Ultrasonidos en endodoncia quirúrgica: seguimiento clínico y prospectivo de dos años / Surgical endodontics retrotips: 2-years clinical and prospective follow-up

Introducción: La endodoncia quirúrgica pretende curar los casos que no ha podido remediar la endodoncia convencional, mejorando el sellado previo, mediante la obturación de una cavidad retrógrada. Actualmente, no está claro si es mejor emplear puntas lisas o recubiertas de material abrasivo para la realización de la cavidad retrógrada. Además, los resultados publicados de endodoncia quirúrgica son controvertidos. El objetivo de este estudio es doble: primero, mostrar los resultados de la endodoncia quirúrgica realizada con ultrasonidos; y segundo, evaluarla influencia de dos tipos de puntas ultrasónicas (lisas y recubiertas) en el resultado. Materiales y metodología: Diseñamos un estudio prospectivo a 1 y 2 años de evolución sobre pacientes y un protocolo actualizado de endodoncia quirúrgica con ultrasonidos y obturación con MTA (Mineral Trioxide Aggregate). Se revisó a los pacientes mediante examen clínico y radiográfico. Resultados: Se incluyeron 161 dientes correspondientes a 101 pacientes. A un año, se revisaron 117 dientes y se alcanzó un porcentaje de éxito general del 79,4%, del 75,3% para las puntas lisas y del 85,3% para las recubiertas. A dos años, se revisaron 118 dientes y se alcanzó un porcentaje de éxito general del 82,2%, del79,3% para las puntas lisas y del 87,9% para las recubiertas. Los resultados mostrados no fueron estadísticamente significativos. Conclusiones: La endodoncia quirúrgica realizada con ultrasonidos alcanza altos porcentajes de éxito y no hay diferencias significativas entre puntas lisas o recubiertas, aunque las recubiertas muestren mejores resultados (AU)

Introduction: Surgical endodontics try for healing conventional root canal treatment failed, improving previous sealing through filling of a root-end cavity. Actually is not clear if it is better used stainless steel ultrasonic retrotips than diamond-coated ultrasonic retrotips for cavity preparation. Moreover, surgical endodontics published results are discussable. The aim of present study is two-fold: first, to show the success rate of surgical endodontics based in ultrasonics; and second, to evaluate both retrotips (stainlesssteel and diamond-coated) influence in success rate. Materials and methods: It was designeda 1-year and 2-years follow-up clinical and prospective study and developed a modern surgical endodontics based in ultrasonics and root-end filling with MTA (Mineral Trioxide Aggregate). Follow-up examination included clinical and radiographic assessment. Results: It was included 161 teeth from 101 patients. 1- year follow-up (..) (AU)

Social demand in ambulatory oral surgery. Experience in the Master of Oral Surgery of Madrid Complutense University (Spain).

OBJECTIVES: An evaluation is made of the surgical activity in the context of the Master of Oral Surgery (Madrid Complutense University, Madrid, Spain), together with an analysis of social demand in ambulatory oral surgery. STUDY DESIGN: A descriptive statistical analysis (frequency and contingency tables) is made of the different parameters relating to the activity carried out in this postgraduate master during two academic years. RESULTS: A total of 6750 interventions were carried out in 5877 patients. Females predominated over males (62% versus 38%), and 59.2% of the subjects were in the 21-40 years age range. The most common procedure was tooth extraction (91%); of these, 83.5% corresponded to molars. Other extractions accounted for 5.5%, while impacted canines represented 1.2% of the interventions, cyst removal 1.2%, and periapical surgery 0.5%. CONCLUSIONS: Our results show third molar extraction to be the most commonly demanded intervention in ambulatory oral surgery.

Social demand in ambulatory oral surgery. Experience in the Master of Oral Surgery of Madrid Complutense University (Spain)

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Objectives. An evaluation is made of the surgical activity in the context of the Master of Oral Surgery (Madrid Complutense University, Madrid, Spain), together with an analysis of social demand in ambulatory oral surgery.Study design. A descriptive statistical analysis(frequency and contingency tables) is made of the different parameters relating to the activity carried out in this postgraduate master during two academic years.Results. A total of 6750 interventions were carried out in 5877 patients. Females predominated over males (62%versus 38%), and 59.2% of the subjects were in the 21-40 years age range. The most common procedure was toothextraction (91%); of these, 83.5% corresponded to molars. Other extractions accounted for 5.5%, while impacted canines represented 1.2% of the interventions, cyst removal 1.2%, and periapical surgery 0.5%.Conclusions. Our results show third molar extraction to be the most commonly demanded intervention in ambulatoryoral surgery

Clinical and radiological course in apicoectomies with the Erbium:YAG laser.

