Manejo de técnicas de elevación de seno entre los profesionales según su experiencia actual / Management of sinus lift techniques among professionals according to their current experience

El objeto de este estudio fue investigar la influencia de la experiencia profesional en el tratamiento de maxilares atróficos y cómo afecta a las indicaciones, la incidencia de complicaciones y la tasa de éxito cuando se utilizan técnicas de elevación del seno maxilar.Se envió una encuesta a través de Google forms a odontólogos en activo que estaban familiarizados con este tipo de técnicas quirúrgicas. Se pidió a los profesionales que indicaran qué técnicas usa ban con más frecuencia en escenarios con hueso residual mayor o menor de 5 mm. También se preguntaron las compli caciones más frecuentes en el uso de las técnicas de elevación del seno maxilar y la tasa de éxito durante los primeros 12-24 meses. La encuesta alcanzó un total de 400 profesionales y la muestra se dividió en 3 grupos. El grupo A estaba compuesto por 158 profesionales con menos de 5 años de experiencia (39,5%), 87 sujetos de entre 6 y 10 años de trayectoria profesional componían el grupo B (21,75%) y el grupo C estaba compuesto por 155 sujetos con más de 10 años de experiencia (38,75%). Como conclusiones, se observó que la experiencia no es un factor decisivo en el éxito de la elevación de seno, ya que ambas técnicas gozan de gran predictibilidad. Si que existe una tendencia en los grupos más experimentados a simplificar la técnica, siendo la complicación más frecuente la perforación de la membrana de Schneider (AU)

The purpose of this study was to investigate the influence of professional experience in the management of atrophic maxilla and how it affects on indications, incidence of complications and survival rate when using maxillary sinus techniques. A survey was lunched via Google forms to active dentists that were familiar with this type of surgical techniques. The professionals were asked for indications of techniques in scenarios with residual bone greater or lesser than 5 mm. The complications more frequently encountered in the use of close and open maxillary sinus techniques and the survival rate during the first 12-24 months were also asked. The survey reached a total of 400 professionals and sample was divided in 3 groups. Group A was composed by 158 professionals with less than 5 years of experience (39.5%), 87 subjects with professional experience ranging between 6 to 10 years composed group B (21,75%) and group C was composed by 155 subjects with more than 10 years of experience (38,75%). According to the conclusions, it was observed that experience is not a decisive factor in the success of sinus lift since both techniques are highly predictable. There is a tendency in the more experienced groups to simplify the technique, the most frequent complication was the perforation of Schneider’s membrane (AU)

Cáncer oral. Factores de riesgo y cambio de tendencia epidemiológica / Oral cancer. Risk factors and change in epidemiological trend

Introducción: El cáncer oral continúa siendo una de las causas de aumento de la morbi-mortalidad en el mundo. Con una incidencia aproximada de 377 mil casos y una mortalidad de 177 mil en el 2020, siendo el carcinoma oral de células escamosas (COCE) el más frecuente. Esta neoplasia afecta predominantemente a hombres y su incidencia aumenta con la edad. Hasta los 80 años, el varón presenta un 40,9% de padecer cáncer y en el caso de las mujeres presentan un 27,0%. A los 85 años, este riesgo aumenta un 49,1% en hombres y un 31,8% en mujeres. Objetivo: Conocer el perfil del paciente con cáncer oral en cuanto a sexo y edad, e identificar los posibles factores etiopatogénicos relacionados con la aparición de ese proceso neoplásico. Material y método: Se realiza un estudio de tipo observacional, descriptivo y retrospectivo en el Servicio de Cirugía Oral y Maxilofacial del Hospital Universitario Ramón y Cajal en el periodo comprendido entre 2004 y 2020. Este estudio ha sido aprobado por el comité de ética de investigación del citado hospital. Resultados: Nuestra muestra ha estado constituida por 46 hombres y 40 mujeres. Todos ellos padecen COCE y tienen una edad media de 66 años ± 14.0 años (66.37; IC al 95%). La mayoría de los pacientes de la muestra han estado concentrados en las décadas de los 60 a los 80 años. Los factores de riesgo más relevantes como predictores de esta enfermedad han sido el tabaco y el alcohol. Los sitios de predilección del carcinoma oral han sido la lengua, la mucosa yugal y el suelo de boca, siendo las localizaciones más frecuentes en el caso de las mujeres la lengua (57,14% vs 42,85%), el reborde alveolar (54,54% vs 45,45%) y la tuberosidad del maxilar (100% vs 0%). (AU)

