Percepción de los estudiantes del grado de Odontología sobre la utilización de un sistema de respuesta interactiva (Kahoot) / Perception of students in dentistry degree on the use of an interactive response system (Kahoot)

Introducción: La adquisición de competencia clínica de diagnóstico en el alumnado de grado de Odontología debe potenciarse con metodologías docentes que le permitan realizar un aprendizaje continuo y autónomo de las materias clínicas. Objetivo: El objetivo del presente trabajo es analizar la percepción de los estudiantes sobre la utilización de la herramienta Kahoot® en la asignatura de Medicina Oral (tercer curso del grado) como estrategia educativa para el reconocimiento de lesiones orales mediante la realización de una encuesta de satisfacción sobre su uso. La herramienta Kahoot® permite a los docentes plantear cuestiones de respuesta múltiple o de verdadero-falso que los alumnos deben responder en un tiempo limitado a través de sus ordenadores personales, teléfonos móviles u otros dispositivos electrónicos conectados a la red wifi. Tras cada respuesta, la herramienta registra la opción correcta y los resultados obtenidos por cada alumno/a, así como su puntuación final y la global del grupo. Materiales y método: Empleamos Kahoot® en cinco de las unidades temáticas del programa durante las clases expositivas. Posteriormente, realizamos al alumnado un test de valoración mediante una escala de tipo Likert (1-5) para registrar la facilidad de utilización y la satisfacción de uso. Resultados: Los resultados obtenidos en los ítems facilidad de uso del sistema (4,31 ± 0,74), motivación (4,18 ± 0,75) y capacidad para aclarar conocimientos (4,13 ± 0,61) muestran una valoración positiva por el alumnado. Conclusiones: Esta metodología de aprendizaje a partir de juegos ha favorecido la enseñanza de conceptos teórico-prácticos y la adquisición de competencias transversales y específicas del grado de Odontología, además de fomentar la participación y el aprendizaje en el aula, lo que orienta al alumnado sobre los principales contenidos del programa y permite una evaluación interactiva de su rendimiento.(AU)

Introduction: The acquisition of clinical diagnostic competence in undergraduate Dentistry students must be enhanced with teaching methodologies that allow them to carry out continuous and autonomous learning of clinical subjects. Aim: The objective of this work is to analyze the students’ perception of the use of the Kahoot® tool in the subject of Oral Medicine (3rd year of the Degree) as an educational strategy for the recognition of oral lesions by conducting a satisfaction survey on its use. The Kahoot® tool allows teachers to pose multiple-answer, or true-false, questions that students must answer in a limited time through their personal computers, mobile phones, or other electronic devices connected to the wifi network. After each answer, the tool records the correct option and the results obtained by each student, as well as their final score and the overall score for the group. Materials and methods: We used Kahoot® in 5 of the thematic units of the program during the lectures/expositive classes. Subsequently, we performed an assessment test on the students using a Likert scale (1-5) to record ease of use and satisfaction with use. Results: The results obtained in the items ease of use of the system (4.31 ± 0.74), motivation (4.18 ± 0.75) and ability to clarify knowledge (4.13 ± 0.61) show the assessment positive by the students. Conclusions: This learning methodology based on games has favored the learning of theoretical-practical concepts and the acquisition of transversal and specific competences of the degree of Dentistry in addition to promoting participation and learning in the classroom, guiding the students on the main contents of the program allowing a interactive evaluation of student performance.(AU)

20 years of alveolar distraction: A systematic review of the literature.

