Artículos (Estomatología)

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Enhancing nursing competencies: An assessment of knowledge and attitudes toward dental trauma management among nursing students—An interventional study
(MDPI, 2024-11-29) Carrion-Ruiz, Beatriz Emilia; Cabrera Fernández, Alberto; Crespo Gallardo, Isabel; Cabanillas Balsera, Daniel; Segura Egea, Juan José; Pabón Carrasco, Manuel; Martín González, Jenifer; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Enfermería; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS-941: Patología dentaria, operatoria dental y endodoncia; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en Salud
Introduction: Traumatic dental injuries (TDIs) present a significant challenge for healthcare professionals. Nurses, often the first point of contact for patients, may lack essential knowledge in dental trauma first aid, as noted in the existing literature. Objective: To assess the knowledge of traumatic dental injuries (TDIs) among undergraduate nursing students before and after a targeted educational intervention. Materials and Methods: This quasi-experimental study evaluated the effectiveness of an educational intervention involving 300 nursing students from two universities in Seville. The educational intervention was led by specialist dentists. A pre-test survey was administered to assess students’ baseline knowledge. The session included a lecture on TDI management, followed by a simulation in which students practiced emergency splinting techniques for referral to a dentist. A post-test survey was then conducted to measure changes in students’ knowledge and attitudes towards dental trauma. Results: Only 25.4% of students had prior training in dental trauma. After the intervention, there was a significant improvement in students’ self-assessed knowledge of first aid for TDIs (p < 0.05). A high percentage of students also reported increased confidence in their ability to reimplant a tooth. Statistical analysis of pre- and post-intervention survey results showed a substantial increase in average scores (p < 0.05). Conclusions: Nursing students initially exhibited limited knowledge in managing dental trauma but demonstrated a positive attitude toward learning this new skill. The targeted educational intervention significantly enhanced their understanding, underscoring the need to incorporate such training into nursing curricula. By improving nursing students’ competence in managing dental injuries, this training can help better preserve dental structures and improve the prognosis for dental trauma cases.
Influence of the physiological pacifier on the development of malocclusions in children: A scoping review
(Mdpi, 2024-11-07) Caleza Jiménez, Carolina; Rodríguez Romero, Inés; Ribas Pérez, David; Biedma Perea, María; Universidad de Sevilla. Departamento de Estomatología
Background: As a result of the dental alterations pacifiers can cause, several designs have been described, differing in the shape and size of the teat. The aim of this review was to compare the influence of the physiological pacifier on the development of malocclusions in children with other types of pacifier. The research question was: does the use of physiological pacifiers cause less dentomaxillary alterations than other designs? Methods: A scoping review was carried out according to the Preferred Reporting Items for Systematic ReviewsandMeta-Analyses(PRISMA)usingPubMed, Embase, and Scopus. The ROBINS-I risk of bias tool was used for the methodology assessment of the included studies. Results: Of the 122 articles identified in the initial search, 5 articles met all the inclusion criteria. In all of them, in general, the use of the pacifier caused malocclusions such as an anterior open bite, a posterior crossbite, an increased overjet, and an involvement of the overbite. Children who began using the physiological pacifier very early, between 0 and 3 months, were less likely to develop finger sucking/thumb sucking compared to children who started after 3 months. In the prevalence of open anterior bite and overjet, there was a significant difference between the use of conventional pacifiers and anatomical pacifiers compared to the use of physiological pacifiers. Conclusions: the physiological pacifier can cause fewer oral alterations and could be the best option as a pacifier, however, more well-designed and high-quality randomised clinical trials are required.