Introduction: Oral cancer continues to be one of the causes of increased morbidity and mortality in the world. With an approximate incidence of 377 thousand cases and a mortality of 177 thousand in 2020, being oral squamous cell carcinoma (COCE) the most frequent. This neoplasm predominantly affects men and its incidence increases with age. Until the age of 80, men have 40.9% of cancer and in the case of women they have 27.0%. At age 85, this risk increases by 49.1% in men and 31.8% in women. Objective: To know the profi le of the patient with oral cancer in terms of sex and age, and to identify the possible etiopathogenic factors related to the appearance of this neoplastic process. Material and method: An observational, descriptive and retrospective study was carried out in the Oral and Maxillofacial Surgery Service of the Ramón y Cajal University Hospital in the period between 2004 and 2020. This study has been approved by the ethics and research committee of the aforementioned hospital. Results: Our sample consisted of 46 men and 40 women. All of them suffer from COCE and have an average age of 66 years ± 14.0 years (66.37; 95% CI). Most of the patients in the sample have been concentrated in the 60s to 80s. The most relevant risk factors as predictors of this disease have been tobacco and alcohol. The sites of predilection of oral carcinoma have been the tongue, the jugal mucosa and the fl oor of the mouth, being the most frequent locations in the case of women the tongue (57.14% vs 42.85%), the alveolar ridge (54.54% vs 45.45%) and the tuberosity of the maxilla (100% vs 0%). (AU)

Association between Oral Cancer and Diet: An Update.

Oral cancer, included within head and neck cancer, is the sixth most common malignant neoplasm in the world. The main etiological factors are tobacco and alcohol, although currently, diet is considered an important determinant for its development. Several dietary nutrients have specific mechanisms of action, contributing to both protection against cancer and increasing the risk for development, growth, and spread. Foods such as fruits, vegetables, curcumin, and green tea can reduce the risk of oral cancer, while the so-called pro-inflammatory diet, rich in red meat and fried foods, can enhance the risk of occurrence. Dietary factors with a protective effect show different mechanisms that complement and overlap with antioxidant, anti-inflammatory, anti-angiogenic, and anti-proliferative effects. The main limitation of in vivo studies is the complexity of isolating the effects related to each one of the nutrients and the relationship with other possible etiological mechanisms. On the contrary, in vitro studies allow determining the specific mechanisms of action of some of the dietary compounds. In conclusion, and despite research limitations, the beneficial effects of a diet rich in vegetables and fruits are attributed to different micronutrients that are also found in fish and animal products. These compounds show antioxidant, anti-inflammatory, anti-angiogenic, and anti-proliferative properties that have a preventive role in the development of oral and other types of cancer.

Assessment of the Economic and Health-Care Impact of COVID-19 (SARS-CoV-2) on Public and Private Dental Surgeries in Spain: A Pilot Study.

OBJECTIVES: The COVID-19 (SARS-CoV-2) pandemic is an ongoing public health challenge, also for the dentistry community. The main objective of this paper was to determine the economic and health-care impact of COVID-19 on dentists in the Autonomous Region of Galicia (Spain). METHODS: This was a descriptive observational study in which the data was collected by means of a self-administered survey (from 1 April 2020 to 30 April 2020). RESULTS: A total of 400 dentists from Galicia responded to the survey. Only 12.3% of the participants could obtain personal protective equipment (PPE) including FFP2 masks. Of the male respondents, 33.1% suffered losses >€15,000 compared to 19.4% of female respondents (OR = 3.121, p < 0.001). Economic losses seem to have contributed to the applications for economic help as 29.5% of the respondents who applied for this measure recorded losses in excess of €15,000 (p = 0.03). Patients complained more about the fact that only emergency care was available during the State of Alarm, in dental surgeries that do not work with insurance companies or franchises. Only 4 professionals tested positive, 50% of whom worked exclusively in private practice and the other 50% who practised in both private and public surgeries. Dentists who practise in the public sector saw more urgent patients per week than those practising in private surgeries (p = 0.013). CONCLUSIONS: The COVID-19 pandemic has had economic repercussions in dentistry as only urgent treatment was available during the State of Alarm. These repercussions seem to be higher in male participants, as the majority of the participants have revealed higher economic losses than females. The level of assistance has also been affected, reducing the number of treated patients, although this quantity has been different in private and public surgeries. By presenting these findings we look to highlight the role that dentists play in society in treating dental emergencies in our surgeries, and this must be recognised and addressed by the relevant authorities, who must provide PPEs as a priority to this group as well as providing special economic aid in accordance with the losses incurred by the sector.

