Publications by authors named "Albert Estrugo-Devesa"

33 Publications

An analysis of the prevalence of peripheral giant cell granuloma and pyogenic granuloma in relation to a dental implant.

BMC Oral Health 2021 04 23;21(1):204. Epub 2021 Apr 23.

Department of Odontoestomatology, Faculty of Medicine and Health Sciences (Dentistry), Bellvitge Campus, University of Barcelona, Barcelona, Spain.

Background: The aim of the present investigation was to evaluate the literature recurrence of peripheral giant cell granuloma and pyogenic granuloma associated with dental implants. It's important to know the characteristics present in these lesions and possible effects on the prognosis of dental implants.

Methods: An electronic search without time restrictions was done in the databases: PubMed/Medline. With the keywords "Granuloma" OR "Granuloma, Giant Cell" OR "peripheral giant cell" OR "Granuloma, Pyogenic" AND "Dental implants" OR "Oral implants".

Results: After applying the inclusion and exclusion criteria, a total of 20 articles were included, which reported 32 lesions (10 pyogenic granulomas, 21 peripheral giant cell granulomas and one peripheral giant cell granuloma combined with peripheral ossifying fibroma, all associated with implants). According to our review, these lesions are more frequent in males and in the posterior region of the mandible. Both excision and curettage of the lesion, compared to only excision, presented similar recurrences (40%). Explantation of the implant was performed in 41% of cases without additional recurrences. The results are not statistically significant when comparing one lesion to the other in terms of explantation (p = 0.97), recurrence (p = 0.57) or bone loss (p = 0.67).

Conclusions: The main therapeutic approach is tissue excision. The lesions show a high recurrence rate (34.4%), which often requires explantation of the associated implant. This recurrence rate is not affected by curettage after excision.
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http://dx.doi.org/10.1186/s12903-021-01566-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8067650PMC
April 2021

Time-to-Treatment in Oral Cancer: Causes and Implications for Survival.

Cancers (Basel) 2021 Mar 16;13(6). Epub 2021 Mar 16.

Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain.

The purpose of this review was to identify and describe the causes that influence the time-intervals in the pathway of diagnosis and treatment of oral cancer and to assess its impact on prognosis and survival. The review was structured according to the recommendations of the Aarhus statement, considering original data from individual studies and systematic reviews that reported outcomes related to the patient, diagnostic and pre-treatment intervals. The patient interval is the major contributor to the total time-interval. Unawareness of signs and/or symptoms, denial and lack of knowledge about oral cancer are the major contributors to the process of seeking medical attention. The diagnostic interval is influenced by tumor factors, delays in referral due to higher number of consultations and previous treatment with different medicines or dental procedures and by professional factors such as experience and lack of knowledge related to the disease and diagnostic procedures. Patients with advanced stage disease, primary treatment with radiotherapy, treatment at an academic facility and transitions in care are associated with prolonged pre-treatment intervals. An emerging body of evidence supports the impact of prolonged pre-treatment and treatment intervals with poorer survival from oral cancer.
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http://dx.doi.org/10.3390/cancers13061321DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000007PMC
March 2021

Head and neck cancer and non-steroidal anti-inflammatory drugs: Systematic review and meta-analysis.

Head Neck 2021 May 8;43(5):1664-1682. Epub 2021 Mar 8.

Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona - Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, Barcelona, Spain.

The objective was to assess the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on head and neck cancer (HNC) outcomes. A systematic review was conducted following the PRISMA guidelines. The MEDLINE and the Cochrane Central Register databases were searched. Risk of bias was assessed by the Cochrane Collaboration's tool and by the Newcastle-Ottawa Scale. Meta-analyses were performed with the RevMan software. Seventeen articles met the inclusion criteria. Quality scores for observational studies ranged between 5 and 8 stars and the RCT was assessed as high risk of bias. NSAIDs use was associated with a 13% risk reduction of HNC (OR: 0.87 95% CI 0.77-0.99). NSAIDs use was associated with a 30% reduced cancer-specific mortality and with a 40% decreased risk on disease-recurrence. NSAIDs may have a modest protective effect on HNC risk and a positive impact on cancer-specific survival and disease-recurrence. The findings do not support a protective role of aspirin on HNC outcomes.
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http://dx.doi.org/10.1002/hed.26663DOI Listing
May 2021

COVID-19 and oral lesions, short communication and review.

J Clin Exp Dent 2021 Mar 1;13(3):e287-e294. Epub 2021 Mar 1.

PhD, DDS, MD. Professor of Oral Pathology. Department of Odontostomatology. Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona. University Campus of Bellvitge, Barcelona, Spain / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.

Background: The COVID-19 disease first appeared in December 2019 in Wuhan, China. The World Health Organization (WHO) declared the pandemic in March 2020, with 40 million cases and a million deaths in October 2020. COVID-19 also includes manifestations on the skin and mucous mucosal membrane. Objective: To evaluate the prevalence of the oral lesions associated to COVID-19 disease; and evaluate their clinical presentation and the hypothesized etiology.

Material And Methods: An electronic literature search was performed in PubMed, Scopus and Índice Médico Español databases. The following combination of keywords and Boolean operators were used: "COVID-19 AND oral manifestations"; "COVID-19 AND oral lesions"; "COVID-19 AND mucosal lesions" ; "COVID-19 AND mucosal manifestations"; "SARS-COV-2 AND oral manifestations"; "SARS-COV-2 AND oral lesions"; "SARS-COV-2 AND mucosal lesions"; "SARS-COV-2 AND mucosal manifestations". Furthermore, the bibliography was reviewed to manually include additional articles. The risk of bias in individual studies was assessed by two blinded reviewers using the Joanna Briggs Institute (JBI) and the evidence levels of the articles found will be cataloged according to the level of evidence and grade of recommendation of Oxford Centre for Evidence-Based Medicine (CEBM).

