Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E1-E2.

Letter to the Editor: Novel evidence on bisphosphonate related osteochemonecrosis of the jaws suggests tooth extractions and overdentures as risk factors.

Kyrgidis A, Vahtsevanos K.

Dr. Kyrgidis Athanassios, 3 Papazoli St, Thessaloniki, 546 30, Greece, akyrgidi@gmail.com.

[No abstract available]

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E3-E7.

The use of tricyclic antidepressants in the treatment of temporomandibular joint disorders: Systematic review of the literature of the last 20 years.

Cascos-Romero J, Vázquez-Delgado E, Vázquez-Rodríguez E, Gay-Escoda C.

Prof. Cosme Gay Escoda, Centro Médico Teknon, C/ Vilana n 12, 08022 Barcelona,Spain, cgay@ub.edu.

Many therapies have been proposed for the management of temporomandibular disorders, including the use of different drugs. However, lack of knowledge about the mechanisms behind the pain associated with this pathology, and the fact that the studies carried out so far use highly disparate patient selection criteria, mean that results on the effectiveness of the different medications are inconclusive. This study makes a systematic review of the literature published on the use of tricyclic antidepressants for the treatment of temporomandibular disorders, using the SORT criteria (Strength of recommendation taxonomy) to consider the level of scientific evidence of the different studies. Following analysis of the articles, and in function of their scientific quality, a type B recommendation is given in favor of the use of tricyclic antidepressants for the treatment of temporomandibular disorders.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E8-E11.

Clinical evaluation of a new artificial saliva in spray form for patients with dry mouth.

Silvestre FJ, Minguez MP, Suñe-Negre JM.

Prof. F.J. Silvestre-Donat, Unidad de Odontología Médico-Quirúrgica, Clínica Odontológica Universitaria, C/ Gascó Oliag 1, 46010-Valencia (Spain), Francisco.Silvestre@uv.es.

Objectives: To determine the efficacy of a new saliva substitute in spray form, for patients with dry mouth. Study design: Thirty-seven patients with dry mouth were selected (16 males and 21 females), with an age of over 60 years and meeting the following inclusion criteria: xerostomia and hyposialia confirmed by sialometry (resting whole saliva / stimulated whole saliva). A new artificial saliva in spray format was applied, with evaluation of the degree of improvement (VAS scale), frequency of application, time to improvement in minutes, duration in minutes, and assessment of organoleptic properties. Results: Twenty of the 37 patients showed almost immediate improvement after application. The mean number of applications/day was 3.89, with a mean duration of effect of 15.3 min. (65% > 15 min.). The flavor was rated as pleasant by 18 patients. Conclusions: Application of the spray is simple and effective, affording immediate relief, and with reasonable acceptance among patients with dry mouth.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E12-E14.

Ancient schwannoma arising from mental nerve. A case report and review.

Subhashraj K, Balanand S, Pajaniammalle S.

Dr. K. Subhashraj, 10, 8th cross, Brindavan, Pondicherry 605 013, India, rajsubhash@rediffmail.com.

Schwannoma is an intraoral rare, benign neoplasm derived from the nerve sheath of peripheral nerves. "Ancient schwannoma" shows histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused with malignant neoplasms. Ancient schwannoma of the head and neck region is relatively uncommon and very few cases had been reported in the oral cavity. We present a case of ancient schwannoma arising from the mental nerve in a 19 year old male which was of eight months duration. Examination revealed a 30 x 25 mm firm, strawberry-like mass in the periapical region of the left lower first premolar, extending anteriorly to the canine and posteriorly to the first molar, obliterating the buccal vestibule, with an intact overlying mucosa. Ultrasonography showed that the tumor was closely associated with the mental nerve on the left side, suggestive of a peripheral neural sheath tumor. Complete excision of the lesion was done under local anesthesia, preserving the mental nerve. The histological picture was strongly suggestive of ancient schwannoma (Antoni A type). There was no evidence of recurrence 18 months after excision. The clinicopathological aspects of this special case are discussed, and the literature regarding this entity is reviewed.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E15-E19.