BACKGROUND: The Vertical Alveolar Distraction Osteogenesis (VADO) technique is an excellent solution for bone and soft tissue neoformation in areas in which there has been significant bone atrophy that hinders normal rehabilitation using dental implants. The goal of this systematic review is to analyze the most relevant articles published on VADO in the literature over the past 20 years. MATERIAL AND METHODS: The review was performed by using the keywords: "alveolar ridge", "distraction ostegenesis" and "dental implant". This search produced a total result of 240 articles. The clinical studies and cases reported in humans amounted to 113 articles, 18 articles referred to studies developed on animals and 33 review articles. The presentation of this systematic analysis follows the criteria described in the PRISMA declaration. RESULTS: 22 articles complied with the inclusion criteria and 7 articles more were added manually, reaching a total sample of 29 studies. Following the analysis of the studies, they were classified into 18 high-quality, 10 mediumquality and 1 low-quality study. Only 4 studies achieved a maximum score of 9 (according to NewCastle Ottawa Scale, NOS). CONCLUSIONS: VADO is a technique with greater potential in vertical gain. The performance of dental implants has a success and survival rate similar to dental implants placed on bones that are not subject to increase techniques.

Survival study of leukoplakia malignant transformation in a region of northern Spain.

BACKGROUND: Oral leukoplakia is the most common potentially malignant disorder (PMD) of the oral cavity. The objectives of this study are to determine the clinicopathologic features in a group of patients with oral leukoplakia of Northern Spain (Galicia), determining the factors associated to clinical risk and analyzing the malignant transformation of these patients. MATERIAL AND METHODS: We included 85 patients. We recorded sex and age, habits like alcohol and tobacco, size, clinical appearance, site, number of lesions, and presence or absence of dysplasia. We assess the association between risk factors and transformation and developed a logistic regression analysis. Finally we used the Kaplan-Meier and log-rank test for the survival analysis. RESULTS: 7 patients (8.2%) had malignant transformation. The mean follow-up of the patients was 4.13 years versus 5.58 years of those who developed carcinoma. Only location and initial dysplasia have a statistically significant relationship with malignant transformation, but when applied the long rank test only the presence of dysplasia remains statistically significant(P<0,026). Oral Cancer Free Survival was 81.9% (0.150) at 11 years for the group without dysplasia. CONCLUSIONS: We found that the presence of dysplasia is the only risk factor that is statistically related to the development of a carcinoma.

The use of tissue microarrays for semiquantitative evaluation of ATPaseC1 expression is ineffective.

We described earlier the possible role of ATPaseC1 expression as a diagnostic and prognostic marker for oral cancer; others have reported its use for tumors of the lung and breast. We assessed ATPaseC1 expression in a sample of oral squamous cell carcinoma (OSCC) using tissue microarrays (TMAs) to analyze the relation between ATPaseC1 expression and clinical, histopathological and prognostic parameters. We performed a retrospective study of 48 cases of OSCC. We constructed TMAs using two different regions of each tumor. V-ATPaseC1 immunohistochemistry was performed and assessed semiquantitatively. ATPaseC1 staining was observed in most of the neoplastic cells in all tumors. Staining was diffusely cytoplasmic and, to a lesser extent, nuclear. The degree of concordance between the measurements performed in tissue microarray 1 (TMA1) and tissue microarray 2 (TMA2), as evaluated using the intra-class correlation coefficient (ICC), was low. We found great variability in the immunohistochemical staining of the different regions of each tumor. We found 16 cases with mild expression (33.3%), 20 with moderate expression (41.7%) and 12 with intense expression (25%). Differences in the clinical-pathological variables studied were not statistically significant. The difficulty of immunohistochemical evaluation, the heterogeneity of the carcinomas and the fact that evaluation of expression requires semiquantitative analysis render the reliability of the results obtained from TMA-based techniques questionable.

The use of CA-IX as a diagnostic method for oral leukoplakia.

The presence and degree of dysplasia are important diagnostic and prognostic criteria for oral leukoplakia, but evaluation of dysplasia is difficult and subjective. Carbonic anhydrase-IX (CA-IX) is expressed primarily in tumor cells and is considered a specific hypoxia marker. We investigated the role of CA-IX in oral leukoplakia. We investigated 30 specimens of oral leukoplakia and 35 dysplasia specimens adjacent to the tumor margin. We analyzed clinical variables including age, sex, degree of dysplasia, and smoking, clinical appearance of leukoplakia, number of lesions, location, size, clinical monitoring, malignant transformation and recurrence. For the immunohistochemical study, we used a noncommercial monoclonal antibody against human CA-IX MAb M75. We found greater CA-IX positivity in nonsmokers, erythroplakia and mottled leukoplakia, those located on the tongue, patients with multiple lesions, 2-4 cm leukoplakias and in recurrent cases, although differences were not statistically significant. All lesions in all samples without dysplasia were negative for CA-IX; however, for all other categories of dysplasia, the percentages of positivity and negativity varied. Regarding the diagnostic index values, we found a sensitivity of 32%, specificity of 100%, a positive predictive value of 100% and a negative predictive value of 13%. Leukoplakias appear mainly in females and potentially are malignant; more than 90% have some degree of dysplasia, and therefore require close clinical and histopathological monitoring. The CA-IX immunohistochemical marker may be useful for screening samples without dysplasia owing to its high specificity.