Results: 249 articles were found in the Medline / Pubmed database. There are no additional articles in the Scopus and Índice Médico Español databases. We selected 14 articles plus 5 more articles due to manual searching. Patients presented a wide variety of oral manifestations. The most prevalent were lesions with a solution of continuity (n = 48, 73.85%) and the most frequent area was the tongue (n = 41, 52.56%). The preferred treatment for the lesions is a localized one by using rinses.

Conclusions: To conclude, after the bibliographic review was performed, we can expect that the COVID-19 disease can cause cutaneous and mucosal lesions as secondary manifestations. Despite more studies being needed to confirm this. COVID-19, SARS-COV-2, oral lesions, oral manifestations.
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http://dx.doi.org/10.4317/jced.57981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920556PMC
March 2021

Epstein-Barr Virus and Peri-Implantitis: A Systematic Review and Meta-Analysis.

Viruses 2021 02 5;13(2). Epub 2021 Feb 5.

Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences (School of Dentistry), Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain.

The exponential growth in the use of dental implants in the last decades has been accompanied by an increase in the prevalence of peri-implant disease. It appears that viruses may have pathogenic potential for the development of this pathology. The objective of this systematic review is to study the possible association between the presence of Epstein-Barr virus and the development of peri-implantitis. An electronic search was conducted in PubMed/MEDLINE, Scielo and Embase databases for cross-sectional and case-control studies in humans published up to and including 4 January 2021. Five studies were included in the qualitative analysis. The meta-analysis did not show a statistically significant difference regarding the prevalence of Epstein-Barr virus in the peri-implant sulcus between implants with peri-implantitis and healthy implants. In conclusion, no association between the human herpesvirus 4 and peri-implantitis was found. Further research on this topic is essential to develop more effective treatments.
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http://dx.doi.org/10.3390/v13020250DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7915238PMC
February 2021

Frequency and type of digital procedures used for the intraoral prosthetic rehabilitation of patients with head and neck cancer: A systematic review.

J Prosthet Dent 2021 Jan 8. Epub 2021 Jan 8.

Professor of Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Researcher of Oral Health and Masticatory System Group, Institut d'Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L'Hospitalet de Llobregat, Barcelona, Spain; Medical Manager and Head of the Medical-Surgical Area of Dentistry Hospital University of Barcelona, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address:

Statement Of Problem: In spite of a digital workflow playing an important role in the intraoral prosthetic rehabilitation of patients with head and neck cancer, information about how it has been implemented and its clinical implications is sparse.

Purpose: The purpose of this systematic review was to evaluate the use of a digital workflow in the intraoral prosthetic rehabilitation of patients with head and neck cancer by analyzing the frequency and type of the digital procedures used.

Material And Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The following terms were applied for the search conducted in the MEDLINE-PubMed, Cochrane, and SciELO databases: (prosthesis OR dental OR rehabilitation) AND (digital OR CAD-CAM OR intraoral scanner) AND (Cancer OR head neck). Articles that specified data on intraoral prosthetic treatment and analyzed the use of a digital workflow in the different prosthetic phases such as digital scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) in patients with head and neck cancer were included. Data from the frequency and type of digital procedures were analyzed.

Results: Thirteen articles were included, and all had incorporated CAD-CAM techniques in at least 1 of the prosthetic treatment stages (scanning, design, and/or fabrication). Only 1 patient was rehabilitated by using a completely digital workflow. The most frequent prosthetic treatment was an obturator (82.6%). Regarding the image capture method, the most used method was cone beam computed tomography (CBCT) (60.9%).

Conclusions: Most reports described the partial use of a digital workflow in the intraoral prosthetic rehabilitation of patients treated for head and neck cancer. A digital workflow is used for specific stages but not for the entire process. More studies are needed to evaluate digital systems, ideally comparing parameters with the conventional method, and to determine whether this technique has more relevant clinical implications.
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http://dx.doi.org/10.1016/j.prosdent.2020.11.025DOI Listing
January 2021

Oral Lichen Planus and Dental Implants: Protocol and Systematic Review.

J Clin Med 2020 Dec 21;9(12). Epub 2020 Dec 21.

Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute), IDIBELL, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08907 Barcelona, Spain.

A systematic review was conducted to answer the following PICO question: "Can patients diagnosed with oral lichen planus (OLP) be rehabilitated with dental implants as successfully as patients without OLP?". A systematic review of the literature was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements to gather available and current evidence of oral lichen planus and its relationship with dental implants. The synthesis of results was performed using a Binary Random-Effects Model meta-analysis. Summary measures were odds ratios (ORs), frequencies, and percentages comparing the survival rate of dental implants placed in patients with OLP vs. those in patients without OLP. The electronic search yielded 25 articles, after removing the duplicated ones, 24 articles were selected. Out of the 24 articles, only 15 fulfilled the inclusion criteria. According to the results of the meta-analysis, with a total sample of 48 patients with OLP and 49 patients without OLP, an odds ratio of 2.48 (95% CI 0.34-18.1) was established, with an I value of 0%. According to the Strength of Recommendation Taxonomy (SORT) criteria, level A can be established to conclude that patients with OLP can be rehabilitated with dental implants.
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http://dx.doi.org/10.3390/jcm9124127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7767368PMC
December 2020

Evaluation of Bone Gain and Complication Rates after Guided Bone Regeneration with Titanium Foils: A Systematic Review.

