Use or abuse of antibiotics as prophylactic therapy in oral surgery: A systematic review.

BACKGROUD: Antibiotics are a type of medication routinely prescribed by dental professionals; however, it is very common that the administration is not justified. Around 15% of dentists admit that they have administered antibiotics unnecessarily more than once a week. The objective of this project is to identify the effectiveness of the use of antibiotics as prophylactic therapy in oral surgery, and to carry out an analysis of the alternatives to pharmacological therapy. METHODS: The search strategy was carried out in the PubMed, Scopus, and ScienceDirect databases. For study selection, a first filter was carried out by title and abstract, which mentioned the use of prophylactic antibiotics in some type of oral surgery. To establish the risk of bias, the JBI Critical Appraisal Checklist for Randomized Controlled Trials was utilized. RESULTS: The type of antibiotics most prescribed as prophylactic therapy were beta-lactams, which were indicated in 100% of the studies. Penicillins predominated, observing amoxicillin as the most indicated drug in 54.1% of the studies (n = 13) followed by the use of amoxicillin in conjunction with clavulanic acid in 33.3% of the studies (n = 8). Of the 21 studies included, 17 mention that there is insufficient evidence to support the use of antibiotics as prophylactic therapy in patients who will undergo some type of oral surgery. CONCLUSIONS: Without a doubt, the biggest challenge is to develop academic update strategies aimed at dentists with active clinical practice and dental students from educational and government institutions to provide updated information about the correct use of prescription drugs.

Antimicrobial resistance in odontogenic infections: A protocol for systematic review.

BACKGROUND: It is estimated that up to 90% of head and neck infections have an odontogenic origin, which are considered among the most common in the oral cavity and maxillofacial region. Bacterial resistance has been 1 of the main problems related to the treatment of this type of infection in recent years. The frequency of this resistance is increasing, which is mainly due to patient self-medication and the mutations that bacteria present. Therefore, the objective of this study is to analyze the antimicrobial resistance of antibiotics commonly administered for the treatment of odontogenic infections. METHOD: To carry out the study, PubMed, ScienceDirect, and Scopus databases were reviewed using the keywords "odontogenic infection", "pharmacological treatment", and "microbial resistance. Studies whose main objective was the pharmacological treatment of odontogenic infections were selected. Exclusions were review-type studies, systematic reviews, or in vitro or animal model studies. For the analysis of risk of bias, the Checklist for Analytical Cross-Sectional Studies of the Joanna Briggs Institute was used. The search and analysis of the studies was carried out by 2 researchers independently. RESULTS: A total of 13 studies were included in this review. The mean age was 39.6 years; the location of the infection in the study subjects was in the submandibular and vestibular spaces; there were periodontal, periapical, and dentoalveolar lesions; the main microorganisms identified were Streptococcus, Staphylococcus, Prevotella, Peptostreptococcus, Clostridium, and Klebsiella; and finally, the main microorganisms identified for bacterial resistance were penicillin, clindamycin and amoxicillin. CONCLUSION: The health professional is obliged to update their knowledge to avoid such antibiotic resistance and thus provide better patient care.

COVID-19 and its manifestations in the oral cavity: A systematic review.

BACKGROUND: SARS-CoV-2 is the virus responsible for coronavirus disease-19 (COVID-19) disease, which has been shown to trigger multiple affectations. One of the first tissue areas to come into contact with the virus is the oral cavity, which develops various alterations. Hence, the objective of this systematic review was to identify the main signs and symptoms of this disease in the oral cavity, and the following research question was established: What are the main oral signs and symptoms in COVID-19-positive persons? METHODS: The electronic databases of PUBMED, SCOPUS, and SCIENCE DIRECT were analyzed, the keywords "ORAL DISEASES," "ORAL MANIFESTACTIONS," and "COVID-19" were used taking into account the following inclusion criteria: studies whose main objective was oral manifestations secondary to the confirmation of COVID-19, plus clinical cases, case series, and retrospective or prospective studies. For the assessment of the risk of bias the JBI Critical Appraisal Checklist for Case Series tool was used. RESULTS: A total of 18 studies were included, the most common initial signs/symptoms after contagion of SARS-CoV-2 were dysgeusia, dry mouth, and burning mouth, and the main signs/symptoms were the presence of ulcerative lesions, dysgeusia, and Candida albicans infections. CONCLUSIONS: It is very important to detect any alteration in the mucosa in patients with COVID-19 and to provide assertive treatment to avoid complications, and try to maintain adequate oral hygiene throughout the course of the disease to avoid the colonization of opportunistic microorganisms and to avoid complications both orally and systemically.