Study of the impact on zygomatic bone using numerical simulation
(MDPI, 2024-11-14) Ruiz-de-León, Gonzalo; Baus Domínguez, María; González Martín, María Isabel; Gutiérrez Corrales, Aída; Torres-Carranza, Eusebio; Martínez-González, Álvaro-José; Torres-Lagares, Daniel; López Millán, Jose Manuel; Ambrosiani Fernández, Jesús; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Cirugía; Universidad de Sevilla. Departamento de Anatomía y Embriología Humana; Universidad de Sevilla. CTS-1050: Cuidados Complejos, Cronicidad y Resultados en Salud; Universidad de Sevilla. CTS-523: Innovación y desarrollo en técnicas y fundamentos de cirugía bucal y craneofacial; Universidad de Sevilla. CTS-1037: Abordaje multidisciplinar de la patología rinosinusal, otológica y de base de cráneo
The zygomatic bone, a fundamental structure in facial anatomy, is exposed to fractures in impact situations, such as traffic accidents or contact sports. The installation of zygomatic implants can also alter the distribution of forces in this region, increasing the risk of fractures. To evaluate this situation, the first step is to develop a complex anatomical model from the stomatognathic point of view so that simulations in this sense can be validated. This study uses numerical simulation using a finite-element method (FEM) to analyze the behavior of the zygomatic bone under impacts of different velocities, offering a more realistic approach than previous studies by including the mandible, cervical spine, and masticatory muscles. Methods: An FEM model was developed based on 3D scans of actual bones, and simulations were performed using Abaqus Explicit 2023 software (Dassault Systemes, Vélizy-Villacoublay, France). The impact was evaluated using a steel cylinder (200 mm length, 40 mm diameter, 2 kg weight) impacted at speeds of 5, 10, 15, and 20 km/h. Zygomatic, maxillary, and mandibular bone properties were based on dynamic stiffness parameters, and bone damage was analyzed using ductile fracture and fracture energy criteria. Results: The results show that at impact velocities of 15 and 20 km/h, the zygomatic bone suffered crush fractures, with impact forces up to 400 kg. At 10 km/h, a combination of crushing and bending was observed, while at 5 km/h, only local damage without complete fracture was detected. The maximum stresses were concentrated at the zygoma–jaw junction, with values above 100 MPa at some critical points. Conclusion: The FEM model developed offers a detailed representation of the mechanical behavior, integrating the main structures of the stomatognathic apparatus of the zygomatic bone under impact, providing valuable information to, for example, advance injury prevention and zygomatic implant design. Higher impact velocities result in severe fractures, underscoring the need for protective measures in clinical and sports settings.
Cepillo iónico versus manual: eficacia en la remoción bioeléctrica de la placa bacteriana
(Ediciones Avances, S.L., 2024) Sanz de Madrid Calvo, José Antonio; Manso Platero, Francisco José; Suárez Marchena, Cira María; Segura Egea, Juan José; Machuca Portillo, María del Carmen; Universidad de Sevilla. Departamento de Estomatología
Introducción: Existe una clara asociación entre la presencia de placa bacteriana y la caries dental y enferme- dades periodontales. El control efectivo de la placa supragingival es la base para la prevención y el tratamiento de ambas enfermedades bucodentales. Objetivos: Determinar la eficacia del cepillo de dientes iónico en la remoción bioeléctrica de la placa bacteriana versus el cepillo dental convencional. Material y Métodos: Ensayo clínico aleatorizado a simple ciego entre un cepillo dental iónico y uno convencio- nal. El seguimiento fue realizado durante cuatro semanas a través de la determinación del índice de placa (IP) y el índice gingival (IG) por un odontólogo. Resultados: Participaron en el estudio 74 sujetos voluntarios, siendo el 51,4% mujeres. La edad media fue de 45 ± 14,73 años. La mejoría del IP con el cepillo iónico fue de 1,37 a 0,96 y con el cepillo convencional de 1,30 a 1,11. La mejoría del IG con el cepillo iónico fue de 0,12 a 0,45 y con el cepillo convencional de 1,30 a 1,11. Conclusiones: Los cepillos dentales iónicos son eficaces en la reducción de caries y gingivitis. La evolución del IP y IG en cada visita mejora entre las personas que han usado el cepillo iónico frente a las que han usado el convencional, no existiendo diferencias estadísticamente significativas entre ambos, aunque la mejoría es superior con el cepilló dental iónico. La evolución del IP y IG a lo largo del tiempo es mejor significativamente entre las personas que han usado el cepillo Iónico.