Materials (Basel) 2020 Nov 25;13(23). Epub 2020 Nov 25.

Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences (School of Dentistry), Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain.

Guided bone regeneration techniques are increasingly used to enable the subsequent placement of dental implants. This systematic review aims to analyze the success rate of these techniques in terms of bone gain and complications rate using titanium membranes as a barrier element. Electronic and hand searches were conducted in PubMed/Medline, Scielo, Scopus and Cochrane Library databases for case reports, case series, cohort studies and clinical trials in humans published up to and including 19 September 2020. Thirteen articles were included in the qualitative analysis. Bone gain both horizontally and vertically was comparable to that obtained with other types of membranes more commonly used. The postoperative complication rate was higher that of native collagen membranes and non-resorbable titanium-reinforced membranes, and similar that of crosslinked collagen membranes and titanium meshes. The survival rate of the implants was similar to that of implants placed in native bone. Due to the limited scientific literature published on this issue, more randomized clinical trials comparing occlusive titanium barriers and other types of membranes are necessary to reach more valid conclusions.
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http://dx.doi.org/10.3390/ma13235346DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728364PMC
November 2020

Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study.

J Clin Exp Dent 2020 Oct 1;12(10):e964-e971. Epub 2020 Oct 1.

MD, DDS, PhD, Associate Professor, Department of Odontostomatology, Faculty of Medicine and Health Sciences, University of Barcelona- Dental Hospital, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.

Background: The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control.

Material And Methods: In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis.

Results: The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ≥ 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 - 3.09; = 0.31).

Conclusions: The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients. Apical periodontitis, diabetes mellitus, endodontic medicine, glycated haemoglobin.
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http://dx.doi.org/10.4317/jced.57191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600214PMC
October 2020

Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study.

J Clin Med 2020 Oct 4;9(10). Epub 2020 Oct 4.

Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)-Dental Hospital, University of Barcelona, 08970 L'Hospitalet de Llobregat, Barcelona, Spain.

Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS.

Materials And Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components.

Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3-4.3; = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2-1.9; = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5-49.7; = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1-1.6; = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6-1.3; = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8-1.7; = 0.49) were associated with MetS.

Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.
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http://dx.doi.org/10.3390/jcm9103205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600401PMC
October 2020

Mouthwash With Alcohol and Oral Carcinogenesis: Systematic Review and Meta-analysis.

J Evid Based Dent Pract 2020 Jun 5;20(2):101407. Epub 2020 Feb 5.

Department of Oral Medicine, Surgery and Implantology, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain; Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry) - Dental Hospital, University Campus of Bellvitge, University of Barcelona, Barcelona, Spain; Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Clinical Head of the Odontological Hospital University of Barcelona, Barcelona Univertisity, Barcelona, Spain. Electronic address:

Background: It has been shown that the risk of developing oral cancer is closely related to the intensity and duration of exposure to alcohol and tobacco. Even so, the use of mouthwashes with alcohol in their compositions and the increased risk of oral cancer has been a source of controversy for decades.

Objective: This study proposes a systematic review and a meta-analysis of the literature, to assess the possible relationship between the use of mouthwashes with alcohol and the development of oral and pharyngeal cancers.

Materials And Methods: A systematic search was done using the Medline and PubMed databases. Exclusion criteria were as follows: articles published in languages other than English or Spanish, systematic reviews, and expert opinions. No limitations were used for publication date.

Results: A total of 14 articles were obtained, 11 case-control studies and 3 clinical trials. Three case-control studies found no statistically significant evidence between the relationship of mouthwash use and oral cancer and the remaining 8 case-control studies found statistically significant evidence. The 3 clinical trials observed a relationship between the use of mouthwashes with alcohol and the possibility of developing cancer due to the genotoxicity and mutagenic capacity of alcohol in chronic contact with oral tissues and mucous membranes. The meta-analysis resulted in an OR = 1.480 and a P-value = .161 (95% CI: 0.855; P-value = 2.561) for the analysis of studies of cancer risk and consumption of mouthwashes with alcohol and OR = 1.057 0.364 (95% CI: 0.951; P-value = 1.174) for studies that related the risk of cancer and mouthwash use without taking into account the presence of alcohol.

Conclusions: There is no sufficient evidence to accept the proposition that the use of mouthwashes containing alcohol can influence the development of oral cancer.
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http://dx.doi.org/10.1016/j.jebdp.2020.101407DOI Listing
June 2020

Apical Periodontitis and Diabetes Mellitus Type 2: A Systematic Review and Meta-Analysis.

J Clin Med 2020 Feb 17;9(2). Epub 2020 Feb 17.

Department of Stomatology, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain.

Objective: Investigate if there is an association between apical periodontitis and diabetes mellitus.

Material And Methods: A bibliographic search was performed on Medline/PubMed, Scopus and Cochrane databases using the keywords apical periodontitis and diabetes mellitus. Published papers written in English and performed on animals or humans were included. Meta-analysis was performed using the OpenMeta (analyst) tool for the statistical analysis. The variables analyzed were the prevalence of Apical Periodontitis (AP) among teeth and patients with Diabetes Mellitus (DM).

