Temporomandibular joint arthroscopy in advanced stages of internal derangement: a retrospective cohort study on the influence of age.

The aim of this investigation was to evaluate the outcomes of patients with advanced internal derangement of the temporomandibular joint who underwent operative arthroscopy, according to age stratified into two groups: <45 years and ≥45 years. The study included a series of 194 patients. Outcome variables were pain intensity and mandibular mobility. Additionally, the difference in arthroscopic findings in these age groups was studied. The data analysis included the paired t-test, χ2 test, and two-way analysis of variance, with a P-value <0.05 indicating statistical significance. A significant reduction in pain and an improvement in maximum inter-incisal opening (MIO) was observed in both groups starting at 1 month of follow-up (P < 0.01). However, the results for MIO were worse in the ≥45 years group (P=0.036) at 12- and 18-months follow-up. Regarding arthroscopic findings, the study showed a higher prevalence of severe chondromalacia in the ≥45 years group (P = 0.031) and disc displacement without reduction in the <45 years group (P = 0.020). Analysis of variance showed a greater pain reduction if no obliteration of the articular space was observed (P = 0.039). In young and older patients, operative arthroscopy can be useful for short-term treatment in advanced stages of internal derangement of the temporomandibular joint.

The minimally invasive arthroscopic anterior myotomy in the treatment of internal derangement of the temporomandibular joint. A detailed description of the surgical technique.

PURPOSE: The aim of this report is to define a modification of the arthroscopic anterior myotomy that avoids disc suturing procedures for the treatment of advanced internal derangement (I D) of the temporomandibular joint (TMJ). SURGICAL TECHNIQUE: The minimally invasive arthroscopic anterior myotomy (MIAAM) is based on a partial resection of the superior belly of the lateral pterygoid muscle performed through a small incision of the articular capsule associated with a scarification of the posterior ligament of the TMJ. The high-frequency wave system, called Coblation, is extremely useful to be able to complete the MIAAM. CONCLUSION: This technique is indicated for patients with ID and Wilkes stages III-IV without response to conservative treatments, and the presence of an integral disc with an appropriate consistency is transcendent for the success of the procedure. Because of the unique characteristics of the MIAAM, it can be considered as an alternative to arthroscopic discopexy procedures.

Síndrome de Gorlin-Goltz; a propósito de un caso / Gorlin-Goltz syndrome; a clinical case

El síndrome de Gorlin-Goltz (SGG) es también conocido como síndrome névico basocelular o síndrome del carcinoma nevoide basocelular. Fue mencionado por primera vez en 1894 por los doctores Jarish y White y fue descrito en 1960 por Robert J. Gorlin. Es un raro trastorno autosómico dominante, ocasionado por una mutación sufrida en el gen Patched 1 (PTCH1) ubicado en el cromosoma 9q223 (este gen desempeña un papel en la supresión tumoral, la estructuración embrionaria y el ciclo celular), que se caracteriza por defectos en el desarrollo y por elevar de manera significativa la predisposición a padecer algún tipo de cáncer. Su prevalencia es variable según el país, pero está aceptada una media de 1:60.000 habitantes/año, siendo la relación hombre/mujer de 1: 0,621. El diagnóstico del SGG puede resultar complejo debido a la variabilidad en la expresividad del síndrome y en la edad de presentación. La manifestación más común en la cavidad oral son los queratoquistes, lesiones que aparecen hasta en el 90% de los pacientes

Gorlin-Goltz Syndrome (GGS) is also known as basal cell nevus syndrome or nevoid basal cell carcinoma syndrome. It was first mentioned in 1894 by Doctors Jarish and White and described in 1960 by Robert J. Gorlin. It is a rare autosomal dominant condition, caused by a mutation suffered in the PTCH1 gene (Patched 1) located on chromosome 9q223 (this gene plays a role in tumour suppression, embryonic structuring and the cell cycle). It is characterised by defects in development and a significantly increased predisposition to suffering from some type of cancer. Its prevalence varies according to the country, but an average of 1 per 60,000 population/year is accepted, with the male/female ratio being 1:0.621. Diagnosing GGS can be complex due to the variability in the expressiveness of the syndrome and the age of presentation. The most common manifestation is the appearance of keratocysts in the oral cavity, which appear in up to 90% of patients

Modified arthroscopic anterior myotomy for internal derangement of the temporomandibular joint: clinical and radiological results.

