Prosthodontic rehabilitation with maxillary implants can be delayed by the low density of available bone. We report the rehabilitation of maxillary edentulism with four implants, in which primary stability was enhanced by using a compression abutment prototype. Application of compression and tension to the peri-implant bone improved resonance frequency values in all four implants at 7 days after the compression protocol.

The in vitro activity of tinidazole against anaerobic periodontal pathogens (25 Prevotella buccae, 18 Prevotella denticola, 10 Prevotella intermedia, 6 Prevotella melaninogenica, 5 Prevotella oralis, 10 Fusobacterium nucleatum and 8 Veillonella spp.) was determined by agar dilution. MIC90 values (minimum inhibitory concentration for 90% of the organisms) were 8 μg/mL for Veillonella spp., 4 μg/mL for P. intermedia, 2 μg/mL for P. buccae, 1 μg/mL for Fusobacterium spp. and 0.5 μg/mL for other Prevotella spp. Cidal activity was studied by killing curves with tinidazole and amoxicillin (alone and in combination) at concentrations similar to those achieved in crevicular fluid (41.2 μg/mL tinidazole and 14.05 μg/mL amoxicillin) against an inoculum of ca. 107 colony-forming units/mL of four bacterial groups, each one composed of four different strains of the following periodontal isolates: Prevotella spp., Fusobacterium spp. and Veillonella spp. (anaerobes) and one amoxicillin-susceptible Streptococcus spp. (facultative) in a proportion of 1:1:1:1. When only β-lactamase-negative Prevotella or Fusobacterium strains were tested, significantly higher reductions were found with amoxicillin (>4 log reduction at 48 h) versus controls. The presence of β-lactamase-positive Prevotella spp. or F. nucleatum strains rendered amoxicillin inactive (no reductions at 48 h), with no differences from controls. Amoxicillin + tinidazole produced >3 log reduction at 24 h and >4 log reduction at 48 h regardless of the presence or not of β-lactamase-positive strains. The presence in crevicular fluid of β-lactamases produced by β-lactamase-positive periodontal pathogens may have ecological and therapeutic consequences since it may protect β-lactamase-negative periodontal pathogens from amoxicillin treatment. In vitro, tinidazole offered high antianaerobic activity against β-lactamase-positive and -negative periodontal pathogens, avoiding amoxicillin inactivation.

Tinidazole is a 5-nitroimidazole initially introduced into clinical medicine in 1969 for the treatment of unicellular parasites. Tinidazole offers selective bactericidal activity, not influenced by the inoculum size, against anaerobic bacteria, that make it of theoretical interest against periodontopathogen infections. This article reviews the required characteristics of an antibiotic directed to odontogenic anaerobic infections, as well as the pharmacodynamic pitfalls of common antibiotic treatments. In addition the in vitro, pharmacokinetic and pharmacodynamic properties of tinidazole are reviewed, assessing the degree of its adhesion to the required characteristics, as well as identifying the gaps to be fulfilled prior to its use in this medical field. Tinidazole offers interesting characteristics making worthy investigations as a candidate for the treatment of anaerobic odontogenic infections. \

Resistance in streptococci or Gram-negative bacteria is associated with antibiotic consumption. Scarce information exists on the antibiotic susceptibility of bacterial isolates from patients with periodontitis in countries with high antibiotic consumption, as this is an area in which microbiological testing is not performed in daily practice. The present study was undertaken to explore the susceptibility of bacterial isolates in periodontitis to antibiotics prescribed in odontology in Spain as treatment for local infections or prophylaxis for distant focal infections. Periodontal samples were prospectively collected in 48 patients classified by pocket depth of <4 mm and >or=4 mm. Species were identified by culture, selecting the five most frequent morphotypes per sample, and polymerase chain reaction (PCR). Susceptibility was determined by E-test. A total of 261 isolates were identified: 72.9% patients had Streptococcus oralis; 70.8% Streptococcus mitis; 60.4% Prevotella buccae; 39.6% Prevotella denticola; 37.5% Fusobacterium nucleatum; 35.4% Prevotella intermedia; 25% Capnocytophaga spp.; 23% Veillonella spp.; 22.9% Prevotella melaninogenica and Streptococcus sanguis; and <20% other species. Streptococcus viridans resistance rates were 0% for amoxicillin, approximately 10% for clindamycin, 9-22% for tetracycline, and for azithromycin ranged from 18.2% for S. sanguis to 47.7% for S. mitis. Prevotella isolates were susceptible to amoxicillin-clavulanic acid, with amoxicillin resistance ranging from 17.1% in P. buccae to 26.3% in P. denticola. Metronidazole resistance was <6% in all Prevotella species, while clindamycin resistance ranged from 0 to 21.1%. beta-Lactamase production was positive in 54.1% Prevotella spp., 38.9% F. nucleatum, 30% Capnocytophaga spp., and 10% Veillonella spp. In this study, amoxicillin-clavulanic acid was the most active antibiotic against all species tested, followed by metronidazole in the case of anaerobes.