Results: Of the total studies found, only 21 met the inclusion criteria. Ten clinical studies on animals, ten studies on humans and a systematic review were included. Meta-analysis shows that the prevalence of teeth with apical periodontitis among patients with diabetes mellitus has an odds ratio of 1.166 corresponding to 507 teeth with AP + DM and 534 teeth with AP without DM. The prevalence of patients with AP and DM shows an odds ratio of 1.552 where 91 patients had AP + DM and 582 patients AP without DM.

Conclusion: Scientific evidence suggests that there could be a common physiopathological factor between apical periodontitis and diabetes mellitus but more prospective studies are needed to investigate the association between these two diseases.
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http://dx.doi.org/10.3390/jcm9020540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074097PMC
February 2020

Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review.

Materials (Basel) 2020 Jan 30;13(3). Epub 2020 Jan 30.

Department of Stomatology, Faculty of Dentistry, University of Seville, 41013 Seville, Spain.

Background: Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials.

Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software.

Results: For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (-) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant.

Conclusion: There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice.
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http://dx.doi.org/10.3390/ma13030622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7040697PMC
January 2020

Validity of a self-reported questionnaire for periodontitis in Spanish population.

J Periodontol 2020 Jan 26. Epub 2020 Jan 26.

Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), Odontological Hospital University of Barcelona, University of Barcelona Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain.

Background: Clinical examination is the gold-standard approach for surveillance of periodontitis; however, it requires large resources. Several self-reported measures have been developed and tested in diverse scenarios with results suggesting that it may be a useful tool for screening periodontal disease in different populations; yet they have not being tested in Spanish population. We aimed to assess the validity of a self-reported questionnaire for periodontitis in a Spanish population from Barcelona during 2018.

Methods: One hundred and twelve participants were enrolled in the study and, in one appointment; a dentist performed the self-reported questionnaire and a full-mouth periodontal examination. Periodontitis was defined as at least mild periodontitis according to three criterion of classification. Receiver-operating characteristics curve analyses were used to test the discriminatory capability, sensitivity and specificity of the self-reported questionnaire and logistic regression models were adjusted to estimate the minimal-set of questions associated with periodontitis.

Results: The self-reported questionnaire had a useful discriminative capability for detecting individuals with periodontitis (area under the curve [AUC] = 0.85 95% CI 0.78-0.92) and its moderate/severe form (AUC = 0.86 95% CI 0.79-0.04) with sensitivity and specificity of 77% and 74% and 73% and 87%, respectively; representing moderate validity. The combination of four-specific questions had high accuracy (AUC = 0.88 95% CI 0.81-0.94) and validity (sensitivity = 92.2%) and was strongly associated with moderate/severe periodontitis after adjusting by socio-demographic factors.

Conclusions: The use of several self-reported questions proved to have a good performance for screening periodontitis in the population under study; specifically, those related with tooth mobility and gum migration. Large community-based studies are needed to test its validity and predictive capability.
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http://dx.doi.org/10.1002/JPER.19-0604DOI Listing
January 2020

Oral lichen planus and its relationship with systemic diseases. A review of evidence.

J Clin Exp Dent 2018 Sep 1;10(9):e938-e944. Epub 2018 Sep 1.

MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona - Head of the Medical Surgical Area and Medical Director of Dentistry Hospital Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain.

Background: Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites.

Objective: Review the relevant information to OLP and its relationship with systemic diseases.

Material And Methods: Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation.

Results: Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients.

Conclusions: Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended. Oral lichen planus, etiopathogenesis, systemic diseases.
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http://dx.doi.org/10.4317/jced.55145DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203921PMC
September 2018

Protective effects of metformin, statins and anti-inflammatory drugs on head and neck cancer: A systematic review.

Oral Oncol 2018 10 1;85:68-81. Epub 2018 Sep 1.

Professor of Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Oral Health and Masticatory System Group, Institut d'Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L'Hospitalet de Llobregat, Barcelona, Spain; Medical Manager and Head of the Medical-Surgical Area of Dentistry Hospital University of Barcelona - University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address:

The main objective of this study was to evaluate the effect of metformin, statins and anti-inflammatory drugs (NSAIDs) on head and neck cancer (HNC). Specifically, the potential beneficial effects on risk, survival and recurrence based on epidemiological studies. PRISMA guidelines were followed. After searching MEDLINE (PubMed), IBECS, LILACS and the Cochrane Central Register for Controlled Trials, 13 studies met the inclusion criteria and so underwent qualitative synthesis (six studies for metformin and seven for NSAIDs). No studies were found for statins. Studies varied in their methodological quality. Meta-analyses showed that metformin exerts significant beneficial effects on HNC risk (RR = 0.71 95% CI 0.61-0.84) and overall survival (RR = 1.71 95% CI 1.20-2.42). Qualitative synthesis also suggests an apparently dose-response relationship and increased benefit when administered alone. The pooled-analyses yielded an almost significant effect of NSAIDs on HNC risk (RR = 0.86 95% CI 0.74-1.01). No associations were found between aspirin use and the risk of HNC (RR = 0.98 95% CI 0.77-1.24) and overall survival (RR = 1.10 95% CI 0.89-1.36). Metformin appears to have beneficial effects on HNC risk and overall survival, with an apparently dose-response relationship and increased benefit when administered alone. NSAIDs also seem to have a modest beneficial effect on HNC risk. No definitive conclusions can be reached for aspirin as the evidence available was proved inconsistent. Further research by means of well designed and conducted studies are needed to determine firm clinical implications. Standardized assessment methods for HNC outcomes should be established and account for known confounding factors such as smoking and alcohol consumption.
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http://dx.doi.org/10.1016/j.oraloncology.2018.08.015DOI Listing
October 2018

Comparison of Marginal Bone Loss Between Implants with Internal and External Connections: A Systematic Review.

