Artículos (Estomatología)

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The role of oxidative stress in periodontitis
(Wiley, 2025-07-17) Bullón Fernández, Pedro; Giampieri, Francesca; Bullón de la Fuente, Beatriz; Battino, Maurizio; Estomatología; CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares
Periodontitis and noncommunicable diseases share an overall inflammatory state often sustained by concomitant oxidative stress as one of the main processes involved. A huge amount of literature supports such a main pathogenic process, which is also considered the therapeutic target. The attempt to control inflammation by acting on oxidative stress has given largely unsatisfactory results, either as preventive or as treatment approaches. To propose new ideas that will help in this field, the paper reviewed all physiological processes involved in oxidative stress in periodontitis. The discussion considers all of them, considering whether they come from endogenous sources, that is, all the intracellular physiological devices and/or processes that are involved in oxidative stress, such as mitochondria, rough endoplasmic reticulum, peroxisomes, autophagy, and aging, or from exogenous sources, that is, the external factors that affect oxidative stress, such as nutrition, physical activity, psychological status, environmental conditions, microbiome, and drugs. The most important conclusion is that all of them should be taken into consideration in future research since we need to address oxidative stress as part of a specific biological and metabolic cellular state in a multicellular organism. To understand the cellular physiology that underlies oxidative stress and consider this point in treating each of our periodontal patients according to a specific oxidative state could be called personalized/precise oxidative stress therapy (POST) and should include the following points: (1) environmental conditions, (2) individual characteristics, and (3) oxidative state of different intracellular organelles.
Relationship between bruxism and obstructive sleep apnea: a systematic review of the literature
(Mdpi; Mdpi Ag, 2025-07-15) García Doblado, Natalia; Barrera Mora, José María; Pastor Dorado, Francisco; Rodríguez Fernández, Juan Carlos; Ballestero Ordeix, Guillem; Espinar-Escalona, E.; Estomatología; CTS353: Estomatología Infantil y Ortodoncia
Background and objectives: The interest in studying the relationship between bruxism and sleep apnea has increased over the past decade, given its prevalence and its implications for both oral and overall health. Bruxism occurs in a significant portion of the population, with an overall incidence ranging between 8 and 31%. Obstructive sleep apnea affects 4–6% of middle-aged men and 2–4% of middle-aged women, and it is associated with diminished quality of life, hypertension, increased cardiovascular risks, traffic accidents, and a higher mortality rate. Although a possible association has been suggested, the causal relationship remains unclear. This review aimed to systematically evaluate the available evidence on the association between SB and OSA, focusing on potential shared risk factors and underlying mechanisms. Methods: An electronic literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library for studies published between 2020 and 2025. Inclusion criteria encompassed observational studies and clinical trials involving adults with SB and/or OSA. Risk of bias was assessed using ROBINS-I, and the certainty of evidence was evaluated using GRADE. The review protocol was not registered. Results: A total of 11 studies met the inclusion criteria. The prevalence of SB was consistently higher in individuals with OSA compared to the general population. Several studies suggest a potential link through autonomic arousals and neurotransmitter dysregulation. However, inconsistencies in diagnostic criteria and moderate methodological quality limited the strength of the findings. Conclusions: There is a notable prevalence of bruxism in patients with OSA, suggesting possible shared pathophysiological mechanisms; however, it is necessary to standardize diagnostic criteria and conduct larger, more standardized studies to clarify the relationship. No funding was received, and the authors declare no conflicts of interest.