The aim of this study was to present the results of a modification of the arthroscopic anterior myotomy for the treatment of internal derangement (ID) of the temporomandibular joint (TMJ): the minimally invasive arthroscopic anterior myotomy (MIAAM). Fifteen joints with Wilkes stages III-IV ID treated with this technique were studied. Clinical data evaluated were pain (visual analogue scale, VAS) and articular movements (preoperatively and at 1, 3, 6, 9, and 12 months postoperative). The position of the disc at 1 year after surgery was compared with the pre-surgical position, using magnetic resonance imaging (MRI). The mean pain level according to the VAS decreased from of 67.8 pre-surgery to 29.0 at the 12-month follow-up (P < 0.001). Functionally, mouth opening increased from a mean 27.8 mm to 36.0 mm (P < 0.001). Evaluation of the MRI images showed statistically significant improvements in disc position in both the closed (P = 0.00002) and open-mouth (P = 0.00001) position. The incidence of re-arthroscopy was 13.3% (2/15). This procedure is an effective method for the improvement of joint function and reduction of pain in patients with ID of the TMJ. However, MIAAM is moderately effective in regards to repositioning of the disc.

Prevalence of palatine tonsilloliths in Dominican patients of varying social classes treated in university clinics.

The relevance of tonsils lies not only in local but also in systemic immunity. One of the most common ailments afflicting the tonsils are palatine tonsilloliths (PT), dystrophic calcifications found in the tonsillar crypts. PT prevalence reports have been conducted for Caucasian and Asian patients, but not for black patients. The aim of this cross-sectional study is to gauge the prevalence of PT in patients who sought treatment at two university clinics in the Dominican Republic, and to analyze any links with the race of patients. Two hundred and nine consecutive patients attending the dental services of two clinics located in different cities in the Dominican Republic, from March 1 to April 30, 2019, were selected. Computed tomography scans of patients were evaluated for a PT diagnosis. Determined prevalence of PT in this population sample was 5.85%. A non-significant relationship between occurrence of PT and race or kind of health service utilized was found. Nonetheless, more white patients used private health clinics while more black patients used the public health system. Previous tonsillitis was the only factor showing a significant correlation with the occurrence of PT. Also, PT prevalence was significantly higher in patients under 40 years of age. General prevalence of PT was significantly lower than reported in previous studies involving other countries/races. Considering the limitations of this study, when comparing it to a previous similar study and taking into account the Asian- and Caucasian-centric results obtained, a race influence on prevalence of calcifications may be suggested. Despite our results showing no racial differences within the Dominican Republic, black patients appear to present a lower prevalence of PT than Caucasian and Asian patients.

Effectiveness of an educational intervention to improve the safety culture in primary care: a randomized trial.

