Lesiones traumáticas en dientes permanentes en escolares atendidos en la Clínica Estomatológica Héroes de Bolivia

Introducción: las lesiones traumáticas provocan alteraciones biológicas, psicológicas y sociales en los niños y adolescentes que la padecen. Objetivo: caracterizar a los escolares con lesiones traumáticas en dientes permanentes, jóvenes de la Clínica Estomatológica Héroes de Bolivia, de Las Tunas, en el período septiembre de 2017 a septiembre de 2019. Materiales y métodos: se realizó un estudio descriptivo transversal en escolares de la clínica estomatológica "Héroes de Bolivia". La población estudio estuvo constituido por 169 escolares que por muestreo probabilístico se estableció, incluyendo a los escolares de 5 a 11 años, con lesiones traumáticas en dientes permanentes anteriores. Las variables estudiadas fueron: edad, sexo, presencia del trauma y tipo según la clasificación de Ingeborg Jacobsen, dientes lesionados, etiología y lugar donde ocurrió la lesión. Se utilizó un formulario. Resultados: el grupo de 9 años con un 21,3 % y el sexo masculino con 113 afectados resultaron los más representativos. El 56,2 % presentó fractura no complicada de corona. El 70,4 % correspondió a incisivos centrales superiores. Las caídas y las prácticas de deporte con 37,2 % y 29,0 % respectivamente fueron las principales causas y el 41,4 % de los traumatismos dentarios ocurrieron en las instituciones escolares. Conclusiones: las lesiones traumáticas de dientes permanentes jóvenes fueron más frecuentes a la edad de 9 años y en el sexo masculino. Las lesiones más frecuentes fue la fractura no complicada de corona y los incisivos centrales superiores los más afectados.

Introduction: traumatic injuries cause biological, psychological and social alterations in children and adolescent who suffer them. Objective: to characterize schoolchildren with traumatic lesions in their young permanent teeth, from Heroes de Bolivia Dental Clinic, Las Tunas, in the period from September 2017 to September 2019. Materials and methods: a cross-sectional descriptive study was conducted in schoolchildren treated at Heroes de Bolivia Dental Clinic. The study population, selected by probabilistic sampling, consisted of 169 schoolchildren aged 5 to 11 years, with traumatic injuries in anterior permanent teeth. The variables studied were: age, gender, presence of trauma and kind according to Ingeborg Jacobsen classification, injured teeth, etiology and place where the lesion occurred. Results: the 9-years-old group, with 21.3 %, and male gender, with 113 children affected, resulted the most representative. 56.2 % presented uncomplicated crown fracture. 70.4 % corresponded to upper central incisors. Falls and sport practices, with 37.2 % and 29.0 % respectively, were the main causes, and 41.4 % of the dental injuries occurred in schools. Conclusions: traumatic injuries of young permanent teeth were more frequent at the age of 9, and in males. The most frequent injury was non-complicated crown fracture, and upper central incisors were the most affected.

Efeitos à distância de feridas cirúrgicas em mucosa oral sobre populações granulocíticas na medula óssea em modelo murino / Remote effects of surgical oral mucosa wounds on populations granulocytes in the bone marrow in a murine model