Evaluation of School Educators' Knowledge of Dental Injuries in Children in Riyadh City: A Survey-Based Study
(Polaris, 2024) Ribas Pérez, David; Rosmery Olivera; Mendoza Mendoza, María Asunción; Solano Mendoza, Beatriz; Estomatología; HUM561: Investigación Suroeste
The loss or displacement of teeth negatively affects children's psychological well-being, functionality, and appearance. Around 25% of children experience dental injuries while at school. Males are more likely to be injured than females, and the upper central incisors are the most frequently affected. The primary causes of traumatic dental injuries (TDIs) include falls, sports, cycling, and car accidents. Children with class II division 1 malocclusion, increased overjet, and inadequate lip coverage, which fails to protect the upper front teeth, are at higher risk of trauma. Previous studies have shown that school teachers generally lack sufficient knowledge in managing TDIs. This study aimed to investigate the influence of factors such as gender, marital status, nationality, type of school, age group, location, educational background, and years of experience on teachers' awareness. This cross-sectional study was conducted using paper-based and online surveys with school teachers in Riyadh. Although the sample size calculation suggested 377 responses, 433 responses were collected to increase the accuracy of the results. The findings indicated that participants lacked appropriate training and knowledge in dental trauma management. Most of the respondents had not attended any dental trauma training courses and expressed a lack of confidence in managing oral injuries if they occurred. However, there was a strong desire to learn, as most respondents expressed interest in further education on dental trauma care.
Impact of parental knowledge on prevention risk of caries in Seville children between 6 and 14 years old, applying the CAMBRA Protocol
(MDPI, 2025-06-23) Pérez de Mora, Esther; Barrera Mora, José María; Arenas-González, Marcela; Mendoza Mendoza, María Asunción; Ribas Pérez, David; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS353: Estomatología Infantil y Ortodoncia; Universidad de Sevilla. HUM561: Investigación Suroeste
Background/Objectives: To explore the association between parental knowledge on dental caries prevention and the risk of caries in pediatric patients aged 6 to 14 years who reside in the province of Seville, using the CAMBRA preventive protocol as an assessment tool. Methods: After the approval granted by the Ethics Committee, a descriptive and analytical observational study was conducted. Caries risk was established using the CAMBRA Questionnaire, pH measurement, and salivary flow rate. To assess the socioeconomic background of the patients and their hygiene and dietary habits, parents completed two surveys: the first about the quality of the patient’s diet, and the second directly related to the CAMBRA questionnaire used and validated by the University of Seville. Results: The final study sample consisted of 300 pediatric patients, aged 6 to 14 years, of whom 54% were boys and 46% were girls. The caries risk distribution was as follows: 33% low, 7% moderate, 48.6% high, and 11.3%. A total of 61.7% of the participants live in urban areas, while 38.3% are from peri-urban regions. There is a statistically significant association between socioeconomic status and family circumstances in children with a risk of caries. Furthermore, an association was established between caries risk, dietary habits, and oral hygiene. Conclusions: Parental knowledge about dental caries prevention and caries risk in children was found to have a strong association with reduced caries risk in children.
Dental audit (I): Exact criteria of dental records; Results of a Phase-III study
(Medicina Oral S.L., 2008-07-01) Martín García, María del Pilar; Ríos-Santos, J.V.; Segura Egea, Juan José; Fernández Palacín, Ana; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Instituto de Biomedicina de Sevilla (IBIS); Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares
Objective: Evaluating the quality of dental records in the Faculty of Dentistry of the University of Seville (Spain). We attempted to collect and/or develop identifiable elements of dental care used to evaluate its appropriateness, as well as to measure its level of filling-in between 1999 and 2004 (Phase III of the record audit). Method: The 46 criteria used to evaluate dental care are shown, measuring —in 50 dental records randomly chosen within a 5-year-time period— their level of filling-in (Phase III of a health audit). Results: A low level of filling-in was observed in all quality criteria defined. No record was found to be free from errors. A maximum of 36 criteria out of 46 was fulfilled (mean of 20.8). Conclusions: The standard of appropriate filling-in was only met in 12 criteria (75 %), the results being poor, due to the importance which clearly deficient aspects related to diagnosis and treatment plan have in the process of patient care. For such reason, we suggest a remedial action (Phase IV) developing a new model of dental record and its subsequent re-evaluation (Phase V), which will be subject to analysis in the second part of this paper.