BACKGROUND: Fostering a culture of safety is an essential step in ensuring patient safety and quality in primary care. We aimed to evaluate the effectiveness of an educational intervention to improve the safety culture in the family and community medicine teaching units in an Atlantic European Region. METHODS: Randomized study conducted in family and community medicine teaching units in Galicia (Spain). Participants were all fourth-year residents and their tutors (N = 138). Those who agreed to participate were randomized into one of two groups (27 tutors/26 residents in the intervention group, 23 tutors/ 23 residents in the control one).All were sent the Survey on Patient Safety Culture. After that, the intervention group received specific training in safety; they also recorded incidents over 15 days, documented them following a structured approach, and had feedback on their performance. The control group did not receive any action. All participants completed the same survey four months later. Outcome measures were the changes in safety culture as quantified by the results variables of the Survey: Patient Safety Grade and Number of events reported. We conducted bivariate and adjusted analyses for the outcome measures. To explore the influence of participants' demographic characteristics and their evaluation of the 12 dimensions of the safety culture, we fitted a multivariate model for each outcome. RESULTS: Trial followed published protocol. There were 19 drop outs. The groups were comparable in outcome and independent variables at start. The experiment did not have any effect on Patient safety grade (- 0.040) in bivariate analysis. The odds of reporting one to two events increased by 1.14 (0.39-3.35), and by 13.75 (2.41-354.37) the odds of reporting 3 or more events. Different dimensions had significant independent effects on each outcome variable. CONCLUSION: A educational intervention in family and community medicine teaching units may improve the incidents reported. The associations observed among organizational dimensions and outcomes evidence the complexity of patient safety culture measurement and, also, show the paths for improvement. In the future, it would be worthwhile to replicate this study in teaching units from different settings and with different health professionals engaged. TRIAL REGISTRATION: It was retrospectively registered with ( ISRCTN41911128 , 31/12/2010).

Depresión y sobrecarga en el cuidado de personas mayores / Depression and burden in the caretaking of elderly

OBJETIVO: Los cuidados informales afectan a la calidad de vida y a la salud emocional. El objetivo de este trabajo fue analizar la relación entre la carga y la depresión en los cuidadores/as medida con Escala de Zarit y GHQ-28 y el deterioro funcional global del anciano medido mediante OARS-MFAQ. MÉTODOS: Estudio transversal descriptivo por entrevistas a 104 personas mayores de 65 años y sus cuidadores/as informales en la ciudad de Ourense. Se realizó un análisis descriptivo y una regresión logística de las variables que influyen en la depresión y la sobrecarga por cuidar ancianos. RESULTADOS: El 82,7% de cuidadores/as eran mujeres con edad media de 63,64 años (IC 95%: 61,05-66,23) y el 10,3% mayor de 80 años. El 32,2% presentaba sobrecarga encontrándose como factores asociados a la misma, cuidar de ancianos más jóvenes (p=0,043), ser pareja del anciano (p=0,003), tener mayor edad (p=0,031) y el riesgo de depresión medida con GHQ (p<0,001). Tener buena percepción de la visión (p=0,038), rechazar el uso de bastón (p=0,002) o silla de ruedas (p=0,015) también se asoció con la sobrecarga. CONCLUSIONES: Las cuidadoras informales son mujeres en torno a 60 años. Aunque no sientan sobrecarga por cuidar, tienen depresión, que es más probable cuanto más severa es la carga y esta se relaciona con la percepción de carencias económicas básicas para el cuidado

OBJECTIVE: Informal care affects the quality of life and emotional health. Objective: To analyze the relationship between burden and depression in caregivers measured by Zarit's Scale and GHQ-28 and the global functional deterioration of the elderly measured by OARS-MFAQ. METHODS: Descriptive observational cross-sectional study in Primary Health Care at Ourense city. 104 people (>65 years old) and their caregivers were interviewed. Descriptive analysis and logistic regression were used to analyze the characteristics that increase the probability to suffer burden and depression. RESULTS: 82.7% of caregivers were women with an average age of 63.64 years (95% CI: 61.05-66.23) and 10.3% were over 80 years old. 32.2% had an overload, associated with taking care of younger people (p=0.043), being a couple of an elder (p=0.003) being older (p=0.031) and the risk of depression which were all found as factors associated with burden, measured by GHQ (p<0.001). Having good perception of the vision (p=0.038), rejecting the use of a cane (p=0.002) or wheelchair (p=0.015) were also associated with factors contributing to burden. CONCLUSIONS: Informal caregivers are women around their sixties, and although they do not feel overburdened for caring, they have depression, more likely the more severe the burden is, and it is related with the perception of economic deficiencies for the caring

The auricular cartilage graft used as interpositional material for disc replacement after failed TMJ operative arthroscopy.

