Publications by authors named "Enric Jane-Salas"

57 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

Implant insertion torque and marginal bone loss: A systematic review and meta-analysis.

Int J Oral Implantol (Berl) 2020 ;13(4):345-353

Purpose: The purpose of this study was to examine the possible association between implant insertion torque and marginal bone resorption.
Materials and methods: Electronic and manual searches were conducted for articles published up to and including March 2020. The databases consulted were MEDLINE (PubMed), Embase, Scielo and Cochrane Library. Meta-analyses were performed to evaluate the marginal bone resorption around dental implants placed with high insertion torque values (≥ 50 Ncm) compared to marginal bone resorption around dental implants placed with low to moderate (< 50 Ncm) insertion torque values.
Results: A total of five prospective studies and two randomised clinical trials were included in the qualitative analysis. Three of them were analysed quantitatively. The meta-analyses did not show a statistically significant difference between the groups at 3, 6 or 12 to 15 months.
Conclusions: No association between insertion torque value and peri-implant marginal bone resorption was found. Further studies of higher methodological quality are necessary to evaluate the possible correlation.

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January 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

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

Survival of Dental Implants in Oncology Patients versus Non-Oncology Patients: A 5-Year Retrospective Study.

Braz Dent J 2020 Nov-Dec;31(6):650-656

School of Dentistry, Department of Odonto-Stomatology, University of Barcelona Dental Hospital, Barcelona, Spain.

Patients with a history of cancer are increasingly common in the dental office. Treating cancer patients requires a multidisciplinary team, which should include the dentist, in order to control the complications that occur in the oral cavity and also to recover the patient undergoing treatment in any of its types: surgical, medical, radiotherapeutic, or its possible combinations. Dental implants can be a safe and predictable treatment option for prosthetic rehabilitation. The aim of this paper is to describe in retrospect the success rate of osseointegrated implants in oncology and non-oncology patients placed by the Master of Dentistry in Oncology and Immunocompromised Patients, as well as the Master of Medicine, Surgery and Oral Implantology of the University of Barcelona Dental Hospital, between July 2011 and March 2016. 466 patients were reviewed, with a total of 1405 implants placed, considering the oncological history of the patients and the implant success rate. The total success rate in the concerned period was 96.65%. When comparing cancer patients with healthy ones, the success rate has been 93.02% in the first case, and 97.16% in the latter. According to the literature review, our results encourage implant placement in cancer patients, it is important to recognize that this is an analysis of a complex care pathway with a large number of confounding variables. However, the findings should not be considered as generalizable.
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http://dx.doi.org/10.1590/0103-6440202003622DOI Listing
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

Corticotomy in orthodontic treatment: systematic review.

Heliyon 2020 May 27;6(5):e04013. Epub 2020 May 27.

Medicine and Surgery, Oral Medicine at the School of Dentistry, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

Objective: The aim of this study is to evaluate corticotomies effects to accelerate or facilitate dental movements in different kind of orthodontic treatments.

Data: This report followed the PRISMA Statement. A total of 9 articles were included in review.

Sources: Two reviewers performed a literature search up to December 2018 in four databases: PubMed, Web of Science, Scopus and SciELO.

Study Selection: Controlled clinical trials and randomized controlled clinical trials conducted in human patients and published during the last 10 years in English were eligible to be selected. The articles should give detailed information about the results and treatment parameters. There were no limitations established in terms of the type of malocclusion to be corrected or the type of orthodontic treatment performed.

Results: The methodological quality and evidence of the selected studies was low. Most of the studies observed a statistically significant increase in the rate of dental movement, when performing alveolar corticotomies as coadjuvants of orthodontic treatment; either with the conventional technique or with piezocision. The effect of combining corticotomy with bone grafts was assessed.

Conclusions: High heterogeneity among studies made it difficult to draw clear conclusions. However, within the limitations of this review, the corticotomy procedures were able to statistically and clinically produce significant temporary decrease in orthodontic tooth movement rate. This technique does not seem to involve major complications compared to conventional orthodontic treatments.

Clinical Relevance: The use of this technique can reduce treatment time and therefore the undesirable effects associated with prolonged treatments.
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http://dx.doi.org/10.1016/j.heliyon.2020.e04013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260439PMC
May 2020

Oral vesiculobullous lesions associated with SARS-CoV-2 infection.

Oral Dis 2021 04 29;27 Suppl 3:710-712. Epub 2020 May 29.