Principales Criterios de Diagnóstico de la Nueva Clasificación de Enfermedades y Condiciones Periodontales

RESUMEN: Tener una clasificación de enfermedades periodontales es de gran utilidad para los clínicos al brindar una guía sistematizada de las distintas manifestaciones de los problemas periodontales. La nueva clasificación de enfermedades y condiciones periodontales de 2017 tiene como una de sus características principales la agrupación de la periodontitis con estadios y grados, como manifestación de enfermedades sistémicas y enfermedades periodontales necrosantes; así como la introducción de un apartado que habla de salud y enfermedad peri-implantaria. En el caso de la periodontitis, el estadio se refiere a la severidad de la enfermedad y la complejidad del tratamiento; mientras que el grado se refiere al ritmo del progreso y riesgo de recidiva de la enfermedad, en este trabajo se ofrece una ruta de diagnóstico didáctica y se desarrollan las principales diferencias entre las últimas dos clasificaciones, al tiempo que compartimos la experiencia al implementar esta nueva clasificación en nuestro instituto.

ABSTRACT: Having a classification of periodontal conditions and diseases is a very useful tool for clinicians by providing a systematic guide to different manifestations of periodontal issues. The 2017 classification of periodontal diseases and conditions has as one of the main characteristics the division of the Periodontitis group classified by stage, which assigns the severity and complexity of the treatment, and by grade, which refers to the rhythm of progression and the risk of future relapse; periodontitis as a manifestation of systemic conditions and necrotizing periodontal diseases. As well as the featuring of peri-implant health and diseases. A more didactic route of diagnostic will be given in this publication and the main differences between the last two classifications will be explained, while we share the experience of implementing this new classification in our institute.

Expression of MicroRNAs in Periodontal Disease: A Systematic Review.

INTRODUCTION: Periodontal disease (PD) is a chronic inflammation of the soft tissues that support the structure of the tooth, and miRNAs are highly dynamic molecules that participate in the regulation of gene expression interfering with multiple genetic targets. The dysregulation of the expression of miRNAs has been associated with different types of pathologies; therefore, they are excellent molecules to be studied as biomarkers. Material and Methods. A search was made in the electronic databases of PubMed, Scopus, and Science Direct. The following key words were used: "microRNAs," "miRNAs," "periodontal disease," "periodontitis," and "biomarker"; employee independent search strategies with the Boolean operators "OR" and "AND"; a further search of the references of the selected studies was performed to detect potential studies that met the selection criteria. The data recollected from each article were author, country, year of publication, sample size, type of sample used to identify miRNAs, methodology used to identify miRNAs, type of periodontal disease, and miRNAs identified. RESULTS: Of the 13 selected studies, 6 used gingival tissue as a sample for the identification of miRNAs, 3 used gingival fluid, 2 used saliva, 1 used serum, and another used periodontal tissue. Chronic periodontitis was the most studied periodontal disease in 9 of the 13 selected articles; 7 used microarrays as the main technique for the identification of miRNAs. qRT-PCR was the assay choice to validate the identified miRNAs. CONCLUSION: The main type of periodontal disease on which most studies are focused is chronic periodontitis, with the main miRNAs being hsa-miR-146a, hsa-miR-146b, hsa-miR-155, and hsa-miR-200. This systematic review is one of the first to carry out an analysis of the current role of miRNAs in PD as biomarkers.