OBJECTIVES: The aim of this study was to evaluate the preoperative and 2-years postoperative clinical and radiological findings in a group of patients after temporomandibular joint discectomy and interpositional autogenous auricular cartilage graft. MATERIALS AND METHODS: The technique involved a disc removal, condylar remodeling and fixation of the graft to the fossa-eminence region. Preoperative and 2-years postoperative clinical findings and magnetic resonance features were evaluated in a group of 13 patients (fourteen joints). RESULTS: In this series, a significant decrease of pain level (p<0.0001) was observed from the first month postoperatively whereas maximal interincisal opening improved significantly (p<0.05) after three months follow-up. Radiographically, the magnetic resonance imaging two years after surgery showed an increase on the condylar features of sclerosis and flattening. CONCLUSION: Discectomy and auricular cartilage interposition graft is an acceptable method for cases of temporomandibular joint dysfunction refractory to the arthroscopic treatment but progressive degenerative changes can be observed after this technique. Although this technique is a surgical option for patients with non-reducing displaced TMJ articular discs, the high failure rate indicates that there may be better alternative surgical procedures to consider.

Uso del plasma rico en factores de crecimiento para el tratamiento y prevención de la osteonecrosis mandibular derivada del uso de bifosfonatos / Use of platelet rich in growth factors in the treatment and prevention of osteonecrosis of the jaws in pacients with biphosphonate

Los bifosfonatos (BFs) son fármacos que se utilizan en el tratamiento y prevención de enfermedades relacionadas con el metabolismo óseo. En 2003 se observa, por primera vez, una relación entre la osteonecrosis mandibular (ONJ) y la ingesta de BFs, surgiendo así el concepto BRONJ (biphosphonate-related osteonecrosis of the jaw). Recientemente el uso del plasma rico en factores de crecimiento (PRGF) se ha introducido en el mundo de la odontología por su capacidad regeneradora de tejidos blandos; sin embargo, su papel en el proceso de regeneración de lesiones producidas por cirugías odontológicas está aún por determinar. El objetivo de esta revisión radica en evaluar la eficacia del PRGF en la realización de actos quirúrgicos en pacientes con BRONJ (AU)

Biphosphonates are a commonly used class of drug in the treatment and prevention of diseases-related bone turn over. By the first time, in 2003, the relation between biphosphonates consumption and develop of osteonecrosis of the jaw (ONJ) was established, bring into being the concept of biphosphonate-related osteonecrosis of the jaws (BRONJ). Recently, plasma rich in growth factors (PRGF) has been introduced in dentistry procedures by its regenerative soft tissues capacities; however, its paper in regenerative procedures when surgical lesions appear is still unclear (AU)

Quiste de klestadt. Revisión de la literatura y presentación de un caso / Klestadt cyst. Review of the literature and presentation of a case

El quiste nasolabial es un quiste muy infrecuente, no odontogénico y que tradicionalmente se ha clasificado dentro de los llamados fisurados. Su etiología es desconocida, se supone que este origen puede estar en la línea de fusión de los procesos frontonasal y maxilares, por retención de restos ectodérmicos. Clínicamente se observa una tumefacción de crecimiento lento, consistencia blanda que produce elevación del ala de la nariz y es asintomático, a no ser que exista infección. En algunos casos de gran expansión se puede llegar a producir una reabsorción ósea del proceso alveolar. Para el diagnóstico son necesarias tomografías computerizadas o resonancias magnéticas, con la finalidad de estudiar los tejidos blandos. El tratamiento de la lesión habitualmente consiste en su resección quirúrgica a través de un acceso intraoral sublabial. Se preenta un caso clínico de una paciente de 66 años de edad que acude a consulta con un aumento de volumen de la narina izquierda y rinorrea derecha. A la exploración extraoral se observa un nódulo en el vestíbulo a nivel de la narina izquierda. Tras el estudio radiológico se conculye que la lesión es compatible con un quiste nasolabial, por lo que se procede asu exéresis mediante abordaje intraoral sublabial. Posteriormente, el análisis anatomopatlogico confirmó el diagnóstico de presunción