Se presenta una revision bibliografica acerca de la aplicacion de antiinflamatorios de forma coadyuvante en el tratamiento periodontal. Tras una breve introduccion, se establecen las bases inmunologicas de la inflamacion y destruccion periodontal, centrandonos en el metabolismo del acido araquidonico y los cuatro mediadores mas implicados actualmente en la destruccion periodontal: prostaglandina E2 (PGE2), prostaglandina F2a (PGF2a), leucotrieno B4 (LTB4) Y factor activador de plaquetas (PAF) , y estableciendo su mecanismo de accion, su relacion con la destruccion periodontal a traves de las metaloproteinasas (MMPs) y su relacion con algunas interleuquinas de la cascada inflamatoria tambien relacionadas con la destruccion tisular. Despues se expone una relacion de los farmaco s mas empleados en la literatura para la inhibicion de todos estos mediadores (Antiinflamatorios no esteroideos o AINEs, acidos grasos omega3, tetraciclinas y bifosfonatos), explicando su mecanismo de accion y los estudios que los han investigado y posteriormente se ha llevado a cabo una recopilacion de los escasos estudios que realizan mediciones clinicas para finalizar estableciendo una serie de conclusiones.

La infeccion por el virus de la inmunodeficiencia humana (VIH) puede tener influencia a nivel periodontal. El deterioro del sistema inmune por una disminucion de los linfocitos TCD4+ puede comprometer las defensas del huesped a nivel sistemico, por lo que se puede aumentar la susceptibilidad a padecer diferentes patologias en la cavidad oral. En este trabajo de revision se recoge el estado actual de la enfermedad periodontal en pacientes VIH+ y trata de abordar como el VIH puede influir en la microbiota subgingival aumentando el riesgo de padecer periodontitis. La presencia de otros factores coadyuvantes podria favorecer la aparicion de patologia o incluso agravarla independiente de la presencia del VIH.

Se presenta una revisión bibliográfica de la evolución en la literatura acerca del plasma rico en plaquetas (PRP).Tras una introducción se expone la composición del PRP, aludiendo fundamentalmente a los factores de crecimiento presentes en él para continuar con la secuencia de obtención y empleo quirúrgico del producto.Posteriormente se puede observar una revisión del proceso de regeneración a nivel histológico desde el momento de colocación hasta la sexta.En el apartado de discusión, se pueden observar los distintos estudios a favor y en contra de la utilización del PRP encontrados en la literatura, y a continuación se apuntan los posibles riesgos recientemente atribuibles al empleo del PRP para terminar con una breve revisión de estudios comparativos de

Squamous cell carcinoma (SCC) is one of the most common malignant cancer of the oral cavity encompassing at least 92.8% of all oral malignancies. Despite improved diagnostic and therapeutic methods over the 20 last years, this tumour is still characterized by a high rate of mortality. The latest advances of molecular biological methods have contributed to better understand the mechanisms involved in the oral carcinogenetic process. Deregulation of cell cycle, apoptosis and cell-cell/cell-matrix adhesions are considered the pathways mainly influencing this multistage event and scientific researches over the last decade have been performed in order to investigate the biological diagnostic and prognostic parameters related to these events (i.e. tumour growth markers, markers of tumour suppression and anti-tumour response, angiogenesis markers, markers of tumour invasion and metastatic potential, cell surface markers, intracellular markers, markers derived from arachidonic acid, and enzymatic markers). The aim of the present review was to outline the current knowledge on the role of some of these tumour biological markers in carcinogenesis of oral SCC.

RESUMENLa mecanobiología ósea se encarga de la interacción entre las señales mecánicas y los mecanismos moleculares en las células y el tejido óseo.El estudio actual de esta disciplina engloba los modelos informáticos, la biología molecular y las técnicas de imagen en alta resolución.En este artículo se revisan los conceptos generales que se estudian en la mecanobiología y biomecánica de los hueso maxilares.Se establecen las principales propiedades biomecánicas del hueso en las diferentes escalas de medición y determinados factores que influyen en la reacción del hueso perimplantario ante las cargas biomecánicas.

Peripheral giant cell granuloma (PGCG) is a non-neoplastic lesion representing a local hyperplastic reaction to injury or inflammation.It is known to be a reactive soft tissue lesion that develops only within the oral cavity, with a slightly predilection for female sex.The usual localization for PGCG is the premolar region and the crest of the edentulous ridge.This study presents three cases of PGCG, including 2 male and 1 female, with an age comprised between 25 and 35 years.All patients were treated with resection biopsy and no one relapsed.With the aim of determine the probable origin of stromal mononuclear cells and multinuclear giant cells, each case was then studied by immunohistochemistry to evaluate the expression of endothelial and monocyte/ macrophage lineage.Immunohistochemical results showed a strong diffuse positivity for CD-68 in round mononuclear stromal cells and in multinucleate giant cells.These latter were immunonegative for CD-34 and only focally positive for á-1 antitrypsin.These results suggest that multinucleated giant cell shows an osteoclast phenotype and that probably derive from monocyte/macrophage lineage and that do not derive from the endothelial cells of the capillary.In second instance, we underlined the importance of an exhaustive dia.

