Biomedical subjects

Leonardo Berini-Aytés

Publications and source records attributed to Leonardo Berini-Aytés.

At least 19 recordsLinked to original sources

PubMed2007

Delayed-onset infections after lower third molar extraction: a case-control study.

PURPOSE: To identify possible risk factors for delayed-onset infections and to develop a model for explaining the effects of these risk factors on the occurrence of delayed-onset infections in an outpatient clinic. MATERIALS AND METHODS: A retrospective case-control study comprising a total of 178 lower third molar extractions performed between 2001 and 2004 in the Oral Surgery and Orofacial Implantology Department of the School of Dentistry of the University of Barcelona, Spain. RESULTS: Bivariate analysis showed tooth sectioning, soft tissue and bone retention, and the position of the lower third molar (according to the classifications of Pell and Gregory, and of Winter) to be significantly associated with the development of delayed-onset infections. A logistic regression model included the following independent variables: position of the lower third molar according to Winter, and Pell and Gregory Classes I, II, and III, and degree of soft tissue retention. CONCLUSIONS: Lower third molars with total soft tissue retention, a lack of distal space and with a vertical or mesioangular tilt are more likely to develop delayed-onset infections. Tooth sectioning, bone retention, and depth of inclusion could also be risk factors for such infections. Heavy smokers seem to be more prone to this complication.

Adult↗

PubMed2006

Influence of lower third molar position on the incidence of preoperative complications.

OBJECTIVE: The present study sought to relate the clinical outcome of mandibular third molar impaction surgery to the orthopanoramic radiographically determined position of the affected teeth based on the classifications of Pell and Gregory, and Winter. STUDY DESIGN: A retrospective study was made of 165 patients undergoing the surgical extraction of lower third molars at School of Dentistry of the University of Barcelona, Barcelona, Spain. The positions of the 259 extracted third molars were documented according to the classifications of Pell and Gregory, and Winter, together with the type of mucosal and bony coverage involved. These tooth position parameters were radiologically assessed using Radio Memory software and were retrospectively correlated to the observed infectious, noninfectious, and neurological postsurgical outcomes. RESULTS: A statistically significant relationship (P < .05) was recorded between the appearance of infectious complications and the position parameters "Pell and Gregory classification," "mucosal coverage," and "bony coverage." A statistically significant relationship (P < .05) was observed between the appearance of noninfectious problems and the parameter "Winter classification." Finally, a significant association (P < .05) was recorded between the position variables and the existence of unwanted neurological changes. CONCLUSIONS: The mandibular position of the impacted third molar may be able to be correlated to the development of complications resulting from impaction removal. Vertical third molars in positions IIA and IIB of the Pell and Gregory classification, with partial mucosal and bony coverage, are the most susceptible to undesired outcomes.

Adolescent↗

PubMed2006

Stafne bone cavity: a retrospective study of 11 cases.

OBJECTIVE: To describe the clinical and radiological characteristics of patients with Stafne bone cavity. STUDY DESIGN: A retrospective, observational study of 11 cases of Stafne bone cavity. After finding an imagine compatible with Stafne bone cavity in the Orthopantomograph(r) of 11 patients, a sialography of the mandibular gland was made in 3 cases, computerized tomography (CT) in 6 cases, and in 4 cases surgical intervention to confirm the diagnosis. RESULTS: The average age was 51.5 years, predominantly males. The entity was diagnosed incidentally during a routine radiology in all cases. The sialography revealed glandular tissue within the defect, and the CT demonstrated the conservation of the lingual cortical and the peripheral origin of the lesion. Glandular tissue was found within the lesions of two of the patients who underwent surgery, and in the other two the cavity was empty. No progressive changes were found in any of the 11 cases. CONCLUSIONS: Stafne bone cavity was an incidental finding, presenting no evolutionary changes, and as such conservatory therapy based on periodic controls was indicated. Currently, complementary techniques such as CT are sufficient to establish a certain diagnosis.

Adult↗

PubMed2006

Antibiotic susceptibility of the bacteria causing odontogenic infections.