Relationship of hypomineralization of primary second molars to the molar-incisor syndrome (MIH) - Systematic review
(Arán Ediciones, 2024) Ribas Pérez, David; Fernández León, Javier; Cerdán Gómez, Fátima; Estrela Sanchís, Filomena; Yuste Bielsa, Silvia; Traver Ferrando, Carla; Gatón Hernandez, Patricia; Saavedra Marbán, Gloria; Universidad de Sevilla. Departamento de Estomatología
Introduction: molar-incisor hypomineralization (MIH) is characterized by the appearance of enamel changes in the first permanent molars and permanent incisors. Similar lesions have been described in primary second molars and the term hypomineralization of deciduous second molars (HDSM) has started being used, with clinical characteristics which are similar to MIH and a predictor of the appearance of MIH in permanent dentition. Objectives: the overall objective was to investigate the relationship between HDSM and the subsequent occurrence of MIH in children with mixed or permanent dentition by means of a systematic review. Material and method: we conducted a systematic review using PubMed, Scopus and Web of Science databases. PICO parameters were children with mixed or permanent dentition affected by HIM and/or HDSM (P), observation of the relationship between HDSM and MIH (I), comparison with the absence of MIH in children with HDSM (C), and establishment of the relationship between MIH and HDSM (O). Keywords: “hypomineralization”, “dental hypoplasia”, “primary second molars”, “deciduous molars” and “molar-incisor hypomineralization”. Results: after applying inclusion and exclusion criteria, a total of12 articles related to the research topic were analyzed. These articles were subjected to the corresponding analysis to draw conclusions. Conclusions: the coexistence of HDSM and MIH suggests an association with HDSM being a potential predictor of MIH with no significant differences by gender, ethnicity, or socioeconomic status. The absence of HDSM does not exclude the possibility of occurrence of MIH. Unlike MIH, the severity of HDSM is not directly related to the number of deciduous second molars (DSM) affected so mild HDSM and a higher number of DSM affected may increase that association. There is no significant association between the presence of HDSM and the severity of MIH, but both tend to correlate in severity when they coexist.
Repercusiones bucodentales del asma en la infancia y adolescencia
(Sociedad de Pediatria de Andalucía Occidental y Extremadura, 2011-10) Gor Chillón, M.J.; Cabrera Domínguez, María Eugenia; Cabrera Suárez, Eugenio Pedro; Domínguez Reyes, Antonia; Universidad de Sevilla. Departamento de Estomatología
Antecedentes: El asma bronquial es la enfermedad crónica más frecuente en la infancia. Su etiología es multifactorial, implica predisposición genética y factores ambientales desencadenantes. El tratamiento farmacológico se basa en dos grupos de fármacos, los broncodilatadores y los antiinflamatorios, que se administran fundamentalmente por vía inhalatoria, quedando el 80% del fármaco depositado a nivel bucofaríngeo. Objetivos: Conocer las repercusiones a nivel de la salud bucodental del asma infantil, bien a causa de los factores físicos y fisiológicos de la enfermedad o como consecuencia de la medicación que toman. Método: Se realiza una revisión sistemática de la literatura científica, en bases de datos PubmedMedline, Scopus, y Cochrane de artículos publicados en ingles desde el año 1998 hasta el año 2011. Resultados: Los cambios en las condiciones de salud oral asociadas al asma que se han descrito en la literatura: mayor número de casos de respiración bucal, lo que supone que los niños tengan más problemas de ortodoncia y mayor índice de gingivitis por deshidratación de la mucosa. No se ha podido demostrar que en los niños con asma haya mayor prevalencia de candidiasis oral. El aumento del riesgo de caries parece estar relacionado con el uso de fármacos que provocan una disminución en la tasa de flujo de saliva y del pH bucal, además de otros factores y hábitos. Conclusiones: Sería necesario seguir investigando sobre las repercusiones bucodentales del asma, ya que hay un aumento en la prevalencia de esta enfermedad. Es importante un control preventivo por parte del odontólogo: revisiones periódicas, instrucciones de higiene bucal, después de usar los inhaladores, programas de fluoraciones y consejos dietéticos.
