Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e494-e498.

Myofascial pain syndrome associated with trigger points: A literature review. (I): Epidemiology, clinical treatment and etiopathogeny.

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

Centro Médico Teknon C/ Vilana n 12 08022 Barcelona, Spain, dolororofacial@eduardovazquez.net.

Over the last few decades, advances have been made in the understanding of myofascial pain syndrome epidemiology, clinical characteristics and aetiopathogenesis, but many unknowns remain. An integrated hypothesis has provided a greater understanding of the physiopathology of trigger points, which may allow the development of new diagnostic, and above all, therapeutic methods, as well as the establishment of prevention policies and protocols by the health profession. Nevertheless, randomized studies are needed to provide a better understanding and detection of the different factors involved in the origin of trigger points.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e499-e505.

Changes in radiological protection and quality control in Spanish dental installations: 1996-2003.

Alcaraz-Baños M, Parra-Pérez MC, Armero-Barranco D, Velasco-Hidalgo F, Velasco-Hidalgo E.

Area de Radiología y Medicina Física. Facultad de Medicina/Odontología, Universidad de Murcia 30100-Campus de Espinardo, Murcia, Spain, mab@um.es.

Introduction: The European Union has established specific directives concerning radiological protection which are obligatory for member States. In addition, all Spanish dental clinics with radiological equipment are required to have an annual quality control check. Objective: To analyze the effect of new European legislation on dental radiological practice in Spain and to determine whether it has resulted in lower doses being administered to patients. Material and Methods: A total of 10,171 official radiological quality control reports on Spanish dental clinics, covering 16 autonomous regions, were studied following the passing of Royal Decree 2071/1995 on quality criteria in radiodiagnostic installations. The reports, compiled by U.T.P.R Asigma S.A., a company authorised by the Nuclear Safety Council, cover the years 1996 to 2003, which has enabled us to monitor the evolution of radiological procedures in dental clinics over a seven year period. Results: According to the reports for 2003, 77.3 % of clinics complied with EU requirements, using equipment of 70 kVp, 8 mA, 1.5 mm Al filters, with a collimator length of 20 cm. However, non-compliance was detected in approximately a third (30.8%) of the equipment inspected: alterations in the kilovoltage used, exposure time, performance of the tubing, dosage, linearity/intensity of current and acoustic-luminous signal 6.86%. The mean skin dose reached 3.11 mGy for patients who received an x-ray of an upper molar, representing a decrease of 18% over the seven years studied. Conclusion: there has obviously been a general improvement in the parameters studied, but only 77.3% of the installations complied fully with official EU regulations concerning dental radiological protection.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e506-e509.

Intravascular Papillary Endothelial Hyperplasia: Report of 4 cases with immunohistochemical findings.

Campos MS, Garcia-Rejas RA, Pinto Jr DS, de Sousa SC, Nunes FD.

Av. Prof. Lineu Prestes, 2227, São Paulo, SP, ZIP code 05508-000, Brazil, mscamp@usp.br.

Intravascular papillary endothelial hyperplasia (IPEH) is a benign endothelial proliferation, usually intravascular, that may mimic angiosarcoma. In this report, four new cases of IPEH involving the oral region are described. The affected sites were the lower lip, labial comissure and the submandibular region. After clinical evaluation, the complete removal of the lesions showed a circumscribed and soft mass. Histologically, the major feature was a reactive proliferation of endothelial cells composed of small papillary structures with hypocellular and hyalinized cores arising in an organized thrombus. Immunohistochemical staining for CD34 was strongly positive in endothelial cells. Vimentin and laminin immunolabelling were also consistent with a vascular origin. In order to verify the proliferative potential of the lesions, the Ki-67 antibody was used, revealing low percentage of labeled cells (<20%). No immunoreactivity for GLUT-1 was observed. Since the complete removal is curative, no additional treatment was necessary, and no signs of recurrence had been observed until now. Due to the particular features of IPEH, it is important for pathologists and clinicians to become familiar with this lesion. Additionally, the specific histological arrangement, including the absence of cellular pleomorphism, mitotic activity and necrosis, represents a guide to help in the differential diagnosis. Moreover, the vascular origin and the proliferative index should be assessed by immunohistochemistry in order to provide an accurate diagnosis.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e510-e513.

Determination of salivary glucose in healthy adults.