AIMS: An evaluation is made of bacterial species and susceptibility to various antibiotics used in application to odontogenic infections of periapical location and in pericoronitis of the lower third molar, with the aim of optimizing the antibiotherapy of such infections and thus preventing unnecessary side effects and over-treatment. MATERIAL AND METHODS: Sixty-four patients with odontogenic infection were selected on the basis of a series of inclusion and exclusion criteria. Samples were collected from lesions under maximally aseptic conditions, avoiding oral saprophytic contamination. The samples were cultured and incubated under aerobic and anaerobic conditions, followed by bacteriological identification and antibiotic susceptibility testing. RESULTS: A total of 184 bacterial strains were isolated and identified, comprising grampositive facultative anaerobes (68%), gramnegative strict anaerobes (30%) and grampositive facultative anaerobes (2%). Regardless of the origin of the odontogenic infection, the causal bacteria yielded the best results in terms of increased sensitivity and lesser resistance with amoxicillin / clavulanate and amoxicillin, respectively (p<0.05). DISCUSSION: There are increasingly numerous reports in the literature of growing bacterial resistance to antibiotics in infectious processes affecting non-buccodental territories. This same tendency has not been observed in relation to oral infections, though important resistance has been documented for certain concrete antibiotics. According to our results, the common-use antibiotics with the greatest sensitivity and lowest resistance were shown to be amoxicillin/clavulanate followed by amoxicillin alone.

Acetamides↗

PubMed2006

Frequency and evolution of lingual nerve lesions following lower third molar extraction.

PURPOSE: To calculate the frequency of lingual nerve (LN) damage caused by lower third molar extraction and describe the evolution of LN sensitivity as well as the prognosis of LN damage based on preoperative data. PATIENTS AND METHODS: A retrospective study of 4,995 lower third molar extractions performed in 3,513 outpatients of the Department of Oral and Maxillofacial Surgery (University of Barcelona, Spain) between January 1998 and September 2001. RESULTS: Twenty-four extractions (0.5%) resulted in LN impairment. All involved ostectomy, with tooth sectioning in 20 cases. Cox regression analysis showed no risk factors for the persistence of LN injury during lower third molar extraction. The sensitivity recovery rate was greater in the first 3 months and then gradually decreased. CONCLUSION: LN impairment usually recovers, the recovery rate being faster in the first months. LN damage is generally associated with ostectomy and tooth sectioning.

Adolescent↗

PubMed2006

Locally aggressive central odontogenic fibroma associated to an inflammatory cyst: a clinical, histological and immunohistochemical study.

The case describes a 38-year-old woman presenting a multilocular radiolucency affecting the entire right half of the lower jaw, with an unerupted third molar displaced to the region of the coronoid process. The histological study showed the presence of fibroblasts, focally with pleomorphic nuclei, dense collagen and an odontogenic epithelium with dystrophic calcifications. A cyst with an important inflammatory infiltrate was, moreover, observed.

Adult↗

PubMed2006

Bilateral bifid mandibular condyle: case report and literature review.

Bifid mandibular condyle is an infrequent and normally asymptomatic morphological alteration of the mandibular condyle. Although the underlying cause is not clear, a number of theories have been proposed, including teratogenic effects in the embryo, vascular alterations during condyle development, and condylar remodeling following fracture. Since Schier first described this anomaly in 1948 in live individuals, further cases have been documented in the literature. We present a new case of bilateral bifid condyle. The disorder was asymptomatic and constituted a casual finding in a young male presenting for the surgical extraction of two impacted molars.

Adult↗

PubMed2005

Pyostomatitis vegetans. Report of two cases and review of the literature.

Pyostomatitis vegetans (PV) is a rare benign chronic mucocutaneous pustular disorder of unknown etiology, though it is usually associated with chronic inflammatory disease of the bowel-particularly ulcerative colitis. At the oral level PV manifests as an exophytic lesion with an erythematous perimeter and a creamy-yellow surface presenting a friable covering membrane which easily disintegrates, giving rise to the development of small ulcers or superficial erosions. The histology shows epithelial acanthosis and superficial ulceration. The underlying connective tissue exhibits neutrophil and eosinophil infiltration, with miliary abscesses in some cases. The present study describes 2 cases of PV associated with ulcerative colitis. The differential diagnosis should be established with Neumann type pemphigus vegetans, since in both cases the lesions are clinically similar and the histology reveals an important eosinophil response, acanthosis, and the formation of intraepithelial miliary microabscesses. The treatment of PV focuses on control of the disease. In the event the orofacial lesions persist, topical oral drugs such as corticoids, with additional antibiotherapy, multivitamin complexes, and nutritional supplements, can be provided.