Int J Oral Maxillofac Implants 2018 May/Jun;33(3):580-589

Purpose: The objective of this systematic review was to compare the loss of marginal bone between implants with internal and external connections by analyzing results reported in studies published after 2010.

Materials And Methods: A literature search in MEDLINE with the keywords "dental implant connections, external internal implant connection, bone loss implant designs, internal and external connection implant studies in humans" was conducted. Clinical trials on human beings, comparing both connections and published in English, from 2010 to 2016 were selected. Their methodologic quality was assessed using the Jadad scale.

Results: From the initial search, 415 articles were obtained; 32 were chosen as potentially relevant based on their titles and abstracts. Among them, only 10 finally met the inclusion criteria. A total of 1,523 patients with 3,965 implants were analyzed. Six out of 10 studies observed that internal connections showed significantly less bone loss compared with external connections. The remaining four articles did not find statistically significant differences between the two connections.

Conclusion: According to this systematic review and considering its limitation due to the degree of heterogeneity between the included studies, both internal and external connections present high survival rates. To assess whether marginal bone loss differs significantly between the two connections, more homogenous clinical studies are needed with identical implant characteristics, larger samples, and longer follow-up periods. Studies included in this review and characterized by long-term follow-ups showed that the external connection is a reliable connection on a long-term basis.
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http://dx.doi.org/10.11607/jomi.6190DOI Listing
August 2018

Pentoxifylline, tocopherol, and clodronate for the treatment of mandibular osteoradionecrosis: a systematic review.

Oral Surg Oral Med Oral Pathol Oral Radiol 2018 05 14;125(5):431-439. Epub 2018 Feb 14.

Oral and Maxillofacial Surgery Department, Vall d'Hebron Hospital, Barcelona, Spain.

Objective: The purpose of this study was to evaluate the healing benefit provided by the antioxidant and antifibrotic properties of pentoxifylline-tocopherol or pentoxifylline-tocopherol-clodronate in combination therapy for osteoradionecrosis.

Study Design: We searched for relevant reports in PubMed by using a combination of "osteoradionecrosis" and the following keywords: "pentoxifillyne," "tocopherol," "vitamin E," or "clodronate." We considered articles in English or Spanish, with no limitations on the publication date.

Results: The combination of pentoxifylline plus tocopherol with or without clodronate was found to be effective for the treatment of mandibular osteoradionecrosis, although data were generally scarce and mostly came from retrospective case series.

Conclusions: This drug therapy is well tolerated and could be promising for the treatment of mandibular osteoradionecrosis, but prospective randomized controlled clinical trials are needed for further clarification.
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http://dx.doi.org/10.1016/j.oooo.2018.02.004DOI Listing
May 2018

Benefits of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and chronic periodontitis: A randomized controlled trial.

J Clin Periodontol 2018 03 19;45(3):345-353. Epub 2018 Jan 19.

Department of Pathology and Experimental Therapeutics, Medical School, IDIBELL-University of Barcelona, Barcelona, Spain.

Background: Periodontitis and diabetes are highly prevalent conditions whose association has long been recognized.

Objective: To evaluate the effect of non-surgical periodontal treatment on serum HbA1c (haemoglobin A1c or glycated haemoglobin) levels in patients with type 2 diabetes.

Research Design And Methods: This was a 6-month, single-masked, randomized clinical trial based on 90 patients (HbA1c: 7.7% (61 mmol/mol) ± 1.13%) who were randomly assigned to either the treatment group (oral hygiene instructions + scaling and root planing using ultrasound and Gracey curettes) or the control group (oral hygiene instructions + supragingival removal of plaque and calculus using ultrasound). Pocket depth, gingival index, and plaque index were assessed at baseline and after 3 and 6 months together with determinations of fasting plasma glucose, HbA1c, and bacterial counts.

Results: Treatment significantly improved the periodontal and metabolic parameters (p < .05), whereas in the control group no improvement was observed. These results were consistent with the bacteriological results in most but not all cases.

Conclusion: Non-surgical periodontal treatment resulted in a better glycaemic status of type 2 diabetes patients and demonstrated the importance of oral health in their general health.
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http://dx.doi.org/10.1111/jcpe.12858DOI Listing
March 2018

Correlation between mandibular bone density and skeletal bone density in a Catalonian postmenopausal population.

Oral Surg Oral Med Oral Pathol Oral Radiol 2018 05 29;125(5):495-502. Epub 2017 Nov 29.

Faculty of Medicine and Health Department of Odontostomatology Sciences, University of Barcelona, Barcelona, Spain; Dental Hospital Barcelona University, Barcelona, Spain; Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, Barcelona 08907, Spain. Electronic address:

Objectives: The aim of this study was to determine if the mandible (MD) experiences reductions in bone mineral density (BMD) similar to the lumbar spine (LS) and femoral neck (FN) in a postmenopausal population.

Study Design: A total of 137 postmenopausal women underwent 3 types of densitometric examinations: LS, FN, and MD as measured in 3 regions (MD-R1, MD-R2, and MD-R3), as well as the entire mandible (MD-Net) using a dual photon bone X-ray densitometer. Densitometry of the LS and FN were performed according to the protocol of the International Society for Clinical Densitometry. Mandibular densitometry was performed using a modification of a previous technique, placing the patient in the left lateral decubitus position, with the head supported by a 13-cm-thick cushion above the temporomandibular joint.