Importancia del ferrule en la restauración de dientes tratados endodónticamente: una revisión de la literatura / Importance of ferrule in the restoration of endodontically treated teeth: a review of the literatura

OBJETIVO Y JUSTIFICACIÓN: El objetivo de esta revisión es una pues-a al día en lo que a efecto ferrule se refiere en restauración de dientes tratados endodónticamente. MATERIAL Y MÉTODOS: Se realizó una búsqueda en la base de datos Pubmed identificando únicamente revisiones sistemáticas relacionadas con el tema a tratar, utilizando la siguiente estrategia de búsqueda en términos Mesh: "ferrule" OR "ferrule effect" AND "Review". Además, se incluyeron estudios clásicos de importancia relevante. RESULTADOS: La búsqueda inicial identificó 29 publicaciones. Tras aplicar los criterios de inclusión y exclusión este número se redujo a 2 7. CONCLUSIÓN: Para que un diente sea restaurable, debemos contar, al menos, con 1'5-2 mm de altura de ferrule, y un grosor del mismo de 1 mm, en especial en las zonas vestibular y lingual/palatina del diente. En caso de no disponer de este "efecto ferrule", éste podrá lograrse mediante alargamiento coronario, extrusión ortodóntica o extrusión quirúrgica

OBJECTIVE AND JUSTIFICATION: The objective of this review is an update as far as ferrule effect is concerned in restoring endodontically treated teeth. MATERIAL AND METHODS: A search was carried out in the Pubmed database, identifying only systematic reviews related to the subject to be treated, using the following search strategy in Mesh terms: "ferrule" OR "ferrule effect" AND "Review". In addition, classic studies of relevant importance were included. RESULTS: The initial search identified 29 publications. After applying the inclusion and exclusion criteria this number was reduced to 27. CONCLUSIONS: For a tooth to be restorable, we must have at least 1.5-2 mm ferrule height, and a thickness of 1 mm, especially in the vestibular and lingual / palatal areas of the tooth. If this "ferrule effect" is not available, it can be achieved by coronary lengthening, orthodontic extrusion or surgical extrusión

Salivary exRNA biomarkers to detect gingivitis and monitor disease regression.

AIM: This study tests the hypothesis that salivary extracellular RNA (exRNA) biomarkers can be developed for gingivitis detection and monitoring disease regression. MATERIALS AND METHODS: Salivary exRNA biomarker candidates were developed from a total of 100 gingivitis and non-gingivitis individuals using Affymetrix's expression microarrays. The top 10 differentially expressed exRNAs were tested in a clinical cohort to determine whether the discovered salivary exRNA markers for gingivitis were associated with clinical gingivitis and disease regression. For this purpose, unstimulated saliva was collected from 30 randomly selected gingivitis subjects, the gingival and plaque indexes scores were taken at baseline, 3 and 6 weeks and salivary exRNAs were assayed by means of reverse transcription quantitative polymerase chain reaction. RESULTS: Eight salivary exRNA biomarkers developed for gingivitis were statistically significantly changed over time, consistent with disease regression. A panel of four salivary exRNAs [SPRR1A, lnc-TET3-2:1, FAM25A, CRCT1] can detect gingivitis with a clinical performance of 0.91 area under the curve, with 71% sensitivity and 100% specificity. CONCLUSIONS: The clinical values of the developed salivary exRNA biomarkers are associated with gingivitis regression. They offer strong potential to be advanced for definitive validation and clinical laboratory development test.