Adult↗

PubMed2005

Incidence and evolution of inferior alveolar nerve lesions following lower third molar extraction.

OBJECTIVES: To calculate the incidence of inferior alveolar nerve (IAN) damage due to lower third molar extraction and to describe the evolution of IAN sensitivity and the prognosis of IAN damage based on preoperative data. STUDY DESIGN: A retrospective study of 4995 lower third molar extractions in 3513 outpatients. RESULTS: Fifty-five extractions (1.1%) resulted in IAN impairment. Cox regression analysis showed age to be a risk factor for the persistence of IAN injury due to lower third molar extraction. The sensation recovery rate was higher in the first 3 months. Fifty percent of the patients showed full recovery after 6 months. CONCLUSIONS: Most cases of IAN impairment following lower third molar extraction recover within 6 months, though in some cases recovery takes more than 1 year. Older patients are at an increased risk of incomplete recovery of chin and lip sensibility after third molar extraction.

Adolescent↗

PubMed2005

Incidence and clinical features of delayed-onset infections after extraction of lower third molars.

OBJECTIVE: To describe the incidence and clinical features of delayed-onset wound infections after lower third molar extractions in an outpatient clinic. STUDY DESIGN: Retrospective forward study of 958 lower third molar extractions in the Oral Surgery and Implantology Department of the School of Dentistry of the University of Barcelona (Spain). RESULTS: Fourteen delayed-onset wound infections were recorded after suture removal (1.5% of the extractions). These infections usually developed 3-5 weeks after extraction. Half of the cases presented a radiolucency around the crown of the third molar. In most cases, ostectomy (13/14) and tooth sectioning (11/14) had been made. CONCLUSIONS: Delayed infections were a rare postoperative complication of lower third molars extractions. Nevertheless, patients should be warned that infection can still occur several weeks after the surgical procedure.

Adolescent↗

PubMed2003

Evaluation and comparison of 2 needle models in terms of blood aspiration during truncal block of the inferior alveolar nerve.

PURPOSE: We conducted a study to determine the possible differences in blood aspiration between 2 needles of the same length and external gauge but with different internal gauges during truncal block of the inferior alveolar nerve. The working hypothesis was that increased blood aspiration may be expected with larger internal gauge needles. MATERIALS AND METHODS: Four clinicians subjected 346 patients to inferior alveolar nerve block and infiltrating anesthesia of the buccal nerve trajectory for the surgical or conventional extraction of the lower third molar. A nonautoaspirating syringe system with 2 types of needle were used: a standard 27-gauge x 35-mm needle with an internal gauge of 0.215 mm and an XL Monoprotect (manufactured by Sofic, Mazamet, France, and distributed by Laboratorios Inibsa, Barcelona, Spain) 27-gauge x 35-mm needle with an internal gauge of 0.265 mm. The following information was recorded for each patient: needle type, gender, anesthetic technique (direct or indirect truncal block) and the number of bone contacts during the procedure, the patient-extraction side, the operator performing the technique, and blood aspiration (either positive or negative). RESULTS: No significant differences (P <.05) were observed on contrasting the blood aspiration positivity with the internal gauge of the needles. Likewise, no significant differences were seen on correlating aspiration to the anesthetic technique used, the number of bone contacts, the operator, or the patient-extraction side. Blood aspiration was observed in 8.7% of cases. CONCLUSIONS: No significant differences were recorded in terms of blood aspiration and internal gauge, operator, patient-extraction side, or the anesthetic technique involved. Consequently, our initial working hypothesis can be rejected, because no increased percentage of blood aspirations was observed for greater internal gauges.

Adult↗

PubMedDate not supplied

Erbium:YAG laser application in the second phase of implant surgery: a pilot study in 20 patients.