Evaluación de higiene oral y características periodontales en pacientes con obesidad: estudio de casos y controles / Evaluation of oral hygiene and periodontal characteristics in patients with obesity: case-control study

Introducción: La obesidad sigue siendo considerada un serio problema de salud pública en el mundo. Aunque es bien sabido que esta condición puede aumentar el riesgo para desarrollar o agravar otras condiciones sistémicas; hoy en día, sigue siendo escasa la información que determine los niveles de asociación entre esta enfermedad sistémica con enfermedades orales como la periodontitis. Objetivo: El objetivo de este estudio fue medir la asociación de pacientes obesos con el desarrollo de periodontitis, así como hábitos de higiene oral. Material y métodos: Se realizó un estudio de casos y controles en 24 pacientes obesos y 24 pacientes sin obesidad. Las variables evaluadas fueron hábitos de higiene bucal, profundidad al sondeo, nivel de inserción clínica y nivel de inflamación gingival. Resultados: Los pacientes obesos tuvieron mayor riesgo para desarrollar bajas frecuencias de cepillado bucal diario (70.8%) y un incremento en la presencia de enfermedad periodontal (70.8%) comparado con los sujetos no obesos (25.0 y 58.3%, respectivamente), lo cual determinó asociaciones estadísticamente significativas (baja frecuencia de cepillado RM = 7.2, IC 95% = 2.0-26.1) y presencia de enfermedad periodontal (RM = 1.7, IC 95% = 0.5-5.7). Conclusiones: Es posible que la obesidad actúe como un factor que facilite la aparición de periodontitis por deficiencias en el cepillado dental diario (AU)

Introduction: Obesity is still considered a serious public health problem in the world. Although it is well known that this condition may increase the risk of developing or aggravating other systemic conditions; nowadays, the information that determines the levels of association between this systemic disease with oral diseases such as periodontitis still scarce. Objective: The objective of this study was to measure the association of obese patients with the development of periodontitis as well as oral hygiene habits. Material and methods: A case-control study was conducted in 24 obese patients and 24 patients without obesity. The variables evaluated were oral hygiene habits, depth of probing, clinical attachment level and gingival inflammation. Results: Obese patients had a higher risk of developing low frequencies of daily oral brushing (70.8%) and an increase in the presence of periodontal disease (70.8%) compared to non-obese subjects (25.0 and 58.3%, respectively) determining statistically significant associations (low frequency of brushing RM = 7.2, 95% CI = 2.0-26.1) and presence of periodontal disease (RM = 1.7, 95% CI = 0.5-5.7). Conclusions: It is possible that obesity acts as a factor that facilitates the presence of periodontitis due to deficiencies in daily toothbrushing (AU)

Conociendo al COVID-19 y la labor odontológica ante la pandemia / Getting to know COVID-19 and dental work in the pandemic

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Frecuencia de Lesiones y Condiciones Orales en Pacientes Mayores de 18 Años en una Clínica de Atención Primaria en México / Frequency of Lesions and Oral Conditions in Patients Older than 18 Years in a Primary Care Clinic in Mexico

RESUMEN: La patología oral es el área de la odontología que se especializa en el diagnóstico y tratamiento de enfermedades orales. Se realizó un estudio transversal, en el cual fueron incluidos pacientes mayores de 18 años que acudieron a una clínica de atención primaria del departamento de estomatología de la universidad Autónoma de Ciudad Juárez, en México y a los cuales independientemente del motivo de consulta se les realizo historia clínica y exploración intraoral detallada. Fueron examinados 650 pacientes (424 mujeres y 226 hombres) con un rango de edad de 18 a 89 años (media=42.27). Las lesiones más frecuentes fueron la queratosis friccional (30,46 %) e hiperplasia fibrosa (6,92 %), la melanosis fisiológica (42,92 %) y los gránulos de Fordyce (36,46 %) fueron las condiciones más identificadas. En las lesiones de la mucosa oral que identificamos estuvo presente el factor traumático de manera crónica, es importante que el odontólogo este familiarizado con las lesiones más frecuentes, con su etiología, características clínicas y tratamiento de cada una de ellas.