The nasolabial cyst is a very infrequent cyst, not odontogenic, that traditionally has been classified within those called fissured. Itsetiology is unknown and signifies that this origin can be in the fusion line of the frontonasal and maxillary processes, due to retention of ectodermal residue. Clinically, a swelling of slow growth and softconsistency is observed that produces the elevation of the lateral part of the nostril and it is asymptomatic, unless there is infection. In some cases of large expansion it can produce an osseous resorption of the alveolar process. For the diagnosis computerized tomographs or magnetic resonances are necessary, for the purpose of studying the soft tissues. The treatment of the lesion usually consists of surgical resection through an intraoralsublabial access. A clinical case is presented of a patient of66 years of age, who comes to the consultation with an increase of the volume of the left nostril and right rhinorrhoea. In the extraoral examination a nodule is observed in the vestibule at the level of the left nostril. After the radiological study it is concluded that the lesion is compatible with a nasolabial cyst, which was removed through a sublabial intraoral approach. Afterwards, the anatomopathological analysis confirmed the presumed diagnosis

Retraso en el tratamiento quirúrgico de premolares supernumerarios incluidos. Un riesgo evitable / Delay in the surgical treatment of impacted supernumerary premolars. An avoidable risk

Los dientes supernumerarios son dientes adicionales a la dentición permanente convencional. A este fenómeno se le puede denominar hiperodoncia. La etiología de los dientes supernumerarios es desconocida, sin embargo, se han postulado algunas teorías para intentar explicar supresencia. Las dos teorías más aceptadas son: la teoría de la hiperactividad de las células epiteliales embrionarias y la teoría de la escisión del folículo dental. Se puede afirmar que la presencia de supernumerarios en dentición permanente es mayor que en dentición temporal, con predilección por la premaxila. El hallazgo de supernumerario es más común en hombres que en mujeres, con una proporción, según la literatura revisada, de2:1.En la mayoría de los casos son asintomáticos y descubiertos en un examen radiográfico de rutina aunque pueden sospecharse por palpación, abombamiento en alguna de las corticales o por alteración en la erupción de los dientes adyacentes. El tratamiento de un supernumerario normalmente es la extracción, por motivos estéticos, funcionales, y para evitar posibles complicaciones. En algunos casos es necessario un tratamiento ortodóncico. El caso clínico que presentamos es un paciente varón de 19 años de edad que tras tratamiento ortodóncico fue diagnosticado de dos premolares supernumerario mandibulares y cuyo retraso en el tratamiento implicó mayores riesgos intraoperarios

The supernumerary teeth are additional teeth to the conventional normal dentition. This phenomenon can be called hyperdontia. The etiology of supernumerary teeth is unknown; however, some theories have been put forward to try to explain their presence. The two most accepted theories are: the theory of hyperactivity of the embryonic epithelial cells and the theory of the splitting of the dental follicle. It can be affirmed that the presence of supernumeraries in permanent teeth is greater than in temporary teeth, with a predilection for the premaxilla. The finding of supernumerary teeth is more common in men than in women, with a proportion, according to the literature reviewed, of 2:1.In the majority of the cases, they area symptomatic and are discovered through a routine radiographic examination although they can be suspected by palpation, ballooning in some of the cortical areas or through alteration in the eruption of the adjacent teeth. The treatment of a supernumerary is normally the extraction, for aesthetic and and functional reasons, and to avoid possible complications. In some cases orthodontic treatment is necessary. The clinical case that we present if of a male patient of 19 years of age who, afeter orthodontic treatment, was diagnosed with two mandibular supernumarary premolars and whose delay in the treatment involved greater intraoperatory risks

Manejo quirúrgico en segundos molares inferiores impactados. A propósito de un caso / Surgical management of impacted second mandibular molars. A case report