OBJECTIVE: A study is made of the efficacy of the Erbium:YAG laser in granulomatous periapical lesions, based on clinical and radiographic controls. MATERIAL AND METHODS: The study comprised a series of 45 patients amenable to periapical surgical treatment of incisors, canines and premolars. A conventional surgical technique was used, with silver amalgam retrograde filling and irradiation of the bone defect and remnant root cement with the Erbium:YAG laser. Clinical and radiographic controls were made during 24 months, assessing the absence of symptoms and the presence of pain, swelling or fistula and ossification of the lesions, respectively. RESULTS: The clinical course proved asymptomatic in 95.5% of the cases. As regards remodeling of the bone cavity, 77.7% had completed ossification after 24 months, 13.3% were in an advanced stage of ossification and 4.5% in an intermediate stage, while 4.5% showed treatment failure. CONCLUSIONS: The combination of silver amalgam and irradiation with the Erbium:YAG laser in periapical surgery showed a very high clinical success rate, with a 77.7% bone cavity remodeling rate after 24 months.

Clinical and radiological course in apicoectomies with the Erbium: YAG LASER

Objetivo. Valorar la eficacia del láser de Erbium:YAG en lesiones granulomatosas periapicales, mediante controles clínicos y radiográficos. Material y método. Estudio clínico en el que participó una muestra de 45 pacientes susceptibles de tratamiento quirúrgico periapical en dientes incisivos, caninos y premolares. Realizándose una técnica quirúrgica convencional con relleno retrógrado de amalgama de plata e irradiación del defecto óseo y cemento radicular remanente con láser de Erbium: YAG. Se realizaron controles clínicos y radiográficos durante 24 meses, valorando la ausencia de síntomas o la presencia de dolor, inflamación o fístula y osificación de las lesiones respectivamente. Resultados. La evolución clínica de los pacientes en un 95,5 por ciento de los casos fue asintomática. En cuanto a la remodelación de la cavidad ósea el 77,7 por ciento terminaron su osificación a los 24 meses, el 13,3 por ciento se encontraban en un estadio avanzado, el 4,5 por ciento en un estadio intermedio y en otro 4,5 por ciento fracasó el tratamiento. Conclusiones.- La combinación de amalgama de plata e irradiación con láser de Erbium:YAG en cirugía periapical supuso un éxito clínico muy elevado y una remodelación de la cavidad ósea del 77,7 por ciento a los 24 meses

Objective. A study is made of the efficacy of the Erbium:YAG laser in granulomatous periapical lesions, based on clinical and radiographic controls. Material and methods. The study comprised a series of 45 patients amenable to periapical surgical treatment of incisors, canines and premolars. A conventional surgical technique was used, with silver amalgam retrograde filling and irradiation of the bone defect and remnant root cement with the Erbium:YAG laser. Clinical and radiographic controls were made during 24 months, assessing the absence of symptoms and the presence of pain, swelling or fistula and ossification of the lesions, respectively. Results. The clinical course proved asymptomatic in 95.5 percents of the cases. As regards remodeling of the bone cavity, 77.7 percents had completed ossification after 24 months, 13.3 percents were in an advanced stage of ossification and 4.5 percents in an intermediate stage, while 4.5 percents showed treatment failure. Conclusions. The combination of silver amalgam and irradiation with the Erbium:YAG laser in periapical surgery showed a very high clinical success rate, with a 77.7 percents bone cavity remodeling rate after 24 months

Variations of interleukin-6 after surgical removal of lower third molars.