Results: Significant correlations were found between densitometry results for the LS and the MD, with P values of .021 at MD-R1 (ramus); .001 at MD-R2 (body); .050 at MD-R3 (symphysis), and .001 at MD-Net (total mandibular density). No correlation was found between mandibular and FN densitometry (P > .05).

Conclusions: According to the results, for this population, it can be affirmed that the MD responds to osteoporosis in ways similar to the LS.
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http://dx.doi.org/10.1016/j.oooo.2017.10.003DOI Listing
May 2018

Halitosis Assessment and Changes in Volatile Sulfur Compounds After Chewing Gum: A Study Performed on Dentistry Students.

J Evid Based Dent Pract 2017 Dec 21;17(4):381-388. Epub 2017 Jun 21.

Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, Barcelona, Spain; Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, Barcelona 08907, Spain; Dental Hospital Barcelona University, Bellvite University Campus, Barcelona, Spain. Electronic address:

Objective: The objective of this study is to estimate the prevalence of halitosis (with subjective and objective methods), evaluate the immediate effect of chewing gum on volatile sulfur compounds (VSCs), assess the perception of halitosis by dentistry students, and estimate the distribution of positive and negative frequencies, when comparing objective and subjective methods for the diagnosis of halitosis.

Methods: The study was performed on a sample of dentistry students attending the Faculty of Medicine and Health Sciences at the University of Barcelona. A questionnaire about halitosis perception was provided and a clinical examination, organoleptic test (OT), and gas chromatography were performed to determine the presence of halitosis. The subjects were also given chewing gum to modify their breath, and gas chromatography was carried out to evaluate possible changes in VSCs.

Results: The sample comprised 80 individuals. Twenty-seven (33.75%) self-perceived halitosis during the period of evaluation; the OT was positive in 38 subjects (47.5%); and individuals positive for halitosis on gas chromatography were distributed as follows: HS in 25 (31.25%), CHSH in 28 (35%), and (CH)S in 70 individuals (87.5%). A statistical difference before and after chewing gum (P < .05) was found for each VSC; a difference in frequencies was observed between the variable OT and HS (P < .05) and between the OT and (CH)S (P < .001). There was no significant difference (P > .05) between the positive and negative frequencies retrieved between the variable OT and CHSH and between the OT and the student's halitosis perception.

Conclusion: Prevalence of halitosis in the studied sample is high, considering that it comprised healthy individuals. The relationship between the OT and gas chromatography is not completely established. Chewing gum could be considered a therapeutic alternative to decrease or neutralize the amount of VSCs present in oral breath.
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http://dx.doi.org/10.1016/j.jebdp.2017.06.001DOI Listing
December 2017

Bacteremia Associated With Oral Surgery: A Review.

J Evid Based Dent Pract 2017 Sep 11;17(3):190-204. Epub 2016 Dec 11.

Department of Pathology and Experimental Therapeutics, University of Barcelona and IDIBELL, Barcelona, Spain; CESPU, IINFACTS, Gandra, Portugal.

Objectives: Bacterial (infective) endocarditis, a microbial infection of the endocardium surfaces after bacteremia, causes significant morbidity and mortality. Recent epidemiologic studies have reported a prevalence of 2-8 cases per 100,000 individuals per year, with the highest incidence in those aged 70-80 years and those living in developed countries. We systematically reviewed the literature on several critical aspects regarding the development of bacteremia after oral surgery. The purpose of this work is to assess the controversy regarding antibiotic prophylaxis before oral surgery.

Materials And Methods: Publications between 1976 and 2015 were included. Clinical studies focusing on oral surgery as the underlying cause were included.

Results: Among the 32 clinical studies reviewed, 3564 cases, accounting for 12,839 blood cultures, were evaluated. In 10 of these studies, amoxicillin usefulness was studied. Antimicrobial prophylaxis before an invasive dental procedure does not prevent bacteremia, although it can decrease both its magnitude and its persistence.

Conclusions: The highly conflicting data and conclusions of the analyzed work highlight the need for new approaches to the study of bacteremia that would provide reliable evidence and thus appropriate prophylactic and therapeutic standards. Many reports have explored the occurrence of bacteremia after dental procedures, but the results have been conflicting.
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http://dx.doi.org/10.1016/j.jebdp.2016.12.001DOI Listing
September 2017

Pyogenic Granuloma/Peripheral Giant-Cell Granuloma Associated with Implants.

Int J Dent 2015 1;2015:839032. Epub 2015 Dec 1.

School of Dentistry, University of Barcelona, Pabellón de Gobierno, University Campus of Bellvitge, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.

Introduction. Pyogenic granuloma (PG) and peripheral giant-cell granuloma (PGCG) are two of the most common inflammatory lesions associated with implants; however, there is no established pathway for treatment of these conditions. This paper aims to illustrate the successful treatment of PG and PGCG and also report a systematic review of the literature regarding the various treatments proposed. Methods. To collect relevant information about previous treatments for PG and PGCG involving implants we carried out electronic searches of publications with the key words "granuloma", "oral", and "implants" from the last 15 years on the databases Pubmed, National Library of Medicine's Medline, Scielo, Scopus, and Cochrane Library. Results. From the electronic search 16 case reports were found showing excision and curettage as the main successful treatment. As no clinical trials or observational studies were identified the authors agreed to present results from a review perspective. Conclusion. This is the largest analysis of PG and PGCG associated with implants published to date. Our review would suggest that PGCG associated with implants appears to have a more aggressive nature; however the level of evidence is very limited. Further cohort studies with representative sample sizes and standard outcome measures are necessary for better understanding of these conditions.
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http://dx.doi.org/10.1155/2015/839032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678085PMC
December 2015

Efficacy of chlorhexidine, dexpanthenol, allantoin and chitosan gel in comparison with bicarbonate oral rinse in controlling post-interventional inflammation, pain and cicatrization in subjects undergoing dental surgery.