Repeatability and accuracy of a paralleling technique for radiographic evaluation of distal bone healing after impacted third molar surgery.

OBJECTIVES: The purpose of this study was to investigate the repeatability and radiographic accuracy of an intraoral paralleling technique to evaluate periodontal bone healing on the distal surface of the second mandibular molar (2 Mm) after impacted third mandibular molar (3 Mm) surgical extraction. METHODS: In order to estimate the variation in different radiographs, three replicas were made, each from 2 Mm, totalling 69 radiographic radicular longitude (RRL) recordings. One operator performed the periapical radiographs in a standard manner, utilizing a modified posterior film holder for the radiographic technique of parallelism, applied on the posterior region with the X-ray beam focused on the centre of 2 Mm. These radiographic recordings of the same region were obtained on three different and separate occasions, over a 12 month evaluation period after surgical extraction of the impacted 3 Mm. The RRL variable was measured and recorded three times by the same operator, with side-by-side comparison of three posterior periapical radiographs, irrespective of when the assessments were performed. RESULTS: There were no statistically significant differences between the three replica recordings (p = 0.969). The correlations between the three sets of measurements were evaluated and found to be highly associated (intraclass correlation reliability coefficient = 0.90) and statistically significant (p≤0.05). The median and mean error of the radiographic technique evaluated was ±0.257 mm and ±0.347 mm, respectively. CONCLUSIONS: The radiographic technique described permits standardization in periapical radiographs with a high repeatability and accuracy in posterior radiographic records (distal surface of 2 Mm) over a postoperative evaluation period of 12 months.

The osteoinductive potential of MTA (Mineral Trioxide Aggregate): a histologic study in rabbits

The objective of this study was to investigatebone response after implantation of MTA (MineralTrioxide Aggregate) in the rabbit mandible.Experiments were carried out on the rightmandibular body of 8 adult male rabbits. Theanimals were divided into two groups (controlgroup and test group). In this in vivo study, MTAwas used as an interpositional graft material incritical-size bone defects of rabbit mandibles.The animals were sacrificed on day 30 after surgery.The samples obtained from the mandibleswere subjected to histological procedures, whichpermitted the collection of sections with a thicknessof 60±10ìm. The sections were stained withHaematoxylin and Eosin and Goldner Trichromestain and examined under a light microscope.No important inflammatory reactions weredetected in any of the samples of the treatedgroup. The results confirm the excellent biocompatibilityof MTA. The implantation of MTA inbone defects led to bone regeneration 4 weeksafter surgery. However, the growth rate was notsignificant and the amount of newly formed bonewas limited with the use of MTA in this specificapplication. Sample examination did not suggestcomplete evidence of new bone growth from eitheran inductive or conductive perspective.The objective of this study was to investigatebone response after implantation of MTA (MineralTrioxide Aggregate) in the rabbit mandible.Experiments were carried out on the rightmandibular body of 8 adult male rabbits. Theanimals were divided into two groups (controlgroup and test group). In this in vivo study, MTAwas used as an interpositional graft material incritical-size bone defects of rabbit mandibles.The animals were sacrificed on day 30 after surgery.The samples obtained from the mandibleswere subjected to histological procedures, whichpermitted the collection of sections with a thicknessof 60+-10microm. The sections were stained withHaematoxylin and Eosin and Goldner Trichromestain and examined under a light microscope.No important inflammatory reactions weredetected in any of the samples of the treatedgroup. The results confirm the excellent biocompatibilityof MTA. The implantation of MTA inbone defects led to bone regeneration 4 weeksafter surgery. However, the growth rate was notsignificant and the amount of newly formed bonewas limited with the use of MTA in this specificapplication. Sample examination did not suggestcomplete evidence of new bone growth from eitheran inductive or conductive perspective