OBJECTIVES: To determine if there is a release of IL-6 after surgical removal of lower third molars and to compare the amount of IL-6 in patients treated with NSAID and in those treated with glucocorticoids. STUDY DESIGN: Prospective study on 73 patients who attended the Oral Surgery Unit (Department of Medicine and Oral Surgery) in the Faculty of Odontology of the Universidad Complutense de Madrid for the surgical removal of their lower third molars. These patients were separated into two groups: the diclofenac group and the methylprednisolone group. A record card was completed with preoperative and postoperative epidemiological and clinic data. Samples of gingival crevicular fluid were collected in order to assess the release of interleukin-6 after surgery. In order to make a broad study of data, the BMDP program was used for statistical analysis. RESULTS: Levels of IL-6 were higher after surgical extraction of lower third molars and remained high until the seventh day after. Levels were higher in the diclofenac group 24hours after surgery, the difference was significant (0.008). CONCLUSIONS: IL-6 is higher after surgical extraction of lower third molars, behaving differently in each of the groups.

The use of methylprednisolone versus diclofenac in the treatment of inflammation and trismus after surgical removal of lower third molars.

OBJECTIVE: To compare the efficacy of methylprednisolone (corticoid) versus diclofenac (nonsteroidal anti-inflammatory--NSAID) in the treatment of inflammation and trismus after the surgical removal of lower third molars. STUDY DESIGN: Prospective study on 73 patients for the surgical removal of their lower third molars. These patients were separated in two groups at random: the diclofenac group and the methylprednisolone group. A record card was filled in with preoperative and postoperative epidemiological and clinic data about inflammation and trismus (three facial measures and mouth opening). In order to make a broad study of data, BMDP program was used for statistics. RESULTS: 24 hours after surgery, patients in the diclofenac group showed a more severe inflammation in one of the facial measurements (<0.05). Trismus was very similar in both groups. CONCLUSIONS: There were no differences in trismus depending on the antiinflammatory used. Patients in the corticoid group showed less inflammation but the difference was not as important as to justify their use.

Uso de metilprednisolona versus diclofenaco en el control de la inflamación y el trismo tras la cirugía del tercer molar inferior / The use of methylprednisolone versus diclofenac in the treatment of inflammation and trismus after surgical removal of lower third molars

Objetivo: Comparar el efecto sobre la inflamación y el trismo de la metilprednisolona (corticoide) versus diclofenaco (antiinflamatorio no esteroideo-AINE-) tras la cirugía del tercer molar inferior.Diseño del estudio: Estudio prospectivo sobre 73 pacientes sometidos a la extracción quirúrgica de los terceros molares inferiores. Fueron divididos de forma aleatoria en dos grupos: De diclofenaco y de metilprednisolona. Se cumplimentó una ficha donde se hizo constar los datos epidemiológicos y clínicos preoperatorios y postoperatorios en relación a la inflamación y el trismo (tres medidas faciales y apertura bucal). Se usó el programa estadístico BMDP para hacer un amplio tratamiento de los datos.Resultados: A las 24 horas el grupo tratado con diclofenaco presentaba mayor inflamación en una de las medidas faciales (p<0.05), no así en las otras dos medidas. El trismo se comportó de forma similar en ambos grupos.Conclusiones: No se encontraron diferencias en el trismo según el antiinflamatorio usado y aunque la inflamación fue algo menor en el grupo de experimentación tratado con corticoides la diferencia no fue tan significativa como para justificar su uso

Objective: To compare the efficacy of methylprednisolone (corticoid)versus diclofenac (nonsteroidal anti-inflammatory -NSAID-) in the treatment of inflammation and trismus after the surgical removal of lower third molars.Study design: Prospective study on 73 patients for the surgical removal of their lower third molars. These patients were separated in two groups at ramdom: the diclofenac group and the methylprednisolone group. A record card was filled in with preoperative and postoperative epidemiological and clinic data about inflammation and trismus (three facial measures and mouth opening). In order to make a broad study of data, BMDP program was used for statistics.Results: 24 hours after surgery, patients in the diclofenac group showed a more severe inflammation in one of the facial measurements (p<0.05). Trismus was very similar in both groups.Conclusions: There were no differences in trismus depending on the antiinflammatory used. Patients in the corticoid group showed less inflammation but the difference was not as important as to justify their use