La apnea del sueño en el niño
(Sociedad de Pediatria de Andalucía Occidental y Extremadura, 2011-04) Domínguez Reyes, Antonia; Rivero Millán, P.; Universidad de Sevilla. Departamento de Estomatología
Antecedentes: Si es importante conocer y tratar odontológicamente al niño en todas sus vertientes, conocer los problemas que la apnea del sueño plantea a nivel del Aparato Estomatognático y sus repercusiones, es una de las cuestiones que más interés suscita en la actualidad. Y ello porque, según se desprende de la literatura por nosotros consultada, los períodos de apnea, no solo pueden ocasionar la muerte súbita en el pequeño paciente, sino, porque, desde el punto de vista odontológico, las alteraciones de la oclusión y otras manifestaciones buco-dentofaciales son causa y efecto de la apnea. Objetivo: Revisión de los artículos publicados en la literatura acerca del Síndrome de Apnea Obstructiva del Sueño (SAOS). Material y métodos: Revisión de la literatura publicada en las distintas bases de datos. Resultados: Se exponen de forma clara y concisa los métodos diagnósticos y opciones terapéuticas para diagnosticar y tratar de forma adecuada al niño que padezca SAOS.
Influence of academic training and professional experience on the management of deep caries lesions
(MDPI, 2024-09-24) Arroyo Bote, Sebastiana; Ribas Pérez, David; Bennasar Verges, Catalina; Rodríguez Menacho, Diego; Villalva Hernandez-Franch, Paloma; Barbero Navarro, Ignacio; Castaño Seiquer, Antonio Luis; Universidad de Sevilla. Departamento de Estomatología
Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. Methods: This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. Results: A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor’s degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master’s degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16–30 years. Conclusions: Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions.
Descriptive study of the oral health status of disadvantaged mexican populations in relation to their adherence to the mediterranean diet
(Universidad Científica del Sur. Lima. Peru, 2024-06-30) Flores-Fraile, Javier; Parra-Garcia, Sergio; Gonzalez-Gil, Diego; Moreno Barrera, Alejandro; Peramato-Benito, Alejandra; Castaño Seiquer, Antonio Luis; Universidad de Sevilla. Departamento de Estomatología
Background: Obesity in Mexico is an alarming problem that has been increasing in recent decades. Dietary factors make this pathology more common at younger ages and closely related to oral health. This study attempts to investigate the association between the oral health status of a Mexican population in the state of Yucatan and their dietary habits. Objective: This study explores the relationship between oral health-related quality of life and adherence to the Mediterranean diet in a disadvantaged population in the state of Yucatan, Mexico. Methods: The research was conducted in July 2023 in Merida, Yucatan (Mexico). The sample consisted of 109 individuals aged between 4 and 72 years old. Data analysis focused on factors such as body mass index (BMI), oral health-related quality of life, and adherence to the Mediterranean diet. Results: A notable presence of caries is observed in individuals with low adherence to the Mediterranean diet (Correlation coefficient 0.040, p=0.682). This underscores the potential interaction between oral health, obesity, and dietary habits. The mean Oral Health-Related Quality of Life (OHIP-14Sp) score was 13.19 ±13.57, median 8.00. Conclusions: This research adds to the increasing evidence that highlights the significance of a balanced diet in enhancing the oral quality of life for people. More research is necessary to explore preventive measures and treatment to raise awareness about oral health within the community.
Physical performance, body composition, and oral health in community-residing older adults: A cross-sectional study
(MDPI, 2024) Irigoyen-Camacho, Maria Esther; Velazquez-Alva, Maria Consuelo; Zepeda-Zepeda, Marco Antonio; Lazarevich, Irina; Castaño Seiquer, Antonio Luis; Flores-Fraile, Javier; Universidad de Sevilla. Departamento de Estomatología
Physical activity is essential for healthy aging. This study aimed to identify an association between physical performance, body fat percentage (%BF), and the perception of oral health-related quality of life (OHRQoL) in independent older adults. Method: A group of active older adults was selected from a government-sponsored reunion center in Mexico City. OHRQoL was assessed using the General Oral Health Index (GOHAI), and nutritional status was assessed using the Mini Nutritional Assessment (MNA) tool. A short physical performance battery (SPPB) was applied, and, for body composition, DXA (dual X-ray absorptiometry) was conducted. Data were analyzed using logistic regression models, and marginal probabilities were obtained. Results: This study involved 366 participants; their mean age was 73.9 (±6.2) years, and 24.9% had type 2 diabetes mellitus (T2DM). OHRQoL information revealed that pain or discomfort in the oral cavity was perceived by 63.9% of the older adults during the previous three months. The SPPB score was low in 159 (43.44%) participants. The logistic regression model revealed that age (OR = 1.13, p < 0.001), T2DM (OR = 2.10, p = 0.009), the risk of malnutrition/malnutrition (OR = 1.76, p = 0.047), high %BF (OR = 1.09, <0.001), and poor OHRQoL (OR = 1.96, p = 0.009) were associated with deteriorated physical performance. Conclusion: OHRQoL self-perception, excess body fat, and nutritional status impacted physical performance. Aging well requires a comprehensive approach.