PURPOSE: Conventional implant dentistry implies 2 surgical stages. In this context, pain is often present in the second stage, despite the fact that it is comparatively less aggressive for the patient. The present pilot study proposes application of Erbium:YAG (Er:YAG) laser for second-stage implant surgery. MATERIALS AND METHODS: Twenty patients were studied with a total of 50 implants in which osseointegration was complete. The subjects were divided into 2 groups: a control group (10 patients with 25 implants), subjected to conventional second-stage surgery; and a group of 10 subjects (also with 25 implants) treated with the Er:YAG laser at second-stage implant surgery. RESULTS: The use of Er:YAG laser obviated the need for local anesthesia and minimized postoperative pain and time needed before starting the second stage. With regard to surgical duration, quality of hemostasis, and success in implant treatment, no differences were reported. DISCUSSION: In the second stage of implant surgery, different types of laser have been used, taking advantage of their bacteridal effect; disadvantages arise from inducing damage to the implant surface and adverse thermal effects. CONCLUSION: The advantages afforded by laser treatment include technical simplicity, the possibility of obviating local anesthesia, absence of postoperative pain and edema, and complete tissue healing by day 5, thus facilitating rapid prosthetic rehabilitation. The technique described can be used in all cases except situations where esthetic considerations prevail in anterior areas, or in the event of a lack of keratinized gingiva surrounding the implant.

Adult↗

PubMedDate not supplied

Periodontitis as a risk factor in patients with ischemic heart disease.

Cardiovascular disease, and particularly ischemic heart disease (IHD), constitutes one of the principal causes of mortality in the western world. Interest has recently increased in the relationship between IHD and different infectious processes as triggering factors of the former, such as Chlamydia pneumoniae and Helicobacter pylori infection. Periodontitis has also been related to an increased risk of coronary disease, since both disorders share common characteristics such as patient age and sex, and a smoking habit, among other aspects. There are many similarities between vascular pathology induced by bacteria and the natural history of atherogenesis. The principal mechanism of action underlying periodontitis and IHD centers on the effect of bacteria and their endotoxins upon inflammatory reaction, hemostasia and lipid metabolic alterations. However, some authors are of the opinion that periodontitis constitutes an epiphenomenon, and that further studies are needed to clarify the cause-effect relation between these two multifactor pathologies.

Adult↗

PubMedDate not supplied

Association between B and/or C chronic viral hepatitis and oral lichen planus.

INTRODUCTION: The chronic liver disease is a pathology produced, mainly, by the alcohol chronic abuse and by the hepatitis B and/or C virus infection. In the last years, it has been widely discussed the possible association between chronic liver disease and oral lichen planus. Recently, it has been suggested that the association between oral lichen planus and liver disease has a viral origin. MATERIAL AND METHOD: The objective of this transversal matched study is to know if there is a relationship between B and/or C viral chronic hepatitis and oral lichen planus. Two groups of 100 patients were selected: a case group with patients. Infected with hepatitis B and/or C virus, and a control group without liver disease matched in age and gender. Oral cavity was explored to detect lichen planus in both groups, but we registered other mucosal alterations. RESULTS: We did not found any patient of the case group with oral lichen planus, but four patients with this disease in the control group. CONCLUSIONS: In our study we did not found any association between the infection with the hepatitis B and/or C virus and oral lichen planus.

Adult↗

PubMedDate not supplied

Complications of ambulatory oral surgery in patients over 65 years of age.

Serious systemic disorders such as hypertension, cerebrovascular or heart disease, diabetes and psychiatric problems are common in elderly patients, and lead to the prescription of different drugs. This may in turn influence oral health, and the dentist should be familiarized with these situations when providing dental treatment in elderly patients. A retrospective study was made of 196 patients over age 65 years to evaluate the type of ambulatory surgery performed under locoregional anesthesia, taking into account the presence of background systemic pathology, multiple drug therapy, oral and dental health, the cause of consultation and the type of anesthesia used, relating these parameters to the development of intra- or postoperative systemic and/or local complications. Some systemic disease was documented in 88% of the patents-- hypertension being the most frequent disorder (in 45% of subjects with systemic disease). On the other hand, 78% of the patients used some medication, and 77% presented for hard-tissue treatment (tooth extractions, bone remodeling, etc.); 61% of all treatments comprised the removal of root fragments (54% of all hard-tissue interventions), symptomatic third molars (15%) or other dental inclusions. Only mild or moderate complications were recorded (13%) -- either local (n = 25) or systemic (n = 1). No significant relation was observed between the development of intra- or postoperative complications and the type of treatment provided or the medication used by these patients. Only diabetes was associated with a significant increase in intra- and postoperative local complications (p<0.003).