ABSTRACT: Oral pathology it's the branch of medicine that focuses on the diagnosis and treatment of oral diseases. A cross-sectional study was carried out in which patients older than 18 years was included, that were attended in the primary care clinic at the stomatology department of the Autonomous University of Ciudad Juárez, in Mexico, and regardless of the reason for consultation the clinical history and intraoral examination was done We examined 650 patients (424 women and 226 men) with an age range of 18 to 89 years (mean=42.27). The most frequent oral lesion was the frictional keratosis (30.46 %), fibrous hyperplasia (6.92 %), physiological melanosis (42.92 %), and fordyce granules (36.46 %). In the oral mucosal lesions identified was present a chronic traumatic factor, it is important that the dental staff knows about the most frequent injuries, their etiology, clinical characteristics and treatment of each one.

Frecuencia de lesiones orales y variantes de lo normal en pacientes del Departamento de Estomatología de la Universidad Autónoma de Ciudad Juárez / Frequency of oral lesions and variants of the normal in patients from the Department of Stomatology, Autonomous University of Ciudad Juarez

Introducción: La exploración intraoral detallada es la clave en el diagnóstico temprano de lesiones potencialmente agresivas; de estamanera, se le ofrece al paciente un tratamiento adecuado y oportuno,reduciendo al máximo posibles complicaciones que pongan en peligrosu integridad y deterioren su calidad de vida. Objetivo: Determinar la frecuencia de lesiones y condiciones de la mucosa bucal en pacientes mayores de 18 años de la clínica de diagnóstico del Departamento de Estomatología de la Universidad Autónoma de Ciudad Juárez, Chihuahua...

Introduction: A detailed intraoral examination is key in the early diagnosis of potentially aggressive lesions; in this way, the patient isoff ered an adequate and timely treatment, reducing to the maximumpossible complications that could endanger his integrity and deterioratehis quality of life. Aim: To determine the frequency of lesions and conditions of the buccal mucosa in patients older than 18 years of the diagnostic clinic of the Department of Stomatology at the Autonomous University of Ciudad Juarez, Chihuahua...

Chronic Suppurative Osteomyelitis of the Mandible Treated with Antibiotics Complemented with Surgical Treatment: A Case Report / Osteomielitis Crónica Supurativa en Mandíbula Tratada con Antibióticos y Cirugía: Reporte de Caso

ABSTRACT: Osteomyelitis is an infection that affects bone and bone marrow, it occurs due to inoculation of microorganisms either directly or by continuous accumulation through a hematogenous way. Female patient, 64 years old, presenting an increase of volume of the parotid masseteric region and right submandibular region, with approximately two weeks of evolution, which had a slightly fluctuating, hyperemic and hyperthermic indurated consistency; the patient complained of severe pain. CT scan and biopsy was indicated. It is imperative to identify the causative agent; the use of antibiotics must be complemented by surgical treatment to eliminate the possibility of a remaining infection.

RESUMEN: La osteomielitis es un proceso infeccioso que afecta al hueso y medula ósea y que se produce debido a la inoculación de microorganismos ya sea de manera directa, por continuidad o bien por medio de la vía hematógena. Paciente femenino de 64 años de edad que presentaba aumento de volumen en región submandibular derecha refiriendo dolor intenso con evolución de 2 semanas aproximadamente, el cual era de consistencia indurada ligeramente fluctuante, hiperémico e hipertérmico; la paciente se quejaba de dolor intenso, se indicó TC y biopsia. En estos casos para tener éxito en el tratamiento el uso de antibióticos debe complementarse con desbridamiento quirúrgico, aunado a un seguimiento estrecho para descartar la posibilidad de una infección remanente.

