P. López Jornet

Síndrome de boca ardiente: Eficacia de la aplicación tópica de capsaicina. Estudio piloto

espanolEl sindrome de boca ardiente es un cuadro clinico complejo en el que el paciente manifiesta una sensacion de escozor o ardor intrabucal sin que aparezcan lesiones clinicas objetivables. Objetivo: Valorar la eficacia mediante la aplicacion de un gel de capsaicina a una concentracion de 0.025 mg., en pacientes con sindrome de boca ardiente. Pacientes y metodo: Se estudiaron a un grupo de 29 pacientes a los que se les realiza un protocolo de recogida de datos que incluye anamnesis, historia medica, exploracion bucal y pruebas complementarias. A 15 de dichos pacientes se les prescribe un gel de capsaicina y se les realiza un seguimiento durante varias semanas. Resultados: La eficacia de la capsaicina es relativamente baja, solo un 13% de los pacientes refiere una mejoria importante (con una disminucion de mas de 3 puntos en las escalas analogico-visuales) y un 6% mejoria parcial (disminucion menor de 3 puntos) con este tratamiento. Discusion: La estomatodinia es un cuadro clinico multifactorial que precisa de una mayor investigacion tanto de su etiologia como de su manejo terapeutico. Es de suma importancia realizar un correcto diagnostico y explicar este al paciente para poder mantener unas metas realistas sobre las posibilidades de exito. EnglishBurning mouth syndrome is a complex clinical condition, patients show a sensation of irritation or intraoral heat without objetivable clinical injuries. Objective: to value the effectiveness of a capsaicin 0,025% gel application in patients with burning mouth syndrome. Patients and methods: 29 patients with burning mouth syndrome was examined by means of anamnesis, medical history, oral explortation and complementary tests. 15 of these patients were administered a capsaicin gel and were examined for several weeks. Results: the effectiveness of capsaicin is relatively low, only 13% of patients refer an important improvement ( with a reduction more tha 3 points in the visual alalogical scales) and 6% partial improvement ( reduction under 3 points) with this treatment. Discussion: burning mouth syndrome is a multifactorial clinical problem that needs a carefuly of its etiology and therapeutic management. It is of extreme importance make a correct diagnosis and explain this condition to the patient to be able to maintain realistic objectives on the success possibilities.

Mouth self-examination in a population at risk of oral cancer

BACKGOUND Cancer of the oral cavity is a public health problem and many cases are not diagnosed until the disease has reached an advanced stage. The aim of this study was to initiate an educational programme in self-examination for patients at risk from oral cancer. METHODS This quasi-experimental study set out to initiate an educational programme in self-examination for patients at risk from oral cancer, assessing the outcomes after three months. In individual 15-minute face-to-face sessions, patients were given information and training in oral cancer risk factors and then verbal instructions as how to carry out oral self-examination. Three months later, patients were interviewed by telephone and asked if they had carried out self-examination independently at home. The programme was evaluated by means of a health belief model questionnaire on perceived susceptibility (3 items), severity (8 items), benefits (4 items), barriers (8 items) and efficacy (6 items). RESULTS Eighty-six patients (37 females [43.1%] and 49 males [56.9%]) with a mean age of 58.60±10.7 completed the oral self-examination programme. Logistic regression analysis indicated that patients who felt themselves subject to susceptibility (OR: 0.03 95% CI: 0.0-0.86; p<0.04), severity (OR 0.23 95% 0.08-0.68; p<0.008) and benefits (OR 0.11 95% 0.02-0.63; p<0.013) were more likely to perform self-examination. CONCLUSIONS Training programmes in oral self-examination are needed to decrease morbidity and mortality from oral cancer.

A new use for self-etching resin adhesives: Cementing bone fragments

OBJECTIVES To evaluate the bond capacities of four self-etching resin cements and the self-etching adhesives of the same manufacturer when used to cement bone fragments and compare them with a well-known N-butyl-2-cyanoacrylate bone adhesive. METHODS 125 cylindrical bone specimens from pig mandibular ramus bone were prepared using terphane burs and cemented to the corticals of 125 other specimens obtained from pig mandibular body bone using the following bond systems: Group A: Adper PLP/Relyx; group B: Optibond/Maxcem; group C: Hystoacryl; group D: AdheSE/Multilink; group E: G-Bond/G-Cem. Shear bond strength was measured 15 min after cement application using a universal testing machine. RESULTS Shear bond strength results: group A 2.54+/-0.23 MPa; group B 4.83+/-0.4 MPa; group C 2.90+/-0.24 MPa; group D 2.10+/-0.17 MPa; group E 4.22+/-0.24 MPa. Values for shear bond strength were significantly greater for group B and E compared to groups A, C and D (p<0.005, test Mann-Whitney). SEM images showed the presence of a hybrid layer similar to that formed by these bond systems when used on dentine. CONCLUSION Within the limitations of an in vitro investigation, results show that self-etching resin cements together with self-etching adhesives may be used for cementing bone fragments.