Age Factors↗

PubMedDate not supplied

Ossifying fibroma of the upper jaw: report of a case and review of the literature.

A number of processes generically referred to as benign fibroosseous lesions comprise different disorders such as fibrous dysplasia, sclerotizing osteomyelitis and ossifying or cementing fibroma. These processes are all characterized by the existence of a vascular fibroblastic stroma, with the production of a calcified matrix ranging from bone to cementum. Ossifying fibroma involves slow-evolving growth with deforming swelling generally arising in the mandible, with possible early dental displacement. From the radiological perspective the disorder generally manifests as a well defined and delimited, unilocular radiotransparency, as a radiotransparent image with central opacifications, or as multilocular transparencies. The lesions exceptionally can be radiopaque. We present the case of a 22-year-old male presenting for evaluation of a three-month, asymptomatic tumor mass in the anterior sector of the upper jaw. Radiologically, the lesion appeared as a radiotransparent zone surrounded by a poorly delimited sclerotic halo. The definitive diagnosis following surgical resection of the lesion was ossifying fibroma. The case is discussed, and a review is provided of the literature on the subject.

Adult↗

PubMedDate not supplied

Analgesic efficacy of diclofenac sodium versus ibuprofen following surgical extraction of impacted lower third molars.

OBJECTIVE: An evaluation is made of the analgesic efficacy of diclofenac sodium versus ibuprofen after impacted lower third molar surgery. STUDY DESIGN: The patients were randomly assigned to one of two groups (ibuprofen or diclofenac). The difficulty of third molar surgery, performed under local anesthesia, was assessed by the degree of inclusion involved. The recorded study variables were pain intensity and the need for rescue medication during one week. The recordings were made once a day at the same time, using a patient-completed questionnaire. RESULTS: Eighty-one patients were finally included in the study (87.1%). The results were similar in the first 48 postoperative hours in both groups, though on the third day the diclofenac group tended to show higher pain scores--the differences being nonsignificant, however (p<0.05). This tendency was also reflected by an increased need for rescue medication and the consumption of a larger number of tablets in the diclofenac group. CONCLUSIONS: There were no statistically significant differences in analgesic efficacy between diclofenac sodium and ibuprofen, though the former was associated with an increased need for supplementary medication in the first two postoperative days (p<0.05).

Adolescent↗

PubMedDate not supplied

Peripheral giant cell granuloma. A report of five cases and review of the literature.

Peripheral giant cell granuloma (PGCG) is a relatively frequent benign reactive lesion of the oral cavity, originating from the periosteum or periodontal membrane following local irritation or chronic trauma. PGCG manifests as a red-purple nodule located in the region of the gums or edentulous alveolar margins, fundamentally in the lower jaw. The lesion can develop at any age, though it is more common between the fifth and sixth decades of life, and shows a slight female predilection. PGCG is a soft tissue lesion that very rarely affects the underlying bone, though the latter may suffer superficial erosion. The present study reviews 5 cases of PGCG, involving 3 males and 2 females between 19-66 years of age, and with presentation in the upper jaw in three cases. Two patients showed radiological concave depression images corresponding to bone resorption. Treatment consisted of resection and biopsy, using a carbon dioxide laser in 2 cases and a cold scalpel in the remaining 3. There were no relapses during postoperative follow-up (range 10 months to 4 years). The differential diagnosis of PGCG includes lesions with very similar clinical and histological characteristics, such as central giant cell granuloma, which are located within the jaw itself and exhibit a more aggressive behavior. Only radiological evaluation can establish a distinction. The early and precise diagnosis of these lesions allows conservative management without risk to the adjacent teeth or bone.

Adult↗