Neste trabalho procuramos determinar os efeitos à distância de um ferimento cirúrgico único na cavidade bucal (localizado no palato duro, de extensão 3 mm) sobre a medula óssea em camundongos C57BL/6. Para isto, quantificamos células totais, eosinófilos, neutrófilos e fagócitos mononucleares, tanto na medula óssea recém-coletada, como na medula óssea cultivada em presença de diferentes citocinas. As citocinas foram utilizadas para revelar defeitos sutis que não são detectáveis no exame da medula óssea recém-coletada. Na medula óssea recém-coletada, foi encontrado um aumento modesto, mas significativo, nos números de neutrófilos. Em culturas incubadas com Interleucina (IL)-3, foi observada uma redução significativa dos números de células totais, neutrófilos e fagócitos mononucleares. Em culturas incubadas com Fator Estimulante de Colônias de Granulócitos (G-CSF), foram observados efeitos negativos semelhantes aos encontrados com IL-3, com supressão de células totais, neutrófilos e fagócitos mononucleares. Em culturas incubadas com Fator Estimulante de Colônias de Granulócitos e Macrófagos (GM-CSF), foi observada redução significativa somente sobre o número de neutrófilos. O mesmo ocorreu na presença de Fator Estimulante de Colônias de Macrófagos (M-CSF). Utilizamos também rhG-CSF (Filgrastim®), que tem atividade em cultura de células murinas, sendo observado efeito negativo apenas sobre neutrófilos, em contraste com o observado na presença de G-CSF murino. O efeito positivo sobre o número de neutrófilos na medula óssea recém-coletada poderia ser explicado pela exposição a microrganismos da microbiota bucal no local da lesão, causando bacteremia. Para testar esta hipótese, adotamos uma estratégia de desinfecção local (Clorhexidina a 0,2% e 0,04%) antes da realização do corte, e avaliamos a repercussão deste tratamento sobre as diferentes respostas anteriormente caracterizadas. O tratamento com Clorhexidina a 0,2% eliminou os efeitos observados anteriormente sobre os números de células totais, neutrófilos e fagócitos mononucleares. Em contrapartida, após o tratamento com Clorhexidina a 0,04% alguns dos efeitos anteriormente encontrados, quanto aos números de neutrófilos e de fagócitos mononucleares, persistiram. Procuramos também avaliar se o bloqueio da resposta de glicocorticóides endógenos ao trauma cirúrgico, pelo uso de Mifepristone (RU486), antagonista do receptor de glicocorticóides, poderia modificar os efeitos da ferida na cavidade bucal sobre a medula óssea. Não houve evidência de bloqueio específico dos efeitos do trauma com o uso de RU486, comparativamente aos controles que receberam veículo. Em experimentos-piloto, avaliamos os efeitos do trauma cirúrgico, induzido em camundongos BP-2 segundo os protocolos utilizados anteriormente em camundongos C57BL/6, obtendo evidência de respostas importantes entre cepas no padrão de resposta da medula óssea. Dentro das limitações do presente estudo, podemos concluir que o trauma cirúrgico bucal atinge a medula óssea à distância, demonstrando efeitos positivos 24h após o trauma e negativos quando utilizamos citocinas. Além disso, a presença de bactérias bucais é responsável pela depressão da resposta da medula. (AU)

In this study, we aimed to identify, using C57BL/6 mice, long-distance effects of a single, surgical oral wound of 3 mm extension in the hard palate, on the bone marrow. To do so, we enumerated total cells as well as eosinophil, neutrophil and mononuclear phagocytes, from recently harvested bone marrow, and from cultured bone marrow following different cytokine stimuli. Cytokines were used to reveal subtle effects on the recently harvest bone marrow. In recently harvested bone marrow, a small but significant increase was found in neutrophil numbers. In cultures exposed to interleukin (IL)-3 there were decreased total cell, neutrophil and mononuclear phagocyte numbers. In cultures exposed to granulocyte-colony stimulating factor (G-CSF), reduced total cell, neutrophil and mononuclear phagocyte numbers were observed resembling those in IL-3-exposed cultures. In cultures exposed to granulocytemacrophage-colony stimulating factor (GM-CSF), significant reduction was fund only in neutrophil numbers. The occurred when macrophage-colony stimulating factor (M-CSF) was used. We also used recombinant human G-CSF (rhG-CSF, Filgrastim®), which acts on murine cells, observing reduction in neutrophil numbers, unlike observations of murine G-CSF. The increase in neutrophil numbers in the fresh bone marrow might be induced by exposure of wounded surfaces to oral microorganisms and possibly by bacteremia. To test this hypothesis, the hard palate was disinfected with clorhexidine (CHX) 0.2% or 0.04%, prior to wounding. The treatment with CHX 0.2% abolished the cytokine effects in the total cell, neutrophil and mononuclear phagocyte numbers. By contrast, after treatment with CHX 0.04%, cytokine effects on the neutrophil and mononuclear phagocyte numbers persisted. We also sought to evaluate whether the effect of oral wounding on bone marrow was dependent on endogenous glucocorticoids. Blockade of the glucocorticoid antagonist receptor with mefipristone (RU486) provided results comparable to those of control group given vehicle only, thus ruling out this hypothesis. In pilot experiments, we also evaluated the effects of surgical trauma in BP-2 mice, using the protocol previously used for C57BL/6 mice, and found significant differences in the bone marrow responses between these two strains. Briefly, our limited experimental evidence shows that oral surgical trauma can influence the bone marrow at distance over a 24h postoperative period, and inducing positive or negative effects on various leukocyte lineages, before and after culture with cytokines. Available evidence points to oral bacteria as involved in these long-distance effects on bone-marrow. (AU)

Comportamiento de los traumatismos dentoalveolares en alumnos de las ESBU del municipio Artemisa / Behaviors of dentoalveolar traumata present in urban basic secondary schools (UBSS) pupils of Artemisa municipality