Variations of interleukin-6 after surgical removal of lower third molars

Objetivos: Determinar si tras la cirugía del tercer molar inferior se produce una liberación de interleuquina-6 (IL-6) y comparar la cantidad de IL-6 en pacientes que tomaron AINES y en aquellos que tomaron glucocorticoides.Diseño del estudio: Estudio prospectivo sobre 73 pacientes sometidos a la extracción quirúrgica de los terceros molares inferiores. Fueron divididos en dos grupos: De diclofenaco y de metilprednisolona. Se recogieron muestras de fluído crevicular gingival para valorar la liberación de interleuquina-6 tras la cirugía. Se usó el programa estadístico BMDP para hacer un amplio tratamiento de los datos.Resultados: Los niveles de IL-6 se elevaron tras la cirugía del tercer molar inferior permaneciendo elevados al séptimo día del postoperatorio, elevándose más a las 24 horas en el grupo de diclofenaco siendo esta diferencia significativa (0,008).Conclusiones: La IL-6 se eleva tras la cirugía del tercer molar inferior, presentando diferente comportamiento en los dos grupos de estudio

Objectives: To determine if there is a release of IL-6 after surgical removal of lower third molars and to compare the amount of IL-6 in patients treated with NSAID and in those treated with glucocorticoids.Study Design: Prospective study on 73 patients who attended the Oral Surgery Unit (Department of Medicine and Oral Surgery) in the Faculty of Odontology of the Universidad Complutense de Madrid for the surgical removal of their lower third molars. These patients were separated into two groups: the diclofenac group and the methylprednisolone group. A record card was completed with preoperative and postoperative epidemiological and clinic data. Samples of gingival crevicular fluid were collected in order to assess the release of interleukin-6 after surgery. In order to make a broad study of data, the BMDP program was used for statistical analysis.Results: Levels of IL-6 were higher after surgical extraction of lower third molars and remained high until the seventh day after. Levels were higher in the diclofenac group 24 hours after surgery, the difference was significant (0.008).Conclusions: IL-6 is higher after surgical extraction of lower third molars, behaving differently in each of the groups

Efectos esterilizantes del láser Erbium:Yag sobre las estructuras dentarias: Estudio in vitro / Sterilizing effects of the Erbium:Yag laser upon dental structures: An in vitro study

Objetivo: Comprobar el efecto esterilizante del láser de Erbium:YAG, a diferentes potencias, en dientes in vitro Diseño del estudio: Estudio in vitro sobre 47 dientes unirradiculares extraídos por motivos periodontales en la Unidad Docente de Cirugía Bucal y Maxilofacial (Departamento de Medicina y Cirugía Bucofacial) de la Facultad de Odontología de la Universidad Complutense de Madrid. Las muestras fueron divididas en tres grupos de irradiación con láser (250mJ, 350mJ y 450mJ) y un grupo control -no irradiados-. A continuación se introdujeron en un medio de enriquecimiento durante 72 horas en anaerobiosis, realizando controles visuales a las 24, 48 y 72 horas. Y posteriormente se realizaron cultivos microbiológicos en agar sangre, para confirmar los resultados de los controles visuales. Resultados: Se observa como a medida que aumenta la potencia de irradiación con el láser hay un mayor porcentaje de esterilización de las muestras, existiendo diferencias estadísticamente significativas entre el grupo control y cualquiera de los grupos láser. Conclusiones: El láser de Erbium:YAG presenta efecto esterilizante sobre las estructuras dentarias in vitro, que se va incrementando a medida que aumenta la potencia de aplicación del mismo

Aim: An evaluation was made of the sterilizing effects of the Erbium:YAG laser at different power ratings upon dental structures in vitro. Design: An in vitro study was made of 47 single-root teeth removed for periodontal reasons in the Oral and Maxillofacial Surgery Teaching Unit (Department of Medicine and Orofacial Surgery, Madrid Complutense University Dental School, Spain). The teeth were divided into three laser irradiation groups (250, 350 and 450 mJ) and a non-irradiated control group. The teeth were then immersed in an enrichment medium for 72 hours under conditions of anaerobiosis, with visual controls after 24, 48 and 72 hours. Posteriorly, microbiological cultures were made in blood agar to confirm the results of the visual inspections. Results: Increased percentage sterilization of the samples was recorded with increasing irradiation power - statistically significant differences being observed between all irradiated groups versus the controls. Conclusions: The Erbium:YAG laser exerts a sterilizing effect upon dental structures in vitro. This effect increases with increasing laser power ratings