Rational use of antimicrobials in dentistry during pregnancy.

Lodi KB, Carvalho LF, Koga-Ito CY, Carvalho VA, Rocha RF.

Dr. Cristiane Yumi Koga Ito, Department of Oral biosciences and Diagnosis, São José dos Campos Dental School, São Paulo State University. Brasil, cristiane@fosjc.unesp.br.

The use of medicines during pregnancy deserves special attention from dentists due to the potential risks to fetal development. The prescription of antimicrobial drugs during this period must be based not only on the etiology of the disease but also on the drug's effect on the embryo, which may be toxic, possibly leading to irreversible lesions. Interest in studies of the teratogenic effects of drugs increased in response to reports of the high incidence of phocomelia in patients treated with thalidomide. Although teratogenicity has long been known, pregnant women today are still exposed to this risk. The effects of drugs depend on the level of susceptibility of the fetus and on the period of exposure during pregnancy. In this context, and considering the paucity of studies on this subject in dentistry, the aim of this review was to offer an up-to-date compilation of data on the antimicrobial drugs most frequently used during pregnancy and the effects of their use.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E20-E27.

Pharmacological interactions of vasoconstrictors.

Gómez-Moreno G, Guardia J, Cutando A, Calvo-Guirado JL.

Dr. Gerardo Gómez-Moreno, Facultad de Odontología, Universidad de Granada. Colegio Máximo s/n, Campus de Cartuja, E-18071, Granada (Spain), ggomez@ugr.es.

This article is the first of a series on pharmacological interactions involving medicaments commonly prescribed and/or used in odontology: vasoconstrictors in local anaesthetics and anti-inflammatory and anti-microbial analgesics. The necessity for the odontologist to be aware of adverse reactions as a result of the pharmacological interactions is due to the increase in medicament consumption by the general population. There is a demographic change with greater life expectancy and patients have increased chronic health problems and therefore have increased medicament intake. The presence of adrenaline (epinephrine) and other vasoconstrictors in local odontological anaesthetics is beneficial in relation to the duration and depth of anaesthesia and reduces bleeding and systemic toxicity of the local anaesthetic. However, it might produce pharmacological interactions between the injected vasoconstrictors and the local anaesthetic and adrenergic medicament administered exogenically which the odontologist should be aware of, especially because of the risk of consequent adverse reactions. Therefore the importance of conducting a detailed clinical history of the general state of health and include all medicaments, legal as well as illegal, taken by the patient.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E28-E33.

Antibiotic prophylaxis to prevent local infection in Oral Surgery: Use or abuse?

Sancho-Puchades M, Herráez-Vilas JM, Berini-Aytés L, Gay-Escoda C.

Prof. Cosme Gay Escoda, Centro Médico Teknon, Instituto de Investigación UB-IDIBEL, C/ Vilana 12, 08022 - Barcelona, Spain, cgay@ub.edu.

Antibiotics have a well-documented efficacy in the treatment of established infections and as prophylactic agents in medically compromised patients. However, the systematic administration of antibiotics to prevent local infections in fit patients is much more controversial. The aim of this paper is to reflect on the justification for prophylactic usage of antibiotics to prevent wound infection and to reason out the most appropriate antibiotic guidelines taking into account available scientific data and studies by other authors. Numerous clinical trials question the efficacy of antibiotics in preventing wound infection. While some studies establish that antibiotics reduce the incidence of postoperative infections, others compare their efficacy to that of placebo. Thus, scientific literature suggests that every oral surgical intervention is not tributary of systematic antibiotic prophylaxis to prevent local infections. Intrinsic surgical risk factors and the patient's individual circumstances must be taken into account. Even though the efficacy of other antibiotics cannot be ruled out due to our limited comprehension of the bacteriologic interrelations intervening in the pathogenesis of postextraction local infection, the amoxicillin-clavulanic acid combination theoretically covers the complete odontogenic bacterial spectrum in Spain. When the prophylactic use of antibiotics is indicated, this should be performed preoperatively, at high doses, and its extent should not exceed 24 hours. Special attention should be paid to antiinfectious local measures that can minimize infection risk during the wound's healing period.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E34-E38.