Predictors of periapical bone healing associated with teeth having large periapical lesions following nonsurgical root canal treatment or retreatment: A cone beam computed tomography-based retrospective study
(Wiley, 2024) Mosquera-Barreiro, Carolina; Ruiz-Piñón, Manuel; Sans, Francesc Abella; Nagendrababu, Venkateshbabu; Vinothkumar, Thilla Sekar; Martín González, Jenifer; Martin-Biedma, Benjamín; Castelo Baz, Pablo; Universidad de Sevilla. Departamento de Estomatología
Aim: Several factors influence the condition of the periapical tissues associated with root filled teeth. The primary objective of this study was to retrospectively evalu ate the extent and speed of bone healing of large periapical lesions associated with nonsurgical root canal treatment or retreatment. The secondary objective was to analyse the relationship between the time to complete healing when analysed using cone beam computed tomography (CBCT) and other possible predictors that affect healing. Methodology: Seventy-nine patients were treated during the years 2013–2020 with large periapical lesions of endodontic origin (10–15mm) as observed on intraoral periapical radiographs (IOPAR) were included. IOPAR and CBCT were available before treatment and during the follow-up (IOPAR every 6months and CBCT every 12months). The volume of periapical lesions was calculated by OsiriX Lite software. Variables such as initial volume of the lesion, age, gender, type of treatment or type of root canal filling were compared to identify the differences between healed and unhealed lesions. Pearson's Chi-square test was used for categorical variables, the t-test for age and the Wilcoxon test for initial volume of the lesion. The association between time to healing and the variables was assessed using univariate analysis and multivariate analysis. The Wilcoxon test was used to observe the association of heal ing time with categorical variables and the correlation index was measured with the quantitative variables. Results: Of the 79 cases analysed, 60 lesions (76%) were completely healed as verified by CBCT in a mean healing time of 19months, of which 60% healed fully between 12 and 18months. Increase in age of patient and larger initial volume of the lesion were associated with a significantly longer healing time (p<.001). Gender, filling material and type of treatment did not have a significant effect on the healing process (p>.05).
Spanish Curriculum in Cariology for undergraduate dental students: Proceedings and consensus
(Wiley, 2022-05) Cortés Martinicorena, Francisco Javier; Ceballos, Laura; Martínez Pérez, Eva; Hernández Juyol, Miguel; Schulte, Andreas G.; Almerich Silla, José Manuel; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología
Introduction Cariology is today a broad-based discipline and in the Spanish university teaching field, all this knowledge is not unified in a curriculum. Therefore, the aim was to develop a consensus text based on the European Core Curriculum, updated, and adapted to the characteristics of the Spanish university environment. Materials and Methods A Spanish Cariology Curriculum Group (SCCG) was set up with members of the Spanish Society of Epidemiology and Oral Public Health (SESPO), Spanish Society of Conservative and Aesthetic Dentistry (SEOC) and Spanish Society of Paediatric Dentistry (SEOP) and university experts to adapt the European Core Curriculum in Cariology for undergraduate dental students (ECCC) for Spain. The work was carried out online during 2018 and 2019, and also face-to-face meetings took place to obtain a draft curriculum open for discussion that was presented to all the Spanish universities. The final modifications to the document were specified in a Consensus Conference of Spanish universities offering a Degree in Dentistry that took place in Madrid on 19 November 2019. Results Thirty-eight university experts, under SCCG supervision, participated in the elaboration of the new framework document. A total of 16 universities, from 23 invited, reached a consensus as to the contents of the Spanish Curriculum in Cariology for undergraduate dental students. This new Curriculum emphasises learning outcomes, uses a consensus-based terminology pertaining to caries and other hard-tissue conditions, and introduces a new domain of competence in Domain III of ECCC. Conclusion This new Cariology Curriculum is the result of a very broad-based consensus of university experts in Spain and lays the foundation for the implementation of an integrated teaching of Cariology in Spain in adherence to Alliance for a Caries Free Future (ACFF) objectives.
