Bariatric surgery as a risk factor in the development of dental caries: a systematic review.

OBJECTIVES: Obesity is one of the most prevalent chronic pathologies in the world and has become a public health problem. At the present time, bariatric surgery (BS) is considered the best option and the only effective method of treatment, but it can occasionally result in a series of alterations at the oral level. This study aims to review the current literature to establish the possible association of patients who have undergone BS and a greater risk of dental caries. STUDY DESIGN: This study is a systematic review of the literature. METHODS: A search was made in the database of Medline (via PubMed), over the last 10 years, using the keywords 'bariatric surgery' OR 'gastrectomy' OR 'obesity surgery,' combined independently with the terms 'saliva' and 'dental caries' by means of the connector 'AND.' The criteria used were those described in the PRISMA® Declaration for performing systematic reviews. Inclusion criteria and study selection: (a) studies done with humans; (b) articles published in English and Spanish; (c) series of cases; and (d) clinical trials. The risk of bias was assessed independently by two authors. In both data extraction and risk of bias assessment, disagreements were resolved through discussion with a third author. RESULTS: Two independent reviewers read the titles and summaries of the 79 articles found. Finally, nine of them were included in the study. In the various articles, the parameters that had clinical relevance to the risk of dental caries were evaluated. CONCLUSIONS: Within the limitations of this study, it is plausible to think that patients who have undergone BS have a greater risk of dental caries. The oral complications associated with BS could be prevented or minimized by including in the multidisciplinary treatment of these patients a team of odontologists who would be responsible for prevention and oral assessment.

Is there an association between dental implants and squamous cell carcinoma?

Introduction The complications associated with dental implants are numerous, most of them of an inflammatory nature; nevertheless, some isolated cases of oral squamous cell carcinoma (OSCC) have been found in the vicinity of the implants. The objective of the present article is to know whether there is an association between dental implants and the development of OSCC.Method and materials A search was carried out in Medline, Tripdatabase and Cochrane with the keywords 'dental implants' AND 'squamous cell carcinoma', and 'dental implant complications' AND 'squamous cell carcinoma.' The criteria for inclusion were articles published in English that dealt with the possible carcinogenic effects of implants and the possible malign transformation of oral lesions after the insertion of the implants. For the analysis, cases were used in which an OSCC had appeared in the peri-implantary mucosa.Results After an initial search, 269 articles were selected, of which 197 were excluded as not being directly related to the subject. Finally, 45 articles were selected, with 23 of them being used in the analysis. In these, 46 cases of OSCC in the vicinity of implants were discussed.Discussion Chronic inflammation in itself can lead to a malign transformation of the oral tissue, while in other cases it is caused and modulated by carcinogens, genetic factors or inherent factors in the patient, or by the dental implants.Conclusions It is not possible to establish a cause-effect relation between the implants and the development of OSCC. Its presence can be confused with peri-implantitis, so that in the cases where it appears suddenly, does not respond to conventional treatment and/or there is anaesthesia or paresthesia, it is advisable to do a biopsy. It is important to make an adequate selection of the patient and reduce or eliminate the risk factors. The findings of the present review are based on case study level of evidence, so meta-analysis is needed to further draw from these results.