Soares MS, Batista-Filho MM, Pimentel MJ, Passos IA, Chimenos-Küstner E.

Rua Dr. Francisco Sarmento Meira,150/101 Bessa - João Pessoa- Paraíba- Brazil Zip code: 58035-420 bessa@mixmail.com.

Objectives: Our aim in this study was to determine the concentration of salivary glucose in healthy individuals and to compare it with the capillary glycemia. Study design: Samples of unstimulated whole saliva were collected from 63 non-diabetic patients. The concentration of salivary glucose and capillary blood was measured in all of the patients. The salivary glucose was determined by enzymatic method and spectrophotometry. The data was then analyzed using the Spearman correlation test, considering values of p<0.05 to be significant. Results: The whole sample consisted of 47.6% males and 52.4% women, with an average age of 37.5+/-15.7 years old. The average rates of unstimulated salivary flow were 0.41+/-0.21 ml/min among males and 0.31+/-0.15 ml/min among females. No significant difference was found based on these results (p=0.078). The average blood glucose among the males studied was 100.05+/-13.51 mg/dL, and among females, it was 99.5+/-13.9 mg/dL. The average salivary glucose for the whole sample was 5.97+/-1.87 mg/dL, with 5.91+/-2.19 mg/dL among males and 5.97+/-1.56 mg/dL among females, respectively, without presenting any significant differences (p=0.908). The concentration of salivary glucose did not present any statistically significant correlation with the capillary glycemia (p=0.732). Conclusions: The results suggest that the concentration of salivary glucose is not dependent on capillary glycemia and that the concentration of salivary glucose does not present significant differences between the measurements for males and females.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e514-e520.

Oral lichenoid lesions related to contact with dental materials: A literature review.

Cobos-Fuentes MJ, Martínez-Sahuquillo-Márquez A, Gallardo-Castillo I, Armas-Padrón JR, Moreno-Fernández A, Bullón-Fernández P.

Facultad de Odontología de Sevilla. C/ Avicena s/n 41009 Sevilla, Spain, mjosecobos@gmail.com.

Oral lichenoid lesions related to contact are defined as oral-cavity eruptions with an identifiable etiology, and are clinically and histologically similar to oral lichen planus. Within this group are found oral lichenoid lesions related to contact with dental materials (OLLC), the most common being those related to silver amalgam. Currently, it remains difficult to diagnose these lesions due to the clinical and histopathological similarity with oral lichen planus and other oral mucosa lesions of lichenoid characteristics. In the present paper, we carry out an updated review of the tests for, and the different characteristics of OLLC, which may aid the diagnosis. For this review, we made searches in the Pubmed(R) and Cochrane(R) databases. Among the literature we found several published papers, from which we have used review papers, case papers, cohort studies, case and control studies, and a meta-analysis study. After carrying out this review, we can conclude that the diagnosis of these lesions is still difficult and controversial. However, there are different aspects in the clinical presentation, pathological study and results obtained when replacing suspect materials, which, when taken together, may be useful when establishing the final diagnosis of OLLC.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e521-e524.

Correlation of serum and salivary CA15-3 levels in patients with breast cancer.

Agha-Hosseini F, Mirzaii-Dizgah I, Rahimi A.

Department of Oral Medicine, School of Dentistry, Tehran University of medical sciences, Tehran, Iran, aghahose@sina.tums.ac.ir.

Objectives: The aim of this study was to assess the relationship between serum and saliva levels of cancer antigen (CA) 15-3 and to compare them between women with and without breast cancer. Study design: A case-control study was carried out on 61 women aged 28-69 years, including women with and without breast cancer (26 as part of the case study and 35 as part of the control group) conducted at the Emam Khomeini Hospital, Tehran University of Medical Sciences. CA15-3 levels were assayed in serum and unstimulated whole saliva by EIA. Unpaired t-test, one-way ANOVA and Pearson correlation were used as statistical analysis. Results: The salivary and serological levels of CA15-3 in the cancer patients were significantly higher (P <0.01) than the salivary and serum levels of healthy controls. They were also higher in stage 2 than in stage 1 in cancer patients. However, the saliva flow rate was significantly lower in the cancer patients (P <0.01). There was a significant positive correlation between serum and saliva CA15-3 concentration (r = 0.614) and also between serum concentration and saliva output of CA15-3 (r = 0.541). Conclusion: The results of the study suggest that salivary CA15-3 may have potential use in the initial detection of breast cancer in women.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e525-e528.