Low-level laser therapy in patients with Burning Mouth Syndrome: A double-blind, randomized, controlled clinical trial
(Medicina Oral S.L., 19-01-14) Spanemberg, Juliana Cassol; Segura Egea, Juan José; Rodríguez de Rivera Campillo, Eugenia; Jané Salas, Enric; Salum, Fernanda Gonçalves; López López, José; Universidad de Sevilla. Departamento de Estomatología
Background: The burning mouth syndrome (BMS) presents with symptoms of burning or pain in the oral cavity, especially in the tongue, lips, and hard and soft palates. Its etiology is yet to be elucidated, but it is considered to be affected by multifactorial, psychological, and local and systemic factors. Objective: Evaluate the effect of LLLT in the treatment of 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 (p > 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 (p=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 (p=0.0538). Conclusions: LLLT may be an alternative treatment for the relief of oral burning in patients with BMS.
MTA HP Repair stimulates in vitro an homogeneous calcium phosphate phase coating deposition
(Medicina Oral S.L., 2019-03-13) Jiménez Sánchez, María del Carmen; Segura Egea, Juan José; Díaz Cuenca, Aranzazu; Universidad de Sevilla. Departamento de Estomatología
Background: To study the mineralization capacity in vitro of the bioceramic endodontic material MTA HP Repair. Material and Methods: Bioactivity evaluation in vitro was carried out, by soaking processed cement disk in simulated body fluid (SBF) during 168 h. The cement surface was studied by Fourier transform infrared spectroscopy (FTIR), field emission gun scanning electron microscopy (FEG-SEM) and energy dispersive X-ray analysis (EDX). Release to the SBF media of ionic degradation products was monitored using inductively coupled plasma atomic emission spectroscopy (ICP-AES). Results: FT-IR showed increasing formation of phosphate phase bands at 1097, 960, 607 and 570 cm-1 with prolonged SBF soaking. FEG-SEM analysis reveals that HP produces a effectively surface covering consisting in homogeneous spherical phosphate phase aggregates with an average diameter of 0.5-1.0 µm. EDX analysis comparing un-treated (hydrated), 24 h and 72 h SBF treated surfaces of MTA HP Repair revealed phosphate deposition after 24 h, with high phosphorous/silicon element ratio signal measured after 24 h, indicating a very high phosphate phase deposition for this material. Conclusions: The study shows that MTA HP Repair produces a quick and effective bioactive response in vitro in terms of crystalline calcium phosphate surface coating formation. The high bioactive response of MTA HP Repair makes it an interesting candidate for endodontic use as repair cement.