BACKGROUND Limited published scientific evidence is available to provide guidance to clinicians on possible increased risks of invasive oral procedures associated with the human immunodeficiency virus (HIV) status of the patient. The aim of this study was to assess post-procedural complications in patients infected with HIV. MATERIAL AND METHODS This was a retrospective cross-sectional study of the records of 101 consecutive HIV patients treated at the School of Dentistry of Madrid Complutense University and Sandoval STD Clinic in Madrid between January 2003 and February 2005. Data were gathered by an experienced dental practitioner using a structured epidemiological questionnaire for information on gender, age, HIV transmission category, medical history, hepatitis B virus (HBV) or hepatitis C virus (HCV) coinfection and other diseases, TCD4+ and TCD8+ count, HIV viral load (VL), platelet count, neutrophil count, international normalized ratio and haemoglobin level; tobacco and alcohol intake, highly active antiretroviral treatment and presence of oral lesions. Information was also collected on complications related to dental treatment (invasive or non-invasive) during the previous 6 months. Chi-squared test and Fisher's exact test were used to establish statistical significance. RESULTS Data were gathered on 314 dental procedures in 101 patients. The overall complication rate was 2.2% (7/314); in 147 invasive procedures, seven complications (4.8%) were documented (one persistent pain, two prolonged bleeding, three infections, one bone sequestrum) including extractions, periodontal scaling, endodontic treatment and biopsy. No differences were found in TCD4+, TCD8+, platelet count, HBV or HCV co-infections or HIV VL between patients with and/or without complications. Patients with complications were mainly in B stage of HIV disease (P=0.020). Oral lesions and smoking habit>20 cig day-1 were documented in 83.3% (P=0.086) and 50% (P=0.060), respectively, of patients with complications. CONCLUSIONS The complication rate was 2.2% overall and 4.8% after invasive dental procedures. Presence of oral lesions, smoking habit or HIV clinical stage B may be predictive factors for oral complications in HIV patients. No relationship was found between complications and virological, immunological or other laboratory values. Studies with wider samples and negative control group are warranted to confirm the absence of an association between HIV positivity and higher risk of oral complications.

La enfermedad periodontal es un proceso infeccioso, cronico y de naturaleza inflamatoria, donde se produce la perdida de los tejidos de sosten del diente. Existe un acuerdo general en que son las bacterias de la placa las responsables del inicio y mantenimiento de la enfermedad; pero se cree que sera el tipo de respuesta inmune del individuo, la responsable del grado de destruccion periodontal que se desarrolle. Se piensa que una respuesta mediada por anticuerpos produciria una mayor destruccion debido a la hiperestimulacion del sistema inmune, mientras que una respuesta celular seria mas protectora con los tejidos periodontales. En este articulo proponemos que, la interleukina 18 (IL-18), citokina inductora de interferon gamma, favoreceria el desarrollo de una respuesta inmune celular, permitiendo una eliminacion bacteriana mas eficaz, reduciendo asi el dano que sufririan los tejidos periodontales.

El control de la placa bacteriana es el metodo principal en la prevencion de las enfermedades periodontales. Cada vez esta mas extendido el denominado control quimico de la placa de manera complementaria a un control mecanico ineficaz. Los farmacos mas utilizados a tal fin son los antisepticos bucodentales, siendo ampliamente aceptada la clorhexidina como el de mayor eficacia. Existen sin embargo numerosas formulaciones d edistintos principios activos, ante lo cual parece justificado revisar la literatura con el objetivo de aclarar la eficacia de los mismos, asi como sus diferentes indicaciones. Palabras clave: clohexidina/uso terapeutico; placa dental/prevencion, control; gingivitis/prevencion y control; colutorios/uso terapeutico.

Human immunodeficiency virus (HIV) and many other viruses can be isolated in blood and body fluids, including saliva, and can be transmitted by genital-genital and especially anal-genital sexual activity. The risk of transmission of HIV via oral sexual practices is very low. Unlike other mucosal areas of the body, the oral cavity appears to be an extremely uncommon transmission route for HIV. We present a review of available evidence on the oral-genital transmission of HIV and analyse the factors that act to protect oral tissues from infection, thereby reducing the risk of HIV transmission by oral sex. Among these factors we highlight the levels of HIV RNA in saliva, presence of fewer CD4+ target cells, presence of IgA antibodies in saliva, presence of other infections in the oral cavity and the endogenous salivary antiviral factors lysozyme, defensins, thrombospondin and secretory leucocyte protease inhibitor (SLPI).