Periimplantitis: revisión de la literatura / Peri-Implantitis: literature review

El uso de implantes ha tomado un gran auge en los últimos años, sin embargo así como se ha visto un aumento en la demanda también se ha visto un incremento en el fracaso de los mismos, existen múltiples razones que intervienen para esto como son; deficiencias en la cantidad y calidad de hueso, patologías óseas preexistentes, mala técnica quirúrgica, implante inadecuado, hábito tabáquico, entre otras. La mucositis periimplantaria y la periimplantitis son las primeras causas de complicaciones en los implantes, los pacientes con enfermedades crónico degenerativas, fumadores y con mala higiene son considerados pacientes de riesgo para presentar periimplantitis. La literatura ofrece tratamientos quirúrgicos y no quirúrgicos los cuales van enfocados a la eliminación de microorganismos y a la desinfección de la superficie del implante, el tratamiento quirúrgico como la debridación y curetaje tienen la finalidad de eliminar la placa bacteriana, desinfectar la superficie del implante así como retirar el tejido dañado por el proceso inflamatorio, el realizar una adecuada historia clínica y valoración previa, permitirá identificar a los pacientes con mayor o menor riesgo de desarrollar periimplantitis, las citas de mantenimiento ayudan a detectar oportunamente posibles complicaciones.

The use of implants has taken a giant leap in recent years, however, greater demand has also resulted in an increase in the failure of these procedures. There are multiple reasons involved such as; deficiencies in the amount and quality of bone, preexisting bone disease, poor surgical technique, improper implant, tobacco habit, among others. The peri-implant mucositis and peri-implantitis are the main causes of complications in implants, patients with chronic degenerative diseases, smokers and patients with poor oral hygiene are considered risk patients to present peri-implantitis. The literature provides surgical and nonsurgical treatments which are focused on the elimination of microorganisms and the disinfection of the implant surface; surgical treatment as debridement and curettage are designed to remove plaque, disinfect the implant surface and remove damaged tissue caused by the inflammatory process, the performance of an adequate medical history and prior assessment will identify patients with greater or lesser risk of developing peri-implantitis, maintenance appointments help in the early detection of possible complications.

Presencia del virus papiloma humano en la cavidad oral: revisión y actualización de la literatura / Presence of human papillomavirus in oral cavity: review and update of literature

El virus del papiloma humano (VPH) forma parte de un grupo de virus ADN heterogéneo llamados papillomaviridae; este virus es causante de múltiples lesiones hiperplásicas, verrucosas y papilomatosas de las células epiteliales de piel y mucosas, existen más de 120 tipos de VPH, de solo 100 se conoce su secuencia genómica completa. Los dos géneros más importantes son los papilomavirus alpha (ð) y los beta (ß), la mayoría de los virus que infectan el área genital pertenecen al género alpha; según sus características clínicas, se pueden subdividir en cutáneos y de mucosa. Si bien las infecciones por este virus son frecuentes en cavidad oral, este campo de la medicina se encuentra en estudio, debido a que la información sobre el tema no es concluyente, es prioritario para el estomatólogo conocer las generalidades acerca del VPH y tratar las lesiones de una manera informada, este virus se asocia a un 35% de los casos de cáncer de cavidad oral, de los cuales el 70% de ellos son de alto riesgo. En México, se tiene estimado que cerca del 43% de los hombres y del 17,5% de las mujeres, todos ellos sanos y sexualmente activos tienen alguna infección por VPH.

The human papillomavirus (HPV) is part of heterogeneous group of DNA viruses called papillomaviridae; this virus causes multiple hyperplastic, papillomatous and warty lesions of epithelial cells of skin and mucosa, there are more than 120 types of HPV, although, the complete genome sequence of only 100 of these is known. The most important types are the alpha papillomavirus (a) and beta (b), most viruses that infect the genital area belong to the alpha type; according to their clinical characteristics, they can be divided in cutaneous and mucosal. HPV infections are common in oral cavity, this field of medicine is currently being studied, considering that the information about this subject is not conclusive, it is a priority for the stomatologist to know the generalities about HPV and treat injuries in an informed manner; this virus is associated to a 35% of cases of oral cancer, of which 70% are considered high risk. In Mexico, it is estimated that about a 43% of men and a 17.5% of women, all of them healthy and sexually active have at least one HPV infection.