Prevalencia de lesiones mucosas en población anciana de la Región de Murcia

Introduccion: El estudio de la prevalencia de la patologia oral es importante, tanto para conocer el estado de salud como las necesidades de tratamiento. En este trabajo se valora la presencia de las lesiones mucosas orales en mayores de 65 anos en pacientes institucionalizados y no institucionalizados de la Region de Murcia Pacientes y metodo: Se estudio una muestra representativa de ancianos de la region de Murcia igualo mayor de 65 anos en total 385 sujetos; tasa de participacion 46%. Se diagnosticaron las lesiones mucosas en base a los criterios establecidos por la OMS Resultados: La prevalencia de las lesiones orales fue de 17,8% (no institucionalizado) y 14,2% institucionalizado. La lesion mas frecuente asociada fue la ulcera traumatica seguida de lengua geografica y candidiasis protesica. Conclusion: Realizar programas de prevencion y diagnostico de lesiones de mucosa oral. Ademas en los casos que se establezcan tratarlas adecuadamente.

Tratamiento quirúrgico de una hiperplasia fibrosa localizada en la desembocadura del conducto de Estenon: Descripción de la técnica

espanolLa hiperplasia fibrosa es una lesion exofitica circunscrita y formada por tejido conectivo fibroso denso, cubierto por un epitelio escamoso estratificado. Se localiza con mas frecuencia en la mucosa yugal, encia, lengua y paladar blando, generalmente zonas donde se produce mayor roce, ya que su etiopatogenia parece estar relacionada con factores irritativos cronicos o traumaticos repetidos. El tratamiento consiste en la extirpacion quirurgica y la eliminacion de los factores irritantes locales. Presentamos un caso de tumoracion unilateral de aspecto fibroso de diez anos de evolucion localizada en mucosa yugal izquierda, que incluia la caruncula de desembocadura del conducto de Estenon. El tratamiento consistio en la canalizacion del conducto para preservar su integridad, extirpacion quirurgica de la lesion con bisturi frio y colocacion de un drenaje activo intraoral. El estudio histopatologico de la muestra confirmo el diagnostico de hiperplasia fibrosa. Tras un ano de seguimiento, el paciente no ha presentado ninguna recidiva, y el drenaje de la glandula parotida izquierda se mantiene normal EnglishThe fibrous hyperplasia is an exofitic injury circumscribed and formed by dense fibrous conective weave, covered by epithelio squamous stratified. lt is located with more frequency in the buccal mucosa, gingiva, tongue and soft palate, generally zones where greater rubbing takes place, since his etiopathogenia seems to be related to chronic irritatives or traumatic repeated factors. The treatment is based in the surgical extirpation and the elimination of the local irritating factors. We present a case of unilateral tumor of fibrous aspect of ten years of evolution located in left buccal mucosa, that included caruncula of opening of Estenons duct. The treatment consisted of the canalization of the duct to preserve its integrity, surgical extirpation of the injury with cold scalpel and positioning of an active intraoral drainage. The histopathologic study of the sample confirmed the diagnosis of fibrous hyperplasia. After one year follow-up, the patient has not presented any recurrence, and the drainage of the left parotid gland is functioning normally

Efficacy of topical chamomile management vs. placebo in patients with oral lichen planus: a randomized double-blind study

The purpose of this study was to compare the clinical therapeutic efficacy of topical applications of chamomile vs. a placebo for treating oral lichen planus (OLP).