Curr Med Res Opin 2015 Dec 4;31(12):2179-83. Epub 2015 Nov 4.

b b Medical Department , Isdin Barcelona , Spain.

Introduction: Reducing post-interventional inflammation and pain in odontostomatological surgery procedures, such as tooth extractions, implants or oral biopsies is a relevant clinical goal. Chlorhexidine oral rinse is commonly used with this aim. Recently a new product containing chlorhexidine, dexpanthenol, allantoin and chitosan (Bexident Post [BP]) in a gel formulation has been developed. We evaluated the efficacy of BP in controlling postsurgical inflammation and pain and in promoting cicatrization in subjects undergoing molar extractions.

Subjects And Methods: We conducted a prospective sequential cross-over, randomized controlled study in patients undergoing surgical removal of at least two impacted mandibular third molars (teeth numbers 38 and 48) (numbers 17 and 32 in the Universal Tooth Numbering System), in two separate sessions, to determine the effect of BP in comparison with bicarbonate (BC) oral rinse (one spoonful in 200 ml of water), both used three times daily. Each subject utilized both products in a randomized sequential manner after each tooth extraction. Primary outcomes of the study were post-procedure pain and inflammation. Secondary outcomes were analgesic pill rescue use (metamizole 1 cap every 8 hours if needed) and an assessor-blinded evaluation of cicatrization with a semi-quantitative scale (good, satisfactory and insufficient). Post-procedure pain was assessed 6 hours after tooth extraction and for seven consecutive days by means of a 10 cm visual analogue scale (VAS) (from 0: no pain to 10: extreme pain). The extent of inflammation was evaluated through metric measurements of facial perimeter using standardized anatomical reference points.

Results: A total of 47 patients (22 men and 25 women; mean age 34 years) were enrolled with a total of 94 molars extracted. Nineteen subjects applied BC as the first sequential treatment and 28 BP as the first. Before surgery no mean differences in the two treatments in inflammation measurements were observed. After surgery mean VAS pain score was similar between the two treatments in the first 6 hours (VAS score = 6.5). A marked progressive reduction in pain intensity with the use of BP was observed throughout the treatment period in comparison with BC (7 day mean scores 3.7 vs. 5.3; p = 0.0001). BP was superior to BC in reducing inflammation with -50% of the inflammation-related measurement (6 mm vs. 12 mm; p = 0.0001). Analgesic pill consumption was lower with BP in comparison with BC (13 pills vs. 24; p < 0.05). Cicatrization was scored 'good' in a higher percentage of subjects during BP use (64%) in comparison with the BC group (13%) (p = 0.0001). No serious side effects were reported with either treatment regimen.

Conclusion: In this trial BP performed better than BC in controlling pain and inflammation in subjects undergoing dental surgery, reducing the consumption of analgesics and favoring better cicatrization.
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http://dx.doi.org/10.1185/03007995.2015.1108909DOI Listing
December 2015

Oral Microbiota, Periodontal Status, and Osteoporosis in Postmenopausal Females.

J Periodontol 2016 Feb 15;87(2):124-33. Epub 2015 Oct 15.

Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, University of Barcelona, Hospitalet, Barcelona, Spain.

Background: Alterations in hormone levels during menopause decrease bone density and may worsen oral health, favoring the growth of periodontal pathogens, whose detection could improve the diagnosis of periodontitis. The aim of this study is to detect and quantify the main periodontal pathogens in the oral microbiota of postmenopausal females and to explore the relationship between clinical and periodontal parameters.

Methods: This was an observational cross-sectional study of 76 postmenopausal females. Dental examinations and sampling for microbiologic evaluation were performed, and a history of osteoporosis/osteopenia was collected. Real-time polymerase chain reaction was used for detecting and quantifying Fusobacterium nucleatum (Fn), Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Campylobacter rectus (Cr), and Tannerella forsythia (Tf). The results obtained were subjected to statistical analyses. Statistical significance was defined as P <0.05.

Results: Periodontitis was detected in 77.1% of females with osteoporosis/osteopenia (P >0.05). A significant correlation was found between osteoporosis and missing teeth. T. forsythia and C. rectus were detected in 100% of the samples, Fn and Pg in 98.7%, and Aa in 73.7%.

Conclusions: Osteoporosis did not influence the prevalence of periodontitis among postmenopausal females. The presence of periodontopathogenic bacteria was not sufficient to confirm disease. A preventive maintenance program for postmenopausal females, particularly osteoporotic females, who are at greater risk of tooth loss, could minimize the potential effects of bone loss on periodontal tissues.
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http://dx.doi.org/10.1902/jop.2015.150365DOI Listing
February 2016

Radiolucent periapical lesions and bone mineral density in post-menopausal women.

Gerodontology 2015 Sep 28;32(3):195-201. Epub 2013 Oct 28.

Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain.

Purpose: To investigate the relationship between radiolucent periapical lesions and bone mineral density in post-menopausal women.