Human papillomavirus in saliva of patients with oral squamous cell carcinoma.

Sahebjamee M, Boorghani M, Ghaffari SR, Atarbashimoghadam F, Keyhani A.

Department of Oral Medicine, Faculty of Dentistry, Tehran University of Medical Science, Tehran-Iran,fatarbashi@student.tums.ac.ir.

Objective: The aim of this study was to evaluate the presence of human papillomavirus (HPV) in saliva rinses of patients with oral squamous cell carcinoma and to analyze the possibility of using saliva as a diagnostic method for screening high-risk patients. Study design: The saliva sample of 22 patients with oral squamous cell carcinoma and 20 age-sex matched healthy controls were obtained. The presence of HPV 6, 11, 16, 18, 31, and 33 was evaluated by polymerase chain reaction (PCR). Results: In 40.9% of the patients and in 25% of the controls, the saliva was shown to be positive for HPV. In 27.3% of the patients and in 20% of the controls, the saliva was shown to be positive for HPV16; and none of the controls, except one patient was shown to be positive for HPV 18. Neither patients nor controls were positive for HPV 31 and 33. These differences were not statistically significant. Conclusions: The results of this study were unable to support the detection of HPV in saliva rinses as a diagnostic method for OSCC.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e529-e532.

Incidence of mandibular fractures in eastern Libya.

Elgehani RA, Orafi MI.

Department of oral and maxillofacial surgery, Post box no 9504 Al Arab Medical University, Benghazi, Libya, maraaiorafi@yahoo.com.

The objective of this retrospective study is to evaluate the incidence of mandibular fractures in the eastern part of Libya and to present our experience in treating this type of facial fracture. We analyzed factors such as the incidence of age, sex, time distribution, cause and site of the fracture and the associated injuries in 493 patients presenting a total of 666 mandibular fractures. These patients were treated at Al-Jala Trauma Hospital, Benghazi-Libya between 2000 and 2006. The results were obtained from 432 males and 61 females, for which the ages ranged from 8 months to 72 years. The maximum number of the patients was recorded in 2004, and the busiest month was May. The most common cause of fracture was road traffic accidents and the most common site was the parasymphysis. Among those treated with closed reduction were 241 patients, whereas 201 patients were treated with open reduction. In conclusion, we found that the results were similar to most studies from developing countries and were in contrast to other studies. This may be due factors such as geography, socioeconomic trends, religion, road traffic legislation and seasons, which differ from one country to another. The period during which there was an embargo in Libya also appears to have affected the results.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e533-e537.

Analysis of the antibiotic prophylaxis prescribed by Spanish Oral Surgeons.

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

Centro Médico Teknon Instituto de Investigación UB-IDIBELL C/ Vilana 12 08022-Barcelona (Spain) cgay@ub.edu.

Aim: To identify prophylactic antibiotic prescription practices among Spanish dentists with preferential dedication to Oral Surgery in different types of tooth extraction surgeries. Method: Members of the Spanish Oral Surgery Society were surveyed on antibiotic prophylaxis use in 4 different tooth extraction modalities scaled according to their surgical invasiveness. Results: Sixty-nine of the 105 distributed questionnaires were returned completed. Thirteen percent of the surveyed surgeons would prescribe antibiotics to prevent postoperative wound infection when confronted with conventional tooth extraction lasting less than 5 minutes. In the case of surgery lasting more than 5 minutes, the percentage of participants that would prescribe antibiotics increased to 39%. When a mucoperiosteal flap was elevated or an ostectomy was performed, 87% and 100%, respectively, would prescribe antibiotic prophylaxis. Amoxicillin and its combination with clavulanic acid were the most commonly prescribed antibiotics. All participants would prescribe the antibiotic orally, starting after surgery and with a duration that ranged from 2-8 days. Conclusions: The results obtained suggest that antibiotic prophylaxis for preventing local odontogenic infection is not being correctly implemented in Spain. This can generate new bacterial resistances, facilitate adverse drug reactions and favor opportunistic infections. Better designed studies are needed in order to clarify the role of antibiotics in the prevention of postsurgical wound infection.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e538-e546.

Measurement of dental implant stability by resonance frequency analysis: A review of the literature.