Posibilidades de terapia hormonal en cirugía e implantología bucofacial. Tratamiento hormonal en cirugía o implantología bucofacial / Hormone therapy possibilities in surgery and buccofacial implantology. Hormone treatment in surgery or buccofacial implantology

INTRODUCCIÓN: La hormona somatotropa (GH) y las hormonas calcitrópicas (PTH, 1,25(OH)2-vit. D3 y calcitonina) han determinado el crecimiento y remodelado óseo, junto con hormonas como las tiroideas, sexuales y diversos factores de crecimiento. DESARROLLO: Esta revisión bibliográfica nos lleva por un camino en el que la terapia hormonal puede ser la clave para resolver el problema de los defectos óseos que surgen en el campo de la Cirugía e Implantología y condicionan el éxito en los resultados (AU)

INTRODUCTION: Somatotropic hormone (GH) and calcitotropic hormones (PTH, 1,25(OH)2-vit.D3 y calcitonin) have determined osseous growth and remodeling, along with hormones such as tyroid, sexual and many growth factors. DEVELOPMENT: This bibliographical review guide us on a way where hormonal therapy may be the key so as to solve the problem of osseous defects which appear in Surgery and Implantology and condition the success in results (AU)

Sterilizing effects of the Erbium:Yag laser upon dental structures: an in vitro study.

AIM: An evaluation was made of the sterilizing effects of the Erbium:YAG laser at different power ratings upon dental structures in vitro. DESIGN: An in vitro study was made of 47 single-root teeth removed for periodontal reasons in the Oral and Maxillofacial Surgery Teaching Unit (Department of Medicine and Orofacial Surgery, Madrid Complutense University Dental School, Spain). The teeth were divided into three laser irradiation groups (250, 350 and 450 mJ) and a non-irradiated control group. The teeth were then immersed in an enrichment medium for 72 hours under conditions of anaerobiosis, with visual controls after 24, 48 and 72 hours. Posteriorly, microbiological cultures were made in blood agar to confirm the results of the visual inspections. RESULTS: Increased percentage sterilization of the samples was recorded with increasing irradiation power - statistically significant differences being observed between all irradiated groups versus the controls. CONCLUSIONS: The Erbium:YAG laser exerts a sterilizing effect upon dental structures in vitro. This effect increases with increasing laser power ratings.

Influence of smoking upon the postoperative course of lower third molar surgery.

OBJECTIVES: To determine whether smoking influences the postoperative course (pain and trismus) of lower third molar surgery, with a clinical evaluation of surgical wound condition and analysis of the possible differences between smokers and nonsmokers. DESIGN: The study subjects were randomly distributed into two groups (smokers and nonsmokers) and subjected to lower third molar extraction in the Unit of Oral and Maxillofacial Surgery (Madrid Complutense University, Spain). The study variables were trismus after 7 days, the intensity of pain and the need for rescue medication during a period of one week. The surgical wound was also assessed (color, presence of plaque, etc). RESULTS: Two cases of postoperative infection were documented among the smokers, and postoperative trismus was found to be greater among the latter (p=0.05). CONCLUSIONS: There were no statistically significant differences between the two groups in terms of pain, though trismus was greater among the smokers. Smoking did not influence wound condition (color, marginal inflammation, appositioning of the margins, ulceration, etc).

Influencia del hábito tabáquico en el postoperatorio de la cirugía del tercer molar inferior / Influence of smoking upon the postoperative course of lower third molar surgery

Objetivos: Determinar si tras la cirugía del tercer molar inferior el tabaco influye en el postoperatorio (dolor y trismo) y valorar clínicamente el estado de la herida, analizando las posibles diferencias entre fumadores y no fumadores.Diseño del estudio: Los pacientes que participaron en el estudio fueron distribuidos de forma aleatoria en dos grupos: Fumadoresy no fumadores. Se les realizó la extracción quirúrgica de los terceros molares inferiores en la Unidad de Cirugía Bucal y Maxilofacial de la Universidad Complutense de Madrid. Las variables registradas fueron el trismo a los 7 días, la intensidad del dolor y la necesidad de medicación de rescate durante un periodo de una semana. Se analizó también el estado de la herida (coloración, presencia de placa, etc.)Resultados: Hubo dos casos de infección postoperatoria en el grupo de pacientes fumadores. El trismo postoperatorio fue mayor en los fumadores (p=0.05)Conclusiones: No hubo diferencias estadísticamente significativas en cuanto a dolor, pero sí se observó un mayor trismo en el grupo de fumadores. El tabaco no influyó en el estado de la herida ( color, inflamación de los bordes, confrontación de los mismos, ulceración, etc.)