Adult's Dentistry Department, Oral Medicine, Universidad Europea de Madrid, Madrid, Spain.

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http://dx.doi.org/10.1111/odi.13382DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267423PMC
April 2021

The Multidisciplinary Team (MDT) Approach and Quality of Care.

Front Oncol 2020 20;10:85. Epub 2020 Mar 20.

Medical Oncology Department, Catalan Institute of Oncology (ICO), B-ARGO, Barcelona, Spain.

The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment of these functions can significantly impact patients' quality of life and psychosocial status, and highlights the crucial role of specialized nurses, dietitians, psycho-oncologists, social workers, and onco-geriatricians, among others. Hence, these professionals should be integrated in HNC MDTs. In addition, involving translational research teams should also be considered, as it will help reducing the existing gap between basic research and the daily clinical practice. The aim of this comprehensive review is to assess the role of the different supportive disciplines integrated in an MDT and how they help providing a better care to HNC patients during diagnosis, treatment and follow up.
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http://dx.doi.org/10.3389/fonc.2020.00085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7100151PMC
March 2020

Clinical manifestations of oral proliferative verrucous leukoplakia: A systematic review.

J Oral Pathol Med 2020 May 9;49(5):404-408. Epub 2020 Feb 9.

School of Dentistry, University of Barcelona, Spain/Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Barcelona, Spain.

Objective: The aim of this systematic review was to gather the available evidence about proliferative verrucous leukoplakia. This systematic review was conducted to answer the question: "What are the main clinical features of PVL patients?".

Material And Methods: A systematic review of the literature was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. An electronic research was carried out using different electronic databases; PubMed, and Scopus. Inclusion criteria were papers which reported at least 10 patients with proliferative verrucous leukoplakia and were published not more than 10 years ago.

Results: A total of 285 records were identified through databases, although only 6 of them were eligible. Most patients were women, above 60 years of age (67.4). Additionally, 28 of them were non-smokers (66.6%) and 24 were non-habitual drinkers (57.1%). The most common locations were gingiva (50.9%), buccal mucosa (44.9%), and tongue (40.6%) CONCLUSION: Level C can be established to conclude the proliferative verrucous leukoplakia demographic data, risk factors, malignant transformation, and location. A strict follow-up on these patients should be mandatory, even after surgical management since they have a high recurrence rate and a malignant transformation.
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http://dx.doi.org/10.1111/jop.12999DOI Listing
May 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

The Application of Statins in the Regeneration of Bone Defects. Systematic Review and Meta-Analysis.

Materials (Basel) 2019 Sep 16;12(18). Epub 2019 Sep 16.

Faculty of Dentistry, University of Seville, 41009 Seville, Spain.

This systematic review aims to analyze the effect of the local application of statins in the regeneration of non-periodontal bone defects. A systematic study was conducted with the Pubmed/Medline, Embase, Cochrane Library and Scielo databases for in vivo animal studies published up to and including February 2019. Fifteen articles were included in the analysis. The local application of the drug increased the percentage of new bone formation, bone density, bone healing, bone morphogenetic protein 2, vascular endothelial growth factor, progenitor endothelial cells and osteocalcin. Meta-analyses showed a statistically significant increase in the percentage of new bone formation when animals were treated with local statins, in contrast to the no introduction of filling material or the introduction of polylactic acid, both in an early (4-6 weeks) and in a late period (12 weeks) (mean difference 39.5%, 95% confidence interval: 22.2-56.9, <0.001; and mean difference 43.3%, 95% confidence interval: 33.6-52.9, < 0.001, respectively). Basing on the animal model, the local application of statins promotes the healing of critical bone size defects due to its apparent osteogenic and angiogenic effects. However, given the few studies and their heterogenicity, the results should be taken cautiously, and further pilot studies are necessary, with radiological and histological evaluations to translate these results to humans and establish statins' effect.
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http://dx.doi.org/10.3390/ma12182992DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766347PMC
September 2019

Relationship of human papillomavirus with diseases of the oral cavity.

Med Clin (Barc) 2019 08 17;153(4):157-164. Epub 2019 May 17.