Efectos de los diferentes colutorios para el tratamiento de la halitosis oral

espanolObjetivo: La halitosis intraoral se define como olor desagradable u ofensivo, que procede de la cavidad oral. La conexion entre mal aliento y compuestos volatiles sulfurados (CVS) fue establecida por Tonzetich 1977. Los diversos productos utilizados para el tratamiento de la halitosis tienen distintos objetivos: enmascarar, antibacteriano, convertir las formas volatiles de los CVS en no volatiles o la suma de los estos dos ultimos. El objetivo es comparar la eficacia de los distintos tratamientos. Material y metodo: Se realizo un estudio piloto doble ciego, controlado se llevo a cabo en 40 sujetos voluntarios diagnosticados de halitosis intraoral repartidos distribuidos de forma aleatoria en 4 grupos de 10 sujetos, asignandole a cada grupo un tratamiento diferente A (triclosan, fluorurosodico, cloruro de zinc, alcohol) B (triclosan, fluorurosodico, cloruro de zinc) fue C (lactato de zinc 0,14%, chorhexidina 0,05%, clorururo de cetilpiridino 0,05%) y D con medicacion placebo. El tratamiento lo realizo 10ml 2 veces dia durante 3 semanas. Los resultados se valoraron el nivel de CVS mediante Halimeter® (ppb). Resultados: No encontramos en este estudio diferencias estadisticas significativas (p=0,4932) en la variable CVS medida mediante el halimeter®. Los valores comparativos de p en los 4 tratamientos ninguno fue menor de p0,01. Conclusiones: Este protocolo no ha mostrado la eficacia de ninguno de los 4 tratamientos empleados en la disminucion de VSC a corto plazo de la halitosis oral EnglishObjective: The halitosis is defined as disagreeable or offensive odor, that comes from the oral cavity. The relationship between badly breath and volatile sulfur compounds (CVS) was established by Tonzetich 1977. The diverse products used for the treatment of the halitosis have different objectives: to mask, antibacterial, to turn the volatile forms of the nonvolatile CVS or the sum of the these two last ones. The objective is to compare the effectiveness of the different treatments. Material and method: Forty volunteers, participated in this study blind double pilot, controlled diagnosed of intraoraI halitosis distributed of random form in 4 groups of 10 subjects, assigning to him to each group a treatment A (triclosan, zinc sodium fluoride, chloride, alcohol) B (triclosan, sodium fluoride, chloride of zinc) was C (zinc lactate 0.14%, chIorhexidine 0.05%, cetylpyridium chloride 0.05%) and D with medication placebo. The treatment 10mI 2 times day during 3 weeks. The results valued the level of CVS by means of Halimeter® (ppb). Results: We did not find in this study significant statistical differences (p=0,4932) in variable CVS measured by means of halimeter®. The comparative values of p in the 4 treatments no was smaller of p0,01. Conclusions: This protocoI has not shown the effectiveness of any of the 4 treatments used in the diminution of short term VSC of the oral halitosis

Penfigoide cicatrizal de largo tiempo de evolución

espanolIntroduccion: El penfigoide cicatrizal es una enfermedad autoinmune, inflamatoria cronica, ampollar, de caracter benigno, que afecta principalmente a membranas mucosas. Objetivo: El objetivo de este articulo es mostrar el seguimiento de los cambios locales (dentales y mucoso s) y sistemicos ocurridos durante un periodo de 15 anos en una paciente con penfigoide cicatrizal. Caso clinico: Mujer de 65 anos de edad, con hipertension arterial controlada mediante farmacos, sin otros antecedentes de interes. No alergias conocidas ni habitos toxicos. Presenta lesiones erosivas y ampollares en encias, paladar y mucosas yugales, sin afectacion de otras mucosas o piel. Actualmente se encuentra en periodo de rehabilitacion protesica. Discusion. Se discuten los tratamientos llevados a cabo, grado de cumplimento, asi como las complicaciones que han ido apareciendo. EnglishIntroduction: The cicatrizal pemphigoid is a chronic inflammatory autoimmune disease, subepithelial blistering disorder, benign, that affects mainly to mucous membranes. Objective: The main aim of this article is to show the pursuit of the local (dental and mucous) and systemic changes that have happened for 15 year in a patient who suffers from cicatrizal pemphigoid. Clinical case: We report the case of a 65 year old woman, with arterial hypertension controlled by medicines, with no other interesting medical record. There are neither any known allergies nor any toxic habits. She suffers from erosive and blister lesions in gums, palate and cheek mucous, without any affectation on other mucous or skin. At present shes in a period of prothetic rehabilitation. Discussion. 15 year-old treatments on this patient are going to be discussed and analysed in this article, both their level of fulfilment and the complications that have been appearing