Endodontic variables in patients with SARS-CoV-2 infection (COVID-19) in relation to the severity of the disease
(Medicina oral S.L, 2023) Poyato Borrego, Manuel; León-López, María; Martín González, Jenifer; Cisneros, José Miguel; Cabanillas Balsera, Daniel; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is the cause of the ongoing coro navirus disease 2019 (COVID-19) pandemic. It has been hypothesized oral health may be related to the severity and complications of COVID-19. The aim of this study was to analyze the prevalence of apical periodontitis and the frequency of root canal treatment in a sample of patients with SARS-CoV-2 infection (COVID-19), correlating them with the severity of the disease. Material and Methods: This retrospective study was conducted following the Strengthening Reporting Observa tional Studies in Epidemiology (STROBE) guidelines. The study examined 280 patients with positive real time PCR COVID-19 test whose treatment was performed in our hospital. Fifty-two patients aged 52.3 ± 17.3 years, including 30 males and 22 females, who had an orthopantomography in their clinical record, performed in the last 2 years, were included. Patients with SARS-CoV-2 infection were grouped as mild or moderate (MM) and severe or critical (SC) illness groups, according to the NIH COVID-19 Treatment Guidelines (Wu & McGoogan 2020). Radiographic records were analyzed and apical periodontitis (AP) was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student’s t test, χ2 test and multivariate logistic regression were used in the statistical analysis. Results: The number of carious teeth was significantly higher in the SC group (3.4 ± 4.1), which showed more than twice as many teeth with carious lesions than the MM group (1.4 ± 1.8) (p = 0.02). Multivariate regression analysis showed association between the number of carious teeth and the severity of SARS-CoV-2 disease (OR = 1.5; 95% CI = 1.1–2.1; p = 0.017). Endodontic status (OR = 7.12; 95% CI = 1.2-40.9; p = 0.027) also correlated with the disease severity. Conclusions: The results suggest that the oral health status of COVID-19 patients correlated with the severity of the SARS-CoV-2 virus infection. Significant association has been found between the severity of COVID-19 dis ease and the presence of a greater number of teeth with caries lesions, as well as with endodontic status.
Physicochemical parameters - hydration performance relationship of the new endodontic cement MTA Repair HP
(Medicina Oral S. L., 2019-06-04) Jiménez Sánchez, María del Carmen; Segura Egea, Juan José; Díaz Cuenca, Aranzazu; Universidad de Sevilla. Departamento de Estomatología
Background: To characterize the chemical composition and textural parameters of the MTA Repair HP precursor powder and their influence to hydration performance. Material and Methods: Un-hydrated precursor material was characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), X-ray fluorescence (XRF), laser diffraction (LD), N2 physisorption and field emission gun scanning electron microscopy (FEG-SEM). Setting time was assessed according to ASTM specification C 266. Hydrated material was analysed by XRD, FT-IR, energy dispersive X-ray (EDX) analysis and FEG-SEM. Results: Ca3 SiO5 and Ca2 SiO4 , in addition to CaWO4 as radiopacifier are the main compositional phases. Other measured parameters indicate high specific surface area of 4.8 m2 g-1, high aluminium content of 1.7 wt.% and low initial and final setting times of 12 and 199 min, respectively. Singular microstructural features consisting of high aspect ratio nanoparticles are main constituents of un-hydrated precursor. Besides, FEM-SEM observation shows notably growth of hexagonal shaped plate-like morphologies homogeneously distributed along the sample during hydration process. Conclusions: The short setting time measured for HP Repair, is correlated with high surface area of precursor powder, high Al content and the absence of compositional sulphate phases.
Periapical and endodontic status of patients with inflammatory bowel disease: age- and sex- matched case-control study
(Wiley, 2022-04-11) Segura Sampedro, Juan José; Jiménez Giménez, Carla; Jane Salas, Enric; Cabanillas Balsera, Daniel; Martín González, Jenifer; Segura Egea, Juan José; López López, José; Universidad de Sevilla. Departamento de Estomatología; Ministerio de Educación, Cultura y Deporte (MECD). España
Aim Crohn's disease (CD) and ulcerative colitis (UC) are two chronic recurrent inflammatory processes of the gastrointestinal tract, grouped under the name inflammatory bowel disease (IBD), causing clinical episodes of intestinal inflammation. The aim of this study was to investigate the possible association between IBD and the prevalence of apical periodontitis (AP) and root canal treatment. Methodology A case–control study design matched to age and sex was used. The study group (SG) included 28 patients with IBD (13 with CD, 15 with UC). Another 28 healthy subjects, without IBD and age- and sex-matched, were included in the control group (CG). Radiographic records were analysed and AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score. Student's t-test, χ2 test and multivariate logistic regression were used in the statistical analysis. Results In the CG, only 17 subjects (61%) had at least one tooth with AP, whilst in the SG group they were 23 patients (82%; OR = 2.98; 95% CI = 0.87–10.87; p = .08). The number of subjects with one or more root filled teeth (RFT) in the CG was 14 (50%), whilst in the SG they were 22 (79%; OR = 3.67; 95% CI = 1.14–11.79; p = .026). At least one RFT with AP was evident in three subjects (10.7%) in the CG, whilst in the SG 15 patients (53.6%) showed RFT with AP (OR = 9.60; 95% CI = 2.35–39.35; p = .001). In the multivariate logistic regression analysis, only endodontic status was found to be associated with IBD (OR = 1.86; 95% CI = 1.24–2.80; p = .003). Conclusion IBD, UC and Crohn’s disease are associated with higher prevalence of RFT and higher percentage of RFT with periapical lesions. Dentists should consider these findings when caring for IBD patients by monitoring the evolution of periapical lesions of endodontically treated teeth.