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La enfermedad periodontal y su potencial repercusión sobre el riesgo de prematuridad / Periodontal disease and its potential repercussion on the risk of prematurity

La salud bucal materna tiene influencia sobre el feto; así, la presencia de enfermedad periodontal en las embarazadas se ha relacionado con nacimientos prematuros y/o de bajo peso (PBP). La determinación de los factores de riesgo de nacimientos de bajo peso representa una prioridad de salud pública por sus implicaciones en la supervivencia, crecimiento y maduración de estos niños. La enfermedad periodontal es una enfermedad infecciosa localizada en el periodonto y causada predominantemente por bacterias Gramnegativas, anaeróbicas y microaerofílicas. La inflamación de los tejidos periodontales produce citoquinas pro-inflamatorias, principalmente interleuquina-'beta (IL-1ß), IL-6, prostaglandina E2 (PG-E2) y factor de necrosis tumoral alfa (TMN-alfa), que podrían tener efectos sistémicos en el huésped. El mecanismo etiopatogénico por el que la enfermedad periodontal podría causar PBP no está todavía completamente aclarado. El objetivo del presente trabajo es realizar una revisión bibliográfica de los últimos estudios en relación con esta patología neonatal (AU)

Mandibular nerve paresthesia caused by endodontic treatment.

The paresthesias of the inferior dental nerve consists of a complication that can occur after performing various dental procedures such as cystectomies, extraction of impacted teeth, apicoectomies, endodontic treatments, local anesthetic deposition, preprosthetic or implantologic surgery. The possible mechanisms of nervous lesions are mechanical, chemical and thermal. Mechanical injury includes compression, stretching, partial or total resection and laceration. The lesion can cause a discontinuity to the nerve with Wallerian degeneration of the distal and integrated fibers of the covering (axonotmesis) or can cause the total sectioning of the nerve (neurotmesis). Chemical trauma can be due to certain toxic components of the endodontic filling materials (paraformaldehyde, corticoids or eugenol) and irrigating solutions (sodium hypochlorite) or local anesthetics. Thermal injury is a consequence of bone overheating during the execution of surgical techniques. We present a clinical case of paresthesia of the inferior dental nerve after the introduction of a gutta-percha point in the mandibular canal during the performance of a root canal therapy of the inferior first molar. The etiology and the treatment of this endodontic complication are described.

Una nueva responsabilidad para los odontólogos en el tratamiento del paciente irradiado / a new responsability for dentist managing the irradiated patient

Los tumores malignos del tracto superior respiratorio y digestivo son frecuentes en España. Los pacientes que padecen estas enfermedades oncológicas, frecuentemente, reciben radioterapia en la boca, cara y cuello para su tratamiento. Clásicamente, los odontólogos han participado en el cuidado de estos pacientes para identificar las recidivas o nuevas lesiones de cáncer y prevenir las caries rampantes y la patología periodontal florida asociada a la xerostomía provocada por el deterioro postirradiación de las glándulas salivales. Además la radioterapi también lesiona la arteria carótida cervical acelerando el proceso de arterioesclerosis. Los odontólogos deben examinar, detenidamente, las radiografías panorámicas de estos pacientes para evidenciar la existencia de ateromas calcificados carotídeos que pueden provocar un desenlace fatal o un accidente cerebrovascular incapacitante (AU)

Efficacy of chlorhexidine mouthrinses with and without alcohol: a clinical study.