Surgical treatment of temporomandibular joint ankylosis: Follow-up of 15 cases and literature review.

Vasconcelos BC, Porto GG, Bessa-Nogueira RV, Nascimento MM.

Dr. B. Vasconcelos, Faculdade de Odontologia de Pernambuco, Universidade Pernambuco, Departamento de Cirurgia e Traumatologia BMF, Av. General Newton Cavalcanti, 1650 Camaragibe - PE, 54753-220 Brazil, belmiro@pesquisador.cnpq.br.

Introduction: Ankylosis may be defined as the fusion of the articular surfaces with bony or fibrous tissue. The treatment of temporomandibular joint ankylosis poses a significant challenge because of the high incidence of recurrence. Purpose: To report 15 cases treated by either gap arthroplasty, or the articular reconstruction technique using costochondral grafts, coronoid process grafts or alloplastic condylar implants; evaluate the results of these surgeries and make a literature review. Methods: The sample was obtained from the records of the Oswaldo Cruz University Hospital (HUOC-UPE) of patients submitted to ankylosis treatment by alloplastic or autogenous graft between March 2000 and October 2006. Pre-and post-operative assessment included a thorough history and physical examination to determine the cause of ankylosis, the maximal incisal opening, etiology and type of the ankylosis, recurrence rate and presence of facial nerve paralysis. Results: The mean maximal incisal opening in the preoperative period was 8.71 + 6.97 mm and in the postoperative period it was 28.50 + 8.10 mm, the recurrence rate was 20% (n=3), and always occurred in ankylosis type IV. Conclusion: The articular reconstruction with alloplastic or autogenous grafts, or gap arthroplasty for the treatment of ankylosis is shown to be efficient in relation to the post-operative maximal incisal opening, recurrence and articular function.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E39-E43.

Chondrosarcoma of the temporomandibular joint. A case report and review of the literature.

Gallego L, Junquera L, Fresno MF, de Vicente JC.

Dr. Luis Junquera, Oviedo University. School of Dentistry, Catedrático José Serrano Street, 33009. Oviedo. Spain, Junquera@uniovi.es.

Chondrosarcoma is a malignant tumor characterized by the formation of cartilage, but not bone, by tumor cells. Only 5% to 10% of chondrosarcomas occur in the head and neck, representing 0.1% of all head and neck neoplasms, with the larynx and the maxillo-nasal region being the most common sites. This report describes an unusual case of chondrosarcoma in a 54-year-old man who presented with pain and swelling in the left preauricular area. Computed tomography demonstrated a soft tissue mass in the left temporomandibular joint without causing erosion of the adjacent bony structures. The tumor was treated by excision in a single block with perilesional tissues, preserving the facial nerve. Histopathologic examination revealed chondrocytes with irregular nuclei with S-100 immunocytochemical staining positive in 30% of the tumor. The diagnosis was a grade I chondrosarcoma. There was no evidence of disease at the 16-month follow-up. The occurrence of chondrosarcoma in the temporomandibular joint (TMJ) is an exceptional event, with only 16 cases described. We report a case of this unusual entity and review the literature.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E44-E50.

Validation the Oral Health Impact Profile (OHIP-14sp) for adults in Spain.

Montero-Martín J, Bravo-Pérez M, Albaladejo-Martínez A, Hernández-Martín LA, Rosel-Gallardo EM.

