubarb (7.72) and walnut (8.00).

Laser Therapy and Occlusal Stabilization Splint for Temporomandibular Disorders in Patients With Fibromyalgia Syndrome: A Randomized, Clinical Trial.

Context • Patients with fibromyalgia syndrome (FMS) report frequent and severe symptoms from temporomandibular disorders (TMDs). The appropriate treatment of TMDs remains controversial. No studies have occurred on the efficacy of therapy with a laser or an occlusal stabilization splint in the treatment of TMDs in patients with FMS. Objective • The study intended to investigate the therapeutic effects of laser therapy and of an occlusal stabilization splint for reducing pain and dysfunction and improving the quality of sleep in patients with TMDs and FMS. Design • The research team designed a single-blinded, randomized clinical trial. Setting • The study took place in the research laboratory at the University of Granada (Granada, Spain). Participants • Participants were 58 women and men who had been diagnosed with FMS and TMDs and who were referred from the clinical setting. Intervention • Participants were randomly assigned to the occlusal-splint or the laser group. The laser group received a treatment protocol in which laser therapy was applied to the participant's tender points, and the occlusal-splint group underwent a treatment protocol in which an occlusal stabilization splint was used. Both groups underwent treatment for 12 wk. Outcomes Measures • Pain intensity, widespread pain, quality of sleep, severity of symptoms, active and passive mouth opening, and joint sounds were assessed in both groups at baseline and after the last intervention. The measurements used were (1) a visual analogue scale (VAS), (2) the Widespread Pain Index (WPI), (3) the Symptom Severity Scale (SSS), (4) the Patient's Global Impression of Change (PGIC), (5) the Pittsburgh Quality of Sleep Questionnaire Index (PSQI), (6) an assessment of the number of tender points, (7) a measurement of the active mouth opening, (8) a measurement of the vertical overlap of the incisors, and (9) the measurement of joint sounds during mouth opening and closing. Results • The group X time interaction for the 2 × 2 mixed analysis of variance found no statistically significant differences between the 2 treatment groups: (1) VAS, P = .591; (2) WPI, P = .112; (3) SSS, P = .227; (4) PGIC, P = .329; (5) number of tender points, P = .107; (6) right and left clicking sounds in the jaw joint during palpation at mouth opening, P = .723 and P = .121, respectively; and (7) right and left clicking sounds in the jaw joint during palpation at mouth closing, P = .743 and P = .698, respectively. Compared with baseline, the laser treatment showed significant improvements on several outcomes, including the VAS, P < .001; WPI, P = .003; and SSS, P = .001. Overall, the study found an average improvement in symptoms from baseline of 21% , P < .001, based on the PGIC. Conclusions • Laser therapy or an occlusal stabilization splint can be an alternative therapeutic treatment for reducing pain symptoms and the clicking sound for TMDs in patients with FMS.

[Clinical and periodontal predictive factors of severity in gingival recession (GR)]. / Parámetros clínicos y periodontales predictores de la severidad de la recesión gingival (RG).

INTRODUCTION: Gingival recession is an unsightly condition due to root exposure. It can lead to dental hypersensitivity, root caries, and tooth loss. OBJECTIVE: To determine the influence of different clinical and periodontal parameters on the severity of gingival recession evaluated at four periods: initial, 6, 12, and 18 months of follow-up. MATERIAL AND METHODS: Forty patients with gingival recession were included in the study. Sociodemographic data, systemic diseases, harmful habits, dental hygiene habits, parafunctional habits, and orthodontic treatment were collected. Periodontal status (plaque index, gingival bleeding index, attached gingiva loss, pocket probing depth, and attachment loss) was also measured. RESULTS: None of the clinical parameters studied influenced the number of teeth with gingival recession. Smokers showed a higher number of teeth with attached gingiva loss (p=0.03). A direct relationship between the severity of gingival recession and plaque index (p=0.02) or 4-6 mm attachment loss (p=0.04) was observed. At six months of follow-up, gingival index was the only parameter that influenced the severity of gingival recession (p=0.01).

Lesiones de la mucosa bucal en pacientes de Mérida, Venezuela / Oral mucosal lesions in patients of Mérida, Venezuela

Existen muy pocos estudios sobre lesiones de la mucosa bucal en Venezuela y ningún estudio de la epidemiología de estas lesiones en el estado de Mérida. El objetivo de este estudio fue determinar la prevalencia de lesiones de la mucosa bucal en una población atendida en centros odontológicos de Mérida, describir las características de las mismas y analizar la influencia de otros parámetros tales como los hábitos de higiene buco-dental, los hábitos nocivos o los hábitos parafuncionales. De los 8640 pacientes atendidos en centros odontológicos públicos y privados durante un año, 120 (el 1,39%) presentaron lesiones de la mucosa bucal. Las lesiones bucales más frecuentemente encontradas fueron úlceras traumáticas (17,5%), herpes recurrente labial (11,7%), estomatitis por prótesis (10%), candidiasis eritematosa (10%) y estomatitis aftosa recurrente (9,2%). Las lesiones de la mucosa bucal fueron más frecuentes en el sexo femenino y su principal localización fue la gingival. La mayoría eran lesiones agudas (< 7 días), no recurrentes, con sintomatología dolorosa y sin factor etiológico atribuible por parte del paciente. Ni los hábitos nocivos, ni los hábitos parafuncionales tuvieron influencia sobre las características clínicas de las lesiones.

There are very few epidemiological studies of oral mucosal lesions in Venezuela. None of these studies has been conducted in the state of Merida. The aim of this study was to determine the prevalence of oral mucosal lesions in a population from Merida, Venezuela, describe their oral lesions’ characteristics and analyze the influence of parameters such as oral hygiene habits, harmful habits or parafunctional habits. Of the 8640 patients seen in public and private dental centers from Merida during one year, 120 (1.39%) had oral mucosal lesions. The oral mucosal lesions most frequently found were: traumatic ulcers (17.5%), recurrent herpes labialis (11.7%), denture stomatitis (10%), erythematous candidiasis (10%) and recurrent aphthous stomatitis (9.2%). The main features of these oral mucosal lesions were: more frequent in females and, main location on the gingiva. Moreover, most of them were acute lesions (< 7 days), non-recurring and painful lesions. Neither harmful habits nor parafunctional habits had influence on the clinical features of the lesions.