La impactación dental es uno de los principales trastornos eruptivos, principalmente en terceros molares y caninos. En el caso de los segundos molares inferiores es poco frecuente, con una incidencia de 0,03-0,21%. Con respecto a la localización, es más habitual en mandíbula que en maxilar, de forma unilateral, con inclinación mesial y ligera predilección por el sexo masculino. La etiología de los molares impactados va a estar relacionada principalmente con una falta de espacio en la arcada, lo que va a impedir su correcta erupción. Esta impactación conlleva problemas estéticos, masticatorios y alteraciones en dientes adyacentes como lesiones cariosas, reabsorciones y patología periodontal. Se han descrito varias opciones terapéuticas para tratar la impactación de los segundos molares inferiores, desde su exodoncia, hasta la combinación de técnicas (..) (AU)

Dental impaction is one of the main eruptive pathologies, which occurs mainly in third molars and canines. In the case of the lower second molars it has a low frequency, within incidence of 0.03 to 0.21%. With regards to the location, it is more common in the mandible molars than in the maxilla, in unilateral form, with mesial inclination and with slight predilection for masculine sex. The etiology of the impacted molars is related mainly to a lack of space in the arches that will prevent its correct eruption. This impaction entails aesthetic, masticatory problems and alterations in adjacent teeth such as carious lesions, tooth resorption and periodontal loss of attachment. Literature has described different therapeutics approaches to deal with the impaction of the lower second molars, these go from their (..) (AU)

¿Tienen nuestros ancianos un adecuado estado nutricional? ¿Influye su institucionalización? / Do our elderly have an adequate nutritional status?

Determinar el estado nutricional de los ancianos de un área de salud rural y ver si la institucionalización es un factor de riesgo. Diseño del estudio: Estudio observacional descriptivo en SAP de Xinzo de Limia 3. Sujetos: El tamaño muestral fue de 311 pacientes mayores de 75 años, seleccionados por muestreo aleatorio simple. Mediciones: Edad, sexo, estado civil, nivel de estudios, institucionalización o no, estado nutricional: valorado mediante el cuestionario MNA y parámetros antropométricos; apoyo social: medido mediante la escala de Duke- Unc; Calidad de vida: con la escala Euro-Quol; patologías asociadas; trastornos de la deglución; tratamiento habitual: tipo de dieta, fármacos. Resultados principales: La mediana de edad era de 82,55 años (DT 4,83 años) y el 51,8% eran mujeres, el 52,7% estaba casado y el 76,8% referían estudios primarios. La mediana de patologías por individuo era del 3 (DT: 1,42) y del número de fármacos usados era de 4 (DT 2,44). El 54,70% vivía acompañado por su pareja u otro familiar. Estaban institucionalizados el 17,4%. La mediana de calidad de vida era de 6,84. Según los resultados del MNA no encontramos ningún caso de desnutrición, pero un 20.3% de los pacientes presentan valores de riesgo. En el análisis multivariante encontramos relación entre la presencia o no de desnutrición y la institucionalización OR = 0,40 (IC 95%, 0,180,87), con el no de patologías OR = 1,30 (IC 95%, 1,03-1,64), calidad de vida OR = 1,40 (IC 95%, 1,14-1,71). Conclusiones: Los pacientes ancianos validos estudiados presentan un buen estado nutricional. Los pacientes con riesgo de presentar desnutrición son un 20,3%, siendo la institucionalización, los mayores de 85 años con mayor número de patologías los que presentan mayor riesgo de desnutrición. La peor calidad de vida y el menor apoyo social influyen negativamente (AU)