The bacteremia of dental origin and its implications in the appearance of bacterial endocarditis
(Medicina oral S.L, 2014) Mang-de la Rosa, María Rocío; Castellanos Cosano, Lizett; Romero-Pérez, María Jesús; Cutando, Antonio; Universidad de Sevilla. Departamento de Estomatología; Instituto de Biomedicina de Sevilla (IBIS)
Numerous systemic diseases may affect the oral cavity and vice versa,in particular severe diseases that involve the heart valve. In these cases, additional measures or a modification to our dental treatment need to be taken. We are aware of various diseases that can cause the emergence of bacterial endocarditis (BE), such as; rheumatic fever, valve lesions due to intravenous drug use, Kawasaki disease and valve surgery, among others. Due to its severity when it is not taken into account in dental treatment, we intend to show the evolution of the antimicrobial prophylaxis towards this condition. Furthermore, we intend to publish the current guidelines of institutions and societies which increasingly encourage rational antimicrobial use. In addition, we intend to examine the evidence of the possible origins of this disease during dental treatment and at the same time describe the necessary considerations that need to be taken during dental treatment.
Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline
(Wiley, 2023-09-29) Duncan, Henry F.; Kirkevang, Lise-Lotte; Peters, Ove A.; El-Karim, Ikhlas; Krastl, Gabriel; Del Fabbro, Massimo; Chong, Bun San; Galler, Kerstin M.; Segura Egea, Juan José; Kebschull, Moritz; Universidad de Sevilla. Departamento de Estomatología; European Society of Endodontology (ESE)
Background The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. Aim To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. Methods This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. Results The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. Conclusion The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
The Role of Apical Periodontitis Disease in the Development of Bisphosphonate-Related Osteonecrosis of the Jaw: An Animal Study
(MDPI, 2023-07-12) Marques Ferreira, Manuel; Abrantes, Ana Margarida; Paula, Anabela; Laranjo, Mafalda; Pires, Ana Salomé; Caramelo, Francisco; Segura Egea, Juan José; Brito, Ana; Carvalho, Lina; Botelho, Maria Filomena; Carrilho, Eunice; Marto, Carlos Miguel; Paulo, Siri; Universidad de Sevilla. Departamento de Estomatología; European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER); Foundation for Science and Technology (FCT), Portugal
Background: Microorganisms and their by-products are responsible for establishing pulpal and periapical diseases. Healing is compromised in patients under bisphosphonate therapy, and the presence of periapical infections can potentially lead to the development of medication-related osteonecrosis of the jaw (MRONJ). This work aimed to evaluate if bisphosphonate therapy is a risk factor for MRONJ development in the presence of periapical lesions. Methods: Two groups of 10 female Wistar rats were used. The experimental group received zoledronate (0.1 mg/kg) intraperitoneally, and the control received a saline solution, three times a week for three weeks. One week after the last injection, apical periodontitis was induced through pulpal exposure in the mandibular first molars. Twenty-one days later, the animals were intravenously injected with 99mTc-HMDP, and the radioactivity uptake by mandibular specimens was counted. In addition, sample radiographs and a histological examination were performed. Results: The bone loss was higher in the control group when compared to the experimental group (p = 0.027). 99mTc-HMDP uptake in the control was reduced compared with the experimental group, although without statistical significance. Conclusions: In the presence of zoledronate therapy, apical periodontitis does not increase the risk of MRONJ development, and periapical lesions have lower bone resorption when compared to the control group.

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