Unidad Medicina Bucal, Departamento de Odontoestomatología, Facultad de de Medicina y Ciencias de la Salud, Odontología, Universitat de Barcelona, Oral Health and Masticatory System Group, Institut d'Investigació Biomédica de Bellvitge (Idibell), l'Hospitalet de Llobregat, Barcelona, España. Electronic address:

Over the last few decades, the human papillomavirus (HPV) infection has emerged as a new epidemic and become a health issue due to its involvement in several cancers affecting the cervix, the anogenital region and the oropharynx. In this review, we aim to understand and explain the distinctive features of HPV-related oropharyngeal squamous cell carcinoma based on its epidemiological data, risk factors, specific topography, HPV subtypes most frequently involved, HPV-status diagnosis, clinical behaviour, prognosis, treatment, and preventive measures. In addition, the relationship of HPV with the development of other head and neck carcinomas and benign lesions of the oral cavity will also be discussed.
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http://dx.doi.org/10.1016/j.medcli.2019.02.027DOI Listing
August 2019

Low-level laser therapy in patients with Burning Mouth Syndrome: A double-blind, randomized, controlled clinical trial.

J Clin Exp Dent 2019 Feb 1;11(2):e162-e169. Epub 2019 Feb 1.

Facultative Director and Clinical Head of the Surgical Medical Area of the Odontological Hospital University of Barcelona.

Background: Evaluate the effect of LLLT in the treatment of burning mouth syndrome (BMS).

Material And Methods: Twenty-one BMS patients were randomly assigned to two groups: 12 in the laser group (LG) and 9 in the control group (CG). Patients in the LG underwent 2-week sessions of LLLT for 4 weeks. The spot tip area of this tool is 0.088cm2, semi-conductor GaAlAs, with a wavelength of 808nm ±5nm (infrared), 200 mW output power, 1.97W/cm2 of power density, 3 J energy per point and application time 15 seconds per point. LLLT was applied punctually, in continuous emissions, on each of the sites where there was a symptom. Symptoms were evaluated with a visual analogue scale (VAS) and patient psychological profiles were assessed using the Hospital Anxiety-Depression Scale. No side effects were recorded. Statistical analysis was carried out via ANOVA and logistic regression analysis.

Results: The initial VAS score mean was 8.9 for the LG and 8.3 for the CG ( >0.05). After the eighth session the VAS score was 5.5 and 5.8 respectively, and at two months it was 4.7 and 5.1 respectively. Improvement variables were established by dichotomizing the pain scales. We obtained levels of significance for the improvement variable for the LG at the two-month follow-up (=0.0038) and for the univariate analysis of the treatment. The improvement was marginally significant in the multivariant analysis of: dry mouth, dysgeusia, pain and the treatment (=0.0538).

Conclusions: LLLT may be an alternative treatment for the relief of oral burning in patients with BMS. Burning mouth syndrome, oral pain, laser dentistry, laser therapy, low intensity laser therapy.
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http://dx.doi.org/10.4317/jced.55517DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383904PMC
February 2019

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

Associations between self-reported periodontal disease, assessed using a very short questionnaire, cardiovascular disease events and all-cause mortality in a contemporary multi-ethnic population: The Multi-Ethnic Study of Atherosclerosis (MESA).

Atherosclerosis 2018 11 20;278:110-116. Epub 2018 Sep 20.

Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain; RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain. Electronic address:

Background And Aims: Periodontal disease (PD) is believed to be associated with cardiovascular disease (CVD) events. Nevertheless, the additive prognostic value of PD for the prediction of CVD events beyond traditional risk factors is unclear, particularly when self-reported using a short questionnaire.

Methods: In the community-based, multicenter, prospective, Multi-Ethnic Study of Atherosclerosis (MESA), PD was assessed at baseline using a two-item questionnaire. We used Cox proportional hazards regression models to evaluate the independent associations between self-reported PD and coronary heart disease (CHD), CVD events, and all-cause death. In addition, the area under the receiver-operator characteristic curve (AUC) was calculated for each of the study endpoints, for models including traditional CVD risk factors alone and models including traditional CVD risk factors plus information on PD. Subgroup analyses were performed stratifying by age and tobacco use.

Results: Among the 6640 MESA participants, high education level, high income, and access to healthcare were more frequent among individuals who self-reported PD. In multivariable analyses, null associations were observed between self-reported PD and incident CVD events, CHD events, and all-cause mortality; and self-reported PD did not improve risk prediction beyond traditional CVD risk factors in terms of AUC, for any of the three study endpoints. Subgroup analyses were consistent with the overall results.

Conclusions: Our findings suggest that the prevalence of self-reported PD may be strongly influenced by educational status and other socioeconomic features. In this context, self-reported PD does not improve CVD risk assessment when evaluated using a brief questionnaire. Future studies should prioritize objective, dental health-expert assessments of PD.
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http://dx.doi.org/10.1016/j.atherosclerosis.2018.09.026DOI Listing
November 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

Open flap versus flapless placement of dental implants. A randomized controlled pilot trial.