Dr Javier Montero Martín, Departamento de Cirugía, Clínica Odontológica. Facultad de Medicina, C/ Alfonso X el Sabio S/N, Campus Miguel de Unamuno, CP:37007, Salamanca, Spain, javimont@usal.es.

Objectives: The oral health-related quality of life indicators are increasingly used to measure the impact of oral conditions on quality of life to complement clinical data in cross-sectional and longitudinal studies. One of the most internationally spread indicators is the Oral Health Impact Profile (OHIP-14), but it has still never been applied in Spain. The aim of this study was to validate the OHIP-14 for use among adults in Spain. Study design: A cross-sectional study was performed in Granada (Spain). A consecutive sample (n=270) of the Regional Government staff visiting the Employment Risk Prevention Centre for a routine medical check-up participated in this study. All participants self-completed the piloted OHIP-14sp and were examined according to World Health Organization methodology for caries, periodontal disease and prosthesis. Reliability analyses and validity tests were carried out to evaluate the psychometric properties of the OHIP-14sp by using two different methods of total scoring (i.e. the Additive and the Simple Count). Results: The reliability coefficient (Cronbach's alpha) of the OHIP-14sp was above the recommended 0.7 threshold and considered excellent (alpha: 0.89). Some subjective factors (perceived dental treatment need, complaints about mouth and self-rated oral satisfaction) were strongly associated with both total scoring methods of the OHIP-14sp, supporting the criterion, construct and convergent validity. Moreover the impact levels were mainly influenced by caries data, e.g., number of teeth requiring extraction (r = 0.21; p<0.01) and number of decayed visible teeth (between premolars) (r = 0.17; p<0.01). The prevalence of impacts was 80.7% using the occasional or more frequently threshold. The most prevalently affected OHIP domains were "psychological discomfort" (53.7%), "functional limitation" (51.1%) and "physical pain" (42.2%). Conclusions: The OHIP-14sp is a precise, valid and reliable instrument for assessing oral health-related quality of life among adult population in Spain.

Med Oral Patol Oral Cir Bucal. 2009 Jan 1;14(1):E51-E56.

Curing effectiveness of resin composites at different exposure times using LED and halogen units.

Ceballos L, Fuentes MV, Tafalla H, Martínez A, Flores J, Rodríguez J.

Laura Ceballos, Health Science Faculty, Rey Juan Carlos University, Avda. Atenas s/n, Alcorcón, Madrid, 28922, Spain, laura.ceballos@urjc.es.

Objective: To compare the polymerization effectiveness of two resin composites cured with a quartz tungsten halogen (QTH) lamp or a light emitting diodes (LED) unit. Study design: Filtek Z250 (3M ESPE) and Spectrum TPH (Dentsply DeTrey) resin composites were placed in 9 mm deep and 4 mm wide metallic molds and cured using the QTH light Hilux 200 (Benlioglu) or the LED unit Smartlite IQ (Dentsply DeTrey) for 20 or 40 s (three specimens per group). Measurement of depth of cure was carried out by means of a scraping technique, according to ISO 4049. The microhardness measurements were performed using a calibrated Vickers indenter (100 g load, 30 s) at depths of 0.5, 1.5, 2.5, 3.5, 4.5 and 5.5 mm from the top of the composite in the same specimens. Results were analyzed by ANOVA, Student's t and Student-Newman-Keuls tests (p<0.05). Results: Filtek Z250 exhibited higher depth of cure and Vickers microhardness values than Spectrum TPH under each experimental condition evaluated. Depth of cure and microhardness were not affected by the curing light used. However, hardness values were influenced by the interaction between curing light and exposure time. Specimens irradiated for 20 s exhibited higher microhardness values when the LED curing light was used. Exposure time had no influence on the microhardness values for depths from 0.5 to 2.5 mm. At higher depths, irradiation for 40 s produced greater microhardness values. Conclusions: Curing effectiveness of resin composite is not only dependent on the curing light unit. Results vary greatly with composite brand, thickness of the resin composite and the duration of the exposure.