BACKGROUND: Plaque control is the main method for preventing periodontal diseases. Chlorhexidine digluconate mouthrinse is widely recognized as helping to maintain plaque control. Most of these mouthrinses contain alcohol, making them impractical for many patients, including those with oral mucosal hypersensitivity. Mouthrinses without alcohol might cause fewer side effects, but also be less efficient. In this study, we evaluated the efficacy of a 0.12% chlorhexidine mouthrinse without alcohol against one with 11% ethanol and a placebo. METHODS: This a double-blind, parallel group study with 96 patients who tested 3 mouthrinses containing 1) chlorhexidine digluconate 0.12% sodium fluoride 0.05%, and ethanol 11% (group 1; CHX-A); 2) the same solution without alcohol (group 2; CHX-NA); and a placebo (group 3; P). Plaque and bleeding indexes were recorded in all patients prior to treatment and at 14 and 28 days. RESULTS: There were significant differences in plaque, gingivitis, and papilla bleeding indexes in both chlorhexidine rinses compared to placebo, but no differences between the 2 CHX products. CONCLUSIONS: In this study, the alcohol-free rinse was as effective as one containing alcohol in controlling plaque and reducing gingival inflammation. Therefore, it would seem that its use can be recommended in all patients, but especially in patients for whom the use of alcohol is contraindicated.

Lupus eritematoso discoide con gingivitis descamativa crónica. Presentación de un caso clínico con histopatología e ininunofluorescencia / Discoid lupus erythematosus with chronic desquamative gingivitis. A case report and histopathological and immunofluorescent study

Se presenta el caso clínico de una paciente a de 55 años de edad con lesiones orales y cutáneas de lupus eritematoso discoide (LED), con la rara particularidad de presentar además uña afectación gingival en forma de gingivitis descamativa crónica (GDC), que no es una manifestación característica del lupus eritematoso y de la que hasta el momento no hemos encontrado ningún caso descrito. Se analizan las características clínicas de las- lesiones orales y cutáneas presentes en nuestra paciente, comentando los hallazgos clínicos e histopatológicos de esta rara asociación. La gingivitis descamativa crónica no se considera una entidad clínica independiente, sino una manifestación crónica inespecífica de diferentes procesos patológicos, fundamentalmente de las dermatopatías con lesiones orales. Se revisan las entidades que pueden concurrir o debutar con una gingivitis descamativa crónica y los criterios histopatológicos del diagnóstico de la lesión discoide del lupus eritematoso. Se valora la importancia de la inmunofluorescencia directa en el diagnóstico diferencial de las lesiones descritas y se recomienda la indicación de un tratamiento tópico con corticoides siempre que existan lesiones orales, independientemente del tratamiento general de la enfermedad sistémica de base y de las medidas generales de protección solar (AU)

Trismus and pain after removal of impacted lower third molars.

PURPOSE: This study evaluated trismus and pain after removal of impacted lower third molars and investigated whether these responses were related to difficulty of surgery. PATIENTS AND METHODS: A consecutive series of 104 patients, all of whom underwent removal of an impacted lower third molar under local surgery, was studied. Difficulty of surgery was evaluated on a modified version of the Parant scale: I, extraction with forceps only; II, extraction by ostectomy; III, extraction by ostectomy and coronal section; IV, complex procedures. Trismus was evaluated in terms of maximum interincisal distance (MID) 1 and 5 days after surgery. Pain was evaluated on the basis of reported analgesic use 1 and 5 days after surgery. RESULTS: Among group I subjects, mean day 1 MID did not differ significantly (P > .05) from mean presurgery MID, whereas mean day 1 MID in groups II, III, and IV was significantly lower than before surgery. In groups II, III, and IV, mean day 5 MID remained lower than before surgery. The proportion of group I patients using analgesics was significantly lower on both days 1 and 5 than the proportion of patients using analgesics in groups II, III, and IV. In all groups, the proportion of patients using analgesics dropped significantly between days 1 and 5. CONCLUSION: Trismus is less severe after simple (forceps-only, grade I) extractions than after surgical extractions (grades II to IV). However, trismus severity after surgical extraction does not depend on difficulty of surgery. Pain, as revealed by reported analgesic use, is likewise less severe after simple extractions. Regardless of extraction type, pain declines between days 1 and 5 postsurgery.