Material And Methods: Seventy-five post-menopausal women were recruited for the study. Bone mineral density was measured using dual-energy X-ray absorptiometry. Three groups were established: healthy bone group, osteopenic group and osteoporotic group. Periapical radiolucencies were diagnosed on the basis of examination of digital panoramic radiographs. Statistical analysis was carried out using anova and chi-squared tests, and logistic regression analysis.

Results: In both the osteopenic and osteoporotic groups, 25% of women showed at least one periapical radiolucency, whereas this was only 7.4% in the healthy bone group (odds ratio = 4.2; p = 0.061). After multivariate logistic regression analysis adjusting for covariates (age, number of teeth, number of root-filled teeth and number of teeth with coronal restorations), a marginally significant association was evident between bone mineral density and the presence of periapical radiolucencies (odds ratio = 1.9; CI 95% = 1.0-3.8; p = 0.050).

Conclusions: After adjusting for covariates, low bone mineral density is marginally associated with a higher frequency of radiolucent periapical lesions.
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http://dx.doi.org/10.1111/ger.12076DOI Listing
September 2015

Medical treatment of post-dental extraction peripheral painful traumatic trigeminal neuropathy.

Quintessence Int 2013 Oct;44(9):703-6

Department of Odontostomatology, School of Dentistry, Barcelona University, Health Campus University of Bellvitge, Barcelona, Spain.

Pain arising from surgical procedures that damage the inferior alveolar nerve typically responds poorly to classic therapies. The present case reports the successful medical treatment of this problem with a 10-day course of a corticosteroid and a concomitant 30-day course of an anticonvulsant.
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http://dx.doi.org/10.3290/j.qi.a29791DOI Listing
October 2013

[Osteoporosis and oral diseases].

Med Clin (Barc) 2013 Feb 31;140(4):169-74. Epub 2012 Jul 31.

Departamento de Odontoestomatología, Facultad de Odontología, Universidad de Barcelona, Barcelona, Spain.

Osteoporosis is a major cause of fractures in elderly women. Bone densitometry is used in order to detect osteoporosis. It has been observed can also be analyzed in the jawbone. The osteoporosis may be associated with resorption of the residual ridge, periodontitis and tooth loss; also the same treatments can affect the jaws. A search was carried out in the Medline-Pubmed database in order to search the association between osteoporosis and oral diseases over the past 5 years. Forty-two articles were obtained after the selection process. The authors stated that: in reference to periodontal disease the results are conflicting, but there seems to be a higher prevalence of the disease and tooth loss and resorption of the crest. Oral bisphosphonates have little risk of causing osteonecrosis, and there is no relationship in the dental implant failure among patients taking bisphosphonates. There is no clear scientific evidence that could link osteoporosis and oral diseases.
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http://dx.doi.org/10.1016/j.medcli.2012.05.029DOI Listing
February 2013

Computer-aided system for morphometric mandibular index computation. (Using dental panoramic radiographs).

Med Oral Patol Oral Cir Bucal 2012 Jul 1;17(4):e624-32. Epub 2012 Jul 1.

School of Dentistry, Department of Odonto-stomatology, University of Barcelona, Barcelona, Spain.

Objective: We propose and validate a computer-aided system to measure three different mandibular indexes: cortical width, panoramic mandibular index and, mandibular alveolar bone resorption index.

Study Design: Repeatability and reproducibility of the measurements are analyzed and compared to the manual estimation of the same indexes.

Results: The proposed computerized system exhibits superior repeatability and reproducibility rates compared to standard manual methods. Moreover, the time required to perform the measurements using the proposed method is negligible compared to perform the measurements manually.

Conclusions: We have proposed a very user friendly computerized method to measure three different morphometric mandibular indexes. From the results we can conclude that the system provides a practical manner to perform these measurements. It does not require an expert examiner and does not take more than 16 seconds per analysis. Thus, it may be suitable to diagnose osteoporosis using dental panoramic radiographs.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476026PMC
http://dx.doi.org/10.4317/medoral.17637DOI Listing
July 2012

Orofacial pain of cardiac origin: review literature and clinical cases.

Med Oral Patol Oral Cir Bucal 2012 Jul 1;17(4):e538-44. Epub 2012 Jul 1.

Departament of Stomatology. School of Dentistry, University of Barcelona, Barcelona, Spain.

Unlabelled: The most common types of orofacial pain originate at the dental or periodontal level or in the musculoskeletal structures. However, the patient may present pain in this region even though the source is located elsewhere in the body. One possible source of heterotopic pain is of cardiac origin.

Objectives: Report two cases of orofacial pain of cardiac origin and review the clinical cases described in the literature.

Study Design: Description of clinical cases and review of clinical cases.

Results And Conclusions: Nine cases of atypical pain of cardiac origin are recorded, which include 5 females and 4 males. In craniofacial structures, pain of cardiac origin is usually bilateral. At the craniofacial level, the most frequent location described is in the throat and jaw. Pain of cardiac origin is considered atypical due to its location, although roughly 10% of the cases of cardiac ischemia manifest primarily in craniofacial structures. Finally, the differential diagnosis of pain of odontogenic origin must be taken into account with pain of non-odontogenic origin (muscle, psychogenic, neuronal, cardiac, sinus and neurovascular pain) in order to avoid diagnostic errors in the dental practice as well as unnecessary treatments.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476012PMC
http://dx.doi.org/10.4317/medoral.17636DOI Listing
July 2012