Odontology 2018 Jul 20;106(3):340-348. Epub 2018 Feb 20.

Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.

The aim of this study was to compare the immediate postoperative period of participants rehabilitated with dental implants placed with a conventional technique or with a minimally invasive technique, without a mucoperiosteal flap elevation (flapless). Participants who needed implant placement were divided into two groups: one group was operated using a mucoperiosteal flap elevation (G_A), and the other with a flapless surgical technique (G_B). Objective clinical parameters including oral hygiene, mouth opening, inflammation (facial perimeter), surgical time and analgesic consumption, as well as subjective parameters of pain and degree of satisfaction with the procedure, were evaluated. 48 implants were placed in 30 participants (15 participants per group). Oral hygiene index, maximum interincisal opening, pain and analgesic consumption values had a significant difference between groups favoring the flapless technique at 24 h and 7 days but at the 15 days' follow-up the differences were only significant for oral hygiene and pain (P < 0.05); there were no statistically significant differences between groups in terms of facial perimeter values and surgical time (P > 0.05). Average on the degree of satisfaction was of 2.6 (SD 0.8) for G_A and 3.6 (SD 1.02) for G_B (P = 0.06). One implant placed in G_A (2.0%) failed before prosthetic loading due to mobility and pain at 3 months' follow-up. Participants operated for implant placement with flapless surgical technique go through less postoperative discomfort. Both techniques show high success rates, but to perform a flapless technique patients must be properly selected.
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http://dx.doi.org/10.1007/s10266-018-0343-8DOI Listing
July 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

Relationship between cardiovascular disease and dental pathology. Systematic review.

Med Clin (Barc) 2017 Sep 20;149(5):211-216. Epub 2017 Jun 20.

Unidad de Medicina Oral, Departamento de Odontoestomatología, UFR de Odontologia, Facultad de Medicina, Universidad de Barcelona/Oral Health and Masticatory System Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, España. Electronic address:

Background And Objective: The relationship between atherothrombotic cardiovascular disease (ATCD) and localised infections in teeth, including caries and chronic apical periodontitis (CAP) has not been studied much and is not well defined.

Method: A systematic search was performed using the scientific databases PubMed and Medline from 1989 to 2016.

Results: A significant relationship was observed with ATCD in 10 out of 10 studies addressing the degree of oral hygiene, in 14 of 17 that included loss of teeth, in 6 of 12 that analysed caries and in 11 of 15 that included CAP. However, there was a huge methodological heterogeneity.

Conclusions: It can be concluded that there is an association between CAP and ATCD. Patients with ATCD present a worse oral hygiene status and fewer teeth.
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http://dx.doi.org/10.1016/j.medcli.2017.05.010DOI Listing
September 2017

Influence of surface modified dental implant abutments on connective tissue attachment: A systematic review.

Arch Oral Biol 2017 Aug 20;80:185-192. Epub 2017 Apr 20.

Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Oral Medicine Unit. Faculty of Medicine and Health Sciences (Dentistry), Barcelona, Spain; Chief Medical Surgical Service. Dental Hospital. University of Barcelona.

Objective: Determine whether surface modified prosthetic abutments for dental implants influence connective tissue attachment to the implant-abutment system.

Design: A systematic review was conducted using the MEDLINE-PubMed database, with two independent reviewers filtering the titles and abstracts. Two reviewers assessed all potentially relevant articles. An assessment was carried out on the level of evidence of the research according to the guidelines of the Oxford Centre for Evidence-Based Medicine (OCEBM).

Results: After an initial search, 109 potentially relevant articles were found. After reading the titles and abstracts, 99 articles were excluded because the surface treatment was limited to the implant and not to the abutment, or because different materials were analysed instead of surface treatments; 28 were also duplicate articles. An additional 6 research studies were included that were of interest and were found by reading the references of the included articles. The studies included are: 7 in vitro studies, 5 experimental studies in animals, 2 clinical trials in humans and 2 clinical cases.

Conclusion: Surface modification for prosthetic abutments on dental implants can achieve connective tissue attachment to the abutment; however, more studies should be conducted in humans to obtain more and better evidence of these results.
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http://dx.doi.org/10.1016/j.archoralbio.2017.04.020DOI Listing
August 2017