Determine the prevalence of malnutrition in valid adults older than 75 years old in Xinzo (Spain), and study institutionalization as a possible risk factor of malnutrition. Methods: This is a cross-sectional study of prevalence. Sample: 311 people over 75 years. Variables studied: Age, gender, marital status, education level, institutionalization or not, nutritional status (MNA and anthropometric parameters), social support (Duke- Unc scale), Quality of life (Euro- Quol scale); associated diseases, swallowing problems, type of diet and medications. Results: The median age was 82.55 years (SD: 4.83), 51.8% were women. The 52.7% were married, regarding the educational level, 76.8% had completed the primary education. The 17.4% were institutionalized. The median of pathologies was 3 (SD:1.42 and the number of drugs for individual was 4 (SD:2.44). The 54.70% lived with another family or partner. The median of quality of life was 6.84. According to the results of the MNA did not find any case of malnutrition, but a 20.3% of patients present values of risk. Multivariate analysis found relationship between the presence or not of malnutrition and the institutionalization OR = 0.403 (95% CI: 0.186-0.872), the number of pathologies OR = 1.301 (95% CI: 1.032-1.641), quality of life OR = 1.401 (95% CI: 1.145-1.716). Conclusion: Our valid elders are well nourished. The age, a good quality of life and a good support are protective factors. The risk of malnutrition is associated to a higher age, to institutionalization and to higher number of pathologies (AU)

Sinusitis maxilar derecha, fractura de suelo de órbita y de la apófisis Pterigoides como complicación inusual en la exodoncia de un tercer molar superior derecho incluido. A propósito de un caso / Right maxillary sinusitis, fracture of orbital floor and of the pterygoid process as an unusual complication in the extraction of an impacted upper right third molar. A case report

La cirugía del tercer molar incluido no está exenta de complicaciones. Estas pueden ser: intraoperatorias, mediatas o tardías. En el caso que se presenta se expone una complicación inusual en la exodoncia del tercer molar superior, una sinusitis maxilar derecha, fractura de suelo de órbita y de la apófisis pterigoides de forma accidental por el desplazamiento del luxador al interior del seno maxilar durante la exodoncia quirúrgica del tercer molar superior derecho (AU)

The surgery of the impacted third molar isnot exempted from complications. These can be: intraoperative, mediate or late. In the event it arises, it presents an unusual complication in the extraction of the upper third molar, right maxillary sinusitis, accidental fracture of the orbital floor and pterygoid process due to the displacement of the luxator to the interior of the maxillary sinus during the surgical extraction of the upper right third molar (AU)

Retirada de implante endosinusal mediante abordaje endoscópico. A propósito de un caso / Endosinusal implant removal by endoscopic approach. A case report

La rehabilitación mediante implantes dentales en pacientes con atrofia ósea en sectores posteriores del maxilar superior supone un reto para el clínico en la práctica diaria. La elevación sinusal, suele ser el procedimiento quirúrgico de elección para el manejo de estas situaciones y posibilita una adecuada rehabilitación implanto soportada. La migración de un implante al espacio antral es una complicación poco común que puede asociarse a la elevación sinusal. Han sido descritas numerosas técnicas para la retirada de implantes desplazados al antromaxilar y, entre ellas, destaca por su reciente incorporación y por su escasa morbilidad el abordaje endoscópico endosinusal. Se presenta el caso clínico de un paciente que fue derivado al servicio de Cirugía Oral y Maxilofacial del Hospital Universitario Madrid-Montepríncipe con diagnóstico de sinusitis aguda producida por un implante (..) (AU)

Rehabilitation with dental implants inpatients with bone atrophy of the posterior maxilla is a challenge that the clinician is faced frequently in daily practice. Sinus lift is a surgical procedure of choice for managing these situations and enables adequate implant rehabilitation. The migration of an implant antral space is a rare complication that may be associated with the technique of lifting the maxillary sinus. Many techniques have been described for removal of implants in the maxillary antrum displaced, among them, is distinguished by its recent incorporation and its low morbidity, the endoscopic approach endosinusal A case report of a patient who was referred (..) (AU)

Inclusión de un canino por la presencia de un supernumerario y un odontoma complejo / Impaction of a canine due to the presence of a supernumerary tooth and a complex odontoma