Quesada-García MP, Prados-Sánchez E, Olmedo-Gaya MV, Muñoz-Soto E, González-Rodríguez MP, Valllecillo-Capilla M.

C/ San Francisco n 3, 2 C. 18800-Baza, Granada, Spain,mpilquesada@hotmail.com.

Dental implant treatment is an excellent option for prosthetic restoration that is associated with high success rates. Implant stability is essential for a good outcome. The clinical assessment of osseointegration is based on mechanical stability rather than histological criteria, considering primary stability (absence of mobility in bone bed after implant insertion) and secondary stability (bone formation and remodelling at implant-bone interface). The aim of this study was to review the literature on Resonance Frequency Analysis (RFA) as a method for measuring dental implant stability. An online search of various databases was conducted on experimental and clinical research published between 1996 and 2008. The studies reviewed demonstrate the usefulness of RFA as a non-invasive method to assess implant stability. Further research is required to determine whether this system is also capable of measuring the degree of dental implant osseointegration.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e547-e553.

Fluoride - an adjunctive therapeutic agent for periodontal disease? Evidence from a cross-sectional study.

Kumar S, Sharma J, Duraiswamy P, Kulkarni S.

Department of preventive and community dentistry Darshan Dental College and Hospital Udaipur. Rajasthan India. 313001 santosh_dentist@yahoo.com.

Objective: To assess the influence of the water fluoride level on periodontal status, by determining the periodontal health status of subjects residing in low, optimum and high fluoride areas. Study design: A cross sectional survey was carried out on 967 adults aged 35-44 years old, from the Udaipur district of India. A stratified cluster random sampling technique was implemented in order to collect a representative sample from low (<0.6 ppm), optimum (0.6 - 1.2 ppm) and high fluoride (>3ppm) areas, based on the fluoride concentration in drinking water. Periodontal status was assessed in accordance to WHO criteria. The Chi-square test was used to compare proportions, and logistic regression analysis was used to determine the contribution of water fluoride levels to periodontal disease. Results: Those residing in areas of low fluoride levels were more likely to present periodontal pockets than those living in high fluoride areas 1.3 (95 % CI 1.11+/-1.86). Subjects living in areas of low fluoride were noted to have a higher risk of periodontal attachment loss of more than 8mm (OR = 1.94, 95% CI 1.67+/-3.85). The risk for presence of periodontal pockets and attachment loss of more than 8mm increased by 1.17 (95 % CI 1.02+/-1.69) and 1.59 (95 % CI 1.27+/-3.29) respectively for those residing in areas of optimum fluoride levels. Deep periodontal pockets were more prevalent (6.3%) among those residing in areas of low fluoride, followed by optimum (5.2%) and high (3.1%). Conclusions: As the fluoride concentrations increased, the prevalence of shallow and deep periodontal pockets decreased. The severity of periodontal disease was significantly associated with fluoride levels, with cases of loss of attachment gradually decreasing when moving from low fluoride areas to high fluoride areas. It appears that longitudinal studies need to be conducted in order to ascertain the benefits; and microbiological analysis of dental plaque and periodontium should be carried out in order to confirm the effects of fluoride on periodontal conditions.

Med Oral Patol Oral Cir Bucal. 2009 Oct 1;14(10):e554-e557.

Periodontal disease affecting tooth furcations. A review of the treatments available.

Sánchez-Pérez A, Moya-Villaescusa MJ.

Unidad de Periodoncia. Universidad de Murcia, Clínica Odontológica Universitaria, 2 Planta, C/ Marqués de los Vélez s/n 30008 - Murcia, Spain, arturosa@um.es.

The molars are the teeth that suffer the greatest periodontal destruction in untreated patients. When periodontal disease affects the furcation of a tooth, the chance that it will be lost increases considerably. An increase in the exposed root surface, anatomical peculiarities and irregularities of the furcation surface all favor the growth of bacteria. These problems make it harder for the patient to maintain hygiene, and impede adequate treatment. The treatment of furcations affected by periodontal disease is one of the most difficult problems for the general dentist and periodontist. The motivation of both the attending professional and of the patient are therefore of great importance. No ideal procedure for treating such lesions exists. The present paper reviews those options that are currently available. Long-term research will be needed, along with the development of new techniques, to solve the problem of furcations affected by periodontal disease, possibly including substitution of the affected tooth by an implant.