El trauma dentoalveolar (TDA) es un problema de salud pública debido a su incidencia y a las graves secuelas que puede dejar. Se realizó un estudio descriptivo, retrospectivo y de corte transversal para determinar el comportamiento de los TDA en alumnos de las escuelas secundarias bàsicas urbanas del municipio Artemisa en el período comprendido entre enero y junio de 2008. El universo fue de 2 684 alumnos y de estos, 309 constituyeron la muestra al estar afectados por algún tipo de TDA. A los afectados se le registraron las siguientes variables: escuela, edad, sexo, etiología del TDA, período en que ocurrió el TDA, arcada afectada, diente lesionado y tipo de lesión. Para recoger los datos se confeccionó un formulario y estos se procesaron estadísticamente por el sistema Excel (INSTAT). Los resultados se presentaron en tablas y gràficos. Se constató que del total de alumnos examinados, sólo el 11,5 por ciento resultó afectado, con un comportamiento homogéneo del TDA en las cuatro ESBU. Al distribuirlos por sexo, aproximadamente màs de la mitad correspondió al masculino y el intervalo de edad de mayor número de afectados fue de 11-12 años. La principal causa de TDA fueron las caídas y el mayor por ciento del total de TDA ocurrió durante el período vacacional. La arcada superior fue la màs propensa a los TDA y fueron los centrales los dientes màs afectados. La pérdida de tejido coronario representó màs de la mitad de las lesiones producidas por los TDA(AU)

The dentoalveolar trauma (DAT) becomes a public health problem due to its significant incidence and the future severe sequalae. A cross-sectional, retrospective and descriptive study was conducted to determine the behavior of DATs in pupils of urban basic secondary schools of Artemisa municipality from January to June, 2008. Sample includes 2 684 pupils and from these, 309 were the real sample who was affected by some kind of DAT. In this group the following variables were registered: school, age, sex, DAT etiology, period of DAT, involved arch, involved tooth and the kind of lesion. For data collection, we designed a form and these were statistically processed by Excel system (INSTAT). Results were showed in tables and charts. We conclude that from the total of pupils examined; only the 11,5 percent was affected with a DAT homogenous behavior in the four basic secondary schools. In distribution by sex, almost the was of male sex and the age interval with higher involvement was of 11-12. The leading cause of DAT was the teeth loss and the great percentage of DAT total occurred during vacations period. The superior arch was the more sensitive to DATs and the central teeth were the more involved. The coronary tissue loss accounted for more half of lesions produced by DATs(AU)

Lesiones traumáticas: conducta odontológica / Injury: dental behavior

En la cavidad bucal se pueden producir una variedad de lesiones de diferente etiología, por ello es muy importante que el odontólogo las identifique y conozca las consecuencias que ocasiona si no se previenen o tratan a tiempo. Se funda como premisa que el cuidado periodontal es, en esencia, labor del odontólogo general y que éste no puede pasar por alto la responsabilidad de proveer atención a todos los pacientes. La incidencia excesivamente elevada de los problemas periodontales entre la población, dificulta que un número reducido de especialistas los pueda enfrentar. Asimismo, el estrecho vínculo entre los tratamientos dentales restaurativos y los regímenes periodontales hace muy importante que el odontólogo general disponga de conocimientos a fondo sobre periodoncia. En la cavidad bucal se producen variedades de lesiones de origen traumático ya sea por injurias químicas, físicas y térmicas estás representan una urgencia en Odontología. El propósito de este reporte es describir las diferentes presentaciones clínicas de dicha patología, su etiología, diagnósticos diferenciales y diferentes métodos de tratamiento, para valorar sus complicaciones y cuidados postoperatorios. Para ello se realizó basado en los lineamientos de la investigación descriptiva documental, una revisión de la literatura nacional e internacional

A variety of different etiologies pathologies can affect the oral cavity, due to this reason, dentists must be able to identify them and their consequences if they are not treated on time. It is primordial for the general practitioner dentists the periodontal care of their patients. Among the population the periodontal diseases are very common and only a reduced number of specialists can treat them. The close relation between restorative dental treatments and periodontal treatment procedures lead to the tendency that de general practitioner has enough knowledge in the periodontal field. Among the variety of pathologic entities that affect the oral mucosa, that presents as ulcer and are really Traumatic lesions in its different types chemical injury, physical injury, thermal injury It is considered one of the emergencies in dentistry. Dentist must be able to recognize and treat them. The purpose of this research is to describe the possible etiologic agents, clinical features and treatment of this disease and also to recommend the multidisciplinary attention to these patient. For this paper was made a study based on the lineaments of the descriptive documental research, mainly with scientific bibliographic references literature national and international