La retención dentaria se define como la detención total o parcial de la erupción de un diente dentro del intervalo de tiempo esperado en relación con la edad del paciente. Incluye tanto los dientes en proceso de erupción como los impactados. La segunda retención más frecuente es la de los caninos, tras los terceros molares inferiores, se localizan en un 85% en el maxilar, un 15%en mandíbula y es más frecuente en el sexo femenino. El diagnóstico de los dientes retenidos, delos dientes supernumerarios y de los tumores odontogénicos, es radiológico, suele realizarse de forma casual en controles rutinarios, o como prueba complementaria ante alteraciones de la erupción, alteraciones intraorales o signos y síntomas de inclusión dentaria. Se presenta un caso clínico con una inclusión del 33 asociado a un supernumerario ya un odontoma. Paciente varón de trece (..) (AU)

Tooth retention is defined as the total or partial stoppage of the eruption of a tooth within the interval of time expected in relation to the patient's age. It includes the teeth in the process of eruption as well as the impacted teeth. The second most frequent retention is that of the canines, following the lower third molars, 85% of which are located in the maxilla, 15% in the mandible and they are more frequent in females. The diagnosis of tooth retention, of supernumerary teeth and of the odontogenic tumours is radiological, usually found by chance in routine checkups, or as a complementary test in the event of disorders in the eruption, intraoral alterations or signs or symptoms of dental impaction. A clinical case is presented with the impaction of the 33 associated to a supernumerary tooth and to an odontoma. Male patient of (..) (AU)

Importancia en el diagnóstico temprano del quiste dentígero; a propósito de un caso / Importance of early diagnosis of dentigerous cysts; a case study

El quiste dentígero, también denominado folicular, es un quiste odontogénico de origen epitelial. Es el segundo quiste odontogénico más común, después del quiste radicular. Los dientes más frecuentemente afectados son los terceros molares mandibulares, caninos maxilares y segundos premolares mandibulares. Se relacionan con la corona de un diente en desarrollo, no erupcionado o incluido. Se presenta un caso clínico de un quiste dentígero en una paciente, mujer, de 58años de edad. A la exploración extraoral no se apreciaron signos relevantes. A la exploración intraoral se observó una tumefacción no dolorosa relacionada con el cordal inferior izquierdo impactado. La exéresis del quiste fue realizada bajo anestesia general. El diagnóstico anatomopatológico, que confirmaba el diagnóstico de presunción, reveló un quiste dentígero. La exodoncia de terceros molares incluidos es una práctica rutinaria en el gabinete (..) (AU)

The dentigerous cyst, also called follicular, is an odontogenic cyst of epithelial origin. It is the second most common odontogenic cyst, following the radicular cyst. The most frequently affected teeth are the mandibular third molars, maxillary canines and mandibular second premolars. They are related to the crown of a developing, not erupting or impacted tooth. A clinical case is presented of a dentigerouscyst in a patient, female, 58 years of age. No relevant signs were observed in the extraoral examination. In the intraoral examination, a non-painful numbness was observed, related to the impacted left lower third molar. The exeresis of the cyst was performed under general anaesthesia. The anatomopathological diagnosis, which confirmed the (..) (AU)

Trastornos eruptivos de segundos molares y terceros molares incluidos. A propósito de un caso / Eruptive disorders of impacted second and third molars. A case study

La literatura determina, que el diente incluido es aquel que permanece completamente rodeado de hueso. Por ello, la erupción fisiológica del molar es interrumpida por diferentes factores que pueden ser de origen físico, dentario, óseo y sistémico. La incidencia de segundos molares inferiores retenidos relacionados con la inclusión de los terceros molares adyacentes, se establece alrededor del 6%.Se presenta un caso clínico donde se exodoncian los segundos y terceros molares del tercer y cuarto cuadrante cerca de la basal mandibular (AU)

The literature determines that the impacted tooth is that which remains completely surrounded by bone. For this reason, the physiological eruption of the molar is interrupted by different factors that may be of a physical, dental, bone and systemic origin. The incidence of retained lower second molars related with the impaction of the adjacent third molars is established at around6%. A clinical case is presented where the second and third molars are extracted from the third and fourth quadrant near the mandibular base (AU)