Objectives: To determine whether smoking influences the postoperative course (pain and trismus) of lower third molar surgery, with a clinical evaluation of surgical wound condition and analysis of the possible differences between smokers and nonsmokers.Design: The study subjects were randomly distributed into two groups (smokers and nonsmokers) and subjected to lower third molar extraction in the Unit of Oral and Maxillofacial Surgery (Madrid Complutense University, Spain). The study variables were trismus after 7 days, the intensity of pain and the need for rescue medication during a period of one week. The surgical wound was also assessed (color, presence of plaque, etc.).Results: Two cases of postoperative infection were documented among the smokers, and postoperative trismus was found to be greater among the latter (p=0.05).Conclusions: There were no statistically significant differences between the two groups in terms of pain, though trismus was greater among the smokers. Smoking did not influence wound condition (color, marginal inflammation, appositioning of the margins, ulceration, etc.)

Eficacia analgésica de diclofenaco versus metilprednisolona en el control del dolor postoperatorio tras la cirugía del tercer molar inferior / Analgesic efficacy of diclofenac versus methylprednisolone in the control of postoperative pain after surgical removal of lower third molars

Objetivo: Comparar la eficacia analgésica de la metilprednisolona(corticoide) versus diclofenaco (antiinflamatorio noesteroideo-AINE-) tras la cirugía del tercer molar inferior.Diseño del estudio: Estudio prospectivo sobre 73 pacientessometidos a la extracción quirúrgica de los terceros molaresinferiores. Fueron divididos de forma aleatoria en dos grupos:De diclofenaco y de metilprednisolona. Se cumplimentó unaficha donde se hizo constar los datos epidemiológicos y clínicospreoperatorios y postoperatorios. La valoración del dolor se hizomediante escala visual analógica y semicuantitativa y número deanalgésicos de rescate consumidos. El control del dolor se hizoen la primera hora, a las 8 horas, 24 horas, 48 y 72 horas.Se usó el programa estadístico BMDP para hacer un ampliotratamiento de los datos.Resultados: En el dolor reflejado por los pacientes en la escalavisual analógica no hubo diferencias de conjunto entre los dosgrupos (aunque sí las hubo en ciertos momentos). Tampocohubo diferencias en el número de analgésicos de rescate consumidos.Conclusiones. La reducción del dolor que se consigue con elcorticoide no es significativa por lo que no está justificado suuso rutinario

Objetive: To compare the analgesic efficacy of methylprednisolone(corticoid) versus diclofenac (nonsteroidal antiinflammatory-NSAID-) after surgical removal of lower third molars.Study Design: Prospective study on 73 patients for the surgicalremoval of their lower third molars. These patients wereseparated in two groups at random: a diclofenac group and amethylprednisolone group. A record card was filled in withpreoperative and postoperative epidemiological and clinic data.The pain level assessment was made on a semiquantitative and ananalogical visual scales and in relation to the amount of rescueanalgesics consumed. Pain levels were measured at 1, 8, 24, 48and 72 hours.In order to make a broad study of data, BMDP program wasused for statistics.Results: In the pain described by patients in the analogical visualscale there were no differences between groups as a whole.There were no differences in the amount of rescue analgesicsconsumed.Conclusions. There is less pain in the corticoid group but not asto justify its routine use

Analgesic efficacy of diclofenac versus methylprednisolone in the control of postoperative pain after surgical removal of lower third molars.