La salud bucal en deportistas: puesta al día / Oral Health in sportsmen. An update

La población deportista está expuesta a diversos factores de riesgo, entre los que se incluyen, traumatismos, caries, erosiones o desgastes, enfermedad periodontal… Estos factores de riesgo a su vez pueden repercutir no sólo a su calidad de vida general, si no a su rendimiento físico. Sin embargo, son numerosos los estudios que demuestran una mala salud bucal entre ellos. A continuación se expone una revisión bibliográfica sobre las principales patologías sufridas por deportistas y su salud bucal en general (AU)

The sports population is exposed to several risk factors, including trauma, caries, erosion or wear, periodontal disease... These risk factors can in turn affect not only their general quality of life but also their physical performance. however, there are numerous studies that demonstrate poor oral health among them. Below is a bibliographic review of the main pathologies suffered by athletes and their oral health in general (AU)

Saliva diagnostics - Current views and directions.

In this review, we provide an update on the current and future applications of saliva for diagnostic purposes. There are many advantages of using saliva as a biofluid. Its collection is fast, easy, inexpensive, and non-invasive. In addition, saliva, as a "mirror of the body," can reflect the physiological and pathological state of the body. Therefore, it serves as a diagnostic and monitoring tool in many fields of science such as medicine, dentistry, and pharmacotherapy. Introduced in 2008, the term "Salivaomics" aimed to highlight the rapid development of knowledge about various "omics" constituents of saliva, including: proteome, transcriptome, micro-RNA, metabolome, and microbiome. In the last few years, researchers have developed new technologies and validated a wide range of salivary biomarkers that will soon make the use of saliva a clinical reality. However, a great need still exists for convenient and accurate point-of-care devices that can serve as a non-invasive diagnostic tool. In addition, there is an urgent need to decipher the scientific rationale and mechanisms that convey systemic diseases to saliva. Another promising technology called liquid biopsy enables detection of circulating tumor cells (CTCs) and fragments of tumor DNA in saliva, thus enabling non-invasive early detection of various cancers. The newly developed technology-electric field-induced release and measurement (EFIRM) provides near perfect detection of actionable mutations in lung cancer patients. These recent advances widened the salivary diagnostic approach from the oral cavity to the whole physiological system, and thus point towards a promising future of salivary diagnostics for personalized individual medicine applications including clinical decisions and post-treatment outcome predictions. Impact statement The purpose of this mini-review is to make an update about the present and future applications of saliva as a diagnostic biofluid in many fields of science such as dentistry, medicine and pharmacotherapy. Using saliva as a fluid for diagnostic purposes would be a huge breakthrough for both patients and healthcare providers since saliva collection is easy, non-invasive and inexpensive. We will go through the current main diagnostic applications of saliva, and provide a highlight on the emerging, newly developing technologies and tools for cancer screening, detection and monitoring.

Emerging technologies for salivaomics in cancer detection.

Salivary diagnostics has great potential to be used in the early detection and prevention of many cancerous diseases. If implemented with rigour and efficiency, it can result in improving patient survival times and achieving earlier diagnosis of disease. Recently, extraordinary efforts have been taken to develop non-invasive technologies that can be applied without complicated and expensive procedures. Saliva is a biofluid that has demonstrated excellent properties and can be used as a diagnostic fluid, since many of the biomarkers suggested for cancers can also be found in whole saliva, apart from blood or other body fluids. The currently accepted gold standard methods for biomarker development include chromatography, mass spectometry, gel electrophoresis, microarrays and polymerase chain reaction-based quantification. However, salivary diagnostics is a flourishing field with the rapid development of novel technologies associated with point-of-care diagnostics, RNA sequencing, electrochemical detection and liquid biopsy. Those technologies will help introduce population-based screening programs, thus enabling early detection, prognosis assessment and disease monitoring. The purpose of this review is to give a comprehensive update on the emerging diagnostic technologies and tools for the early detection of cancerous diseases based on saliva.