OBJECTIVE: To compare the analgesic efficacy of methylprednisolone (corticoid) versus diclofenac (nonsteroidal antiinflammatory-NSAID-) after surgical removal of lower third molars. STUDY DESIGN: Prospective study on 73 patients for the surgical removal of their lower third molars. These patients were separated in two groups at random: a diclofenac group and a methylprednisolone group. A record card was filled in with preoperative and postoperative epidemiological and clinic data. The pain level assessment was made on a semiquantitative and an analogical visual scales and in relation to the amount of rescue analgesics consumed. Pain levels were measured at 1, 8, 24, 48 and 72 hours. In order to make a broad study of data, BMDP program was used for statistics. RESULTS: In the pain described by patients in the analogical visual scale there were no differences between groups as a whole. There were no differences in the amount of rescue analgesics consumed. CONCLUSIONS: There is less pain in the corticoid group but not as to justify its routine use.

Aplicaciones del láser en Implantología: alternativas al tratamiento convencional / Laser applications in implantology: convencional treatment alternatives

Los avances de la tecnología láser han promovido el interés de los profesionales hacia nuevas aplicaciones en diferentes áreas como es el caso de la Implantología. El láser se ha propuesto fundamentalmente para realizar descubrimientos de implantes sumergidos, eliminación de hiperplasias gingivales, así como para la posible esterilización de los implantes en las enfermedades periimplantarias. El propósito de este trabajo es realizar una revisión sobre los estudios publicados en esta línea, intentando aclarar los aspectos más controvertidos del tema (AU)

Laser technology advancements have promoted professionals interest to new applications in different areas like implantology. Laser has been used principally in second-stage , gingival hyperplasic elimination and attempted sterilization in periimplantary diseases. The purpose of this work is an overview of literature publications in this line, trying to clarify the controversy aspects (AU)

Percepción y nivel de comprensión del consentimiento informado en la cirugía del tercer molar inferior / Perception and level of understanding of the informed consent in lower third molar surgery

La firma del consentimiento informado por parte del paciente es obligatoria antes de cualquier intervención. Objetivos: Los objetivos de este artículo original fueron: -Conocer el nivel de comprensión del consentimiento informado por parte del paciente. -Determinar el porcentaje de pacientes que rechazan el tratamiento al conocer los riesgos del mismo. Pacientes y metodo: Participaron en el estudio 385 pacientes a los que se les extrajo el tercer molar quirúrgicamente tras haber firmado el consentimiento informado. Posteriormente se les realizó una encuesta para comprobar si habían comprendido la finalidad del consentimiento informado y su opinión sobre el procedimiento. Resultados: Los datos se trataron mediante estadística descriptiva. Lo más destacable es que el 100 por ciento de los pacientes firmaron el consentimiento informado y se sometieron a la cirugía. El 99,74 por ciento entendió claramente qué le harían en la intervención. El 97 por ciento sabía que se podían presentar complicaciones y el 94 por ciento entendió que podía negarse a la intervención. Más de la mitad (61,56 por ciento) pensaba que el consentimiento sirve para eximir de responsabilidad al profesional. Al 98,96 por ciento les parece útil este tipo de información. Conclusiones: El consentimiento informado fue comprendido por la mayoría de los pacientes y ninguno de ellos se negó a la intervención (AU)

Aspectos sobre Ia demanda social en urgencias de cirugía bucal / Aspects about social demands in oral surgery emergencies

Los estudios sobre urgencias en Odontoestomatología y más concretamente en Cirugía Bucal, son escasos, por ello en este trabajo los objetivos fueron analizar la frecuencia de estas urgencias, así como describir las distintas patologías que las causan y averiguar cuál de ellas es la más frecuente. La metodología seguida fue la realización de un estudio descriptivo, prospectivo longitudinal de tres meses de duración, en el Hospital Clínico de San Carlos de Madrid, sobre las Urgencias en el Servicio de Cirugia Bucal El tamaño muestra¡ fue de 144 pacientes De los resultados obtenidos destacan los siguientes: la caries fue la patología que más urgencias desencadenó un 28,5 por ciento La perlcoronaritis provocó el 11,1 por ciento de las urgencias y los problemas de tipo infeccioso o inflamatorio tras la exodoncia de un tercer molar inferior causaron el 10,4 por ciento de las urgencias Ya en menor proporción se observaron fracturas dentarias, patología de ATM, problemas periodontales, hemorragias, parestesias, patología de glándulas salivales, etc. Como conclusión más importante se puede citar que la urgencia en Cirugía Bucal supone un 5 por ciento de la demanda asistencial, siendo la caries la patología más frecuente (AU)