In vitro evaluation of the type of implant bed preparation with osteotomes in bone type IV and its influence on the stability of two implant systems
(Medicina Oral S.L., 2009-09-01) García Vives, Nuria; Andrés García, Rodrigo; Ríos-Santos, J.V.; Fernández Palacín, Ana; Bullón Fernández, Pedro; Herrero Climent, Mariano; Herrero Climent, Federico; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares
Objectives: 1) To evaluate and compare the stability of two types of implants in an animal model after preparing the implant bed with various sequences of osteotomes in bone type IV. 2) To evaluate the hypothesis of whether or not the sequence of using osteotomes influences the primary implant stability. Material and Method: We selected bone from cow ribs, which in its cross section (the most medullar area of the bone) would be equivalent to a type IV human bone. We used fifteen ribs, in which six implant beds were prepared in each rib block using different preparation protocols for seating three conical Swiss Plus SPB implants of 3.7 x 10 mm versus three MK III parallel wall implants of 4 x 10 mm.Three preparations, each with a diameter, were made for the implants, using osteotomes that progressively increased the diameter of the implant bed. In the first preparation, the complete sequence of osteotomes was used; in the second preparation, the last osteotome was left out; and in the third preparation, the implant was placed after only passing through the first osteotome. Once the implants were seated, we proceeded to evaluate the stability (Osstell® ISQ-value). The locations were randomly chosen (by a coin toss). Results and statistical analysis: We performed a statistical analysis of the ISQ values that were obtained during the different preparations carried out for the Mk III and Swiss Plus implants. The average range and standard deviation were calculated. The hypothesis was compared by a two-way variance analysis (type of implant/ different sequences of preparing the implant bed). It was considered significant for a p <0.05. The statistical results obtained for the values of the Mk III implant were significant (p = 0.042). Conclusions: The results of this in vitro study conclude that the tapered shape provides more primary stability to the implant and suggest that a short sequence of osteotomes in bone type IV provide more primary stability than the complete sequence.
In vitro evaluation of the influence of the cortical bone on the primary stability of two implant systems
(Medicina Oral S.L., 2009-02) Andrés García, Rodrigo; García Vives, Nuria; Herrero Climent, Federico; Fernández Palacín, Ana; Ríos-Santos, J.V.; Herrero Climent, Mariano; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación, Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares
Aims: Immediate loading has become a predictable option for treatment, while one of the main requirements for its implementation is obtaining appropriate primary stability in implants. With that aim, conical implants are commercially available, since, according to specialized literature, they provide greater stability. One of the methods to measure implant stability which has evolved to further stages is resonance frequency analysis (RFA). In the present paper we attempt to evaluate the influence of the cortical bone on the primary stability of two implants of similar diameter and length. Study design: 15 fresh cow ribs were selected and six different implant beds were prepared in each. These preparations corresponded to two different implant systems: A Swiss Plus from Zimmer Dental® and an Mk IV from Nobel Biocare®. Two drilling protocols were used for soft bone, hard bone and bone without cortical. After preparing the beds, the implants were placed and implant primary stability was measured with the Osstell® mentor. Results: Higher ISQ (Implant Stability Quotient) values were observed for both implant systems when the cortical bone is maintained than when it is eliminated, the difference being statistically significant in the case of Mk IV implants. Conclusions: The results from this study show the importance of preserving cortical bone during drilling in order to obtain greater primary stability.
Assessment of periapical status: A comparative study using film-based periapical radiographs and digital panoramic images
(Medicina Oral S.L., 2010-11-01) Ríos-Santos, J.V.; Ridao Sacie, Cristina; Bullón Fernández, Pedro; Fernández Palacín, Ana; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
Aim: To compare the use of film-based periapical radiographs and digital panoramic images displayed on monitor and glossy paper in the assessment of the periapical status of the teeth. Methodology: A total of 86 subjects were examined. All participants underwent a full-mouth radiographic survey (14 periapical radiographs) and a digital panoramic radiography. The periapical status of all appraised teeth was assessed. Results: Periapical radiographs allowed the assessment of the periapical status of a significantly higher percentage of teeth (87.4%) Digital radiography had a significantly reduced potential to allow assessment of the periapical status (p<0.01). Only 58.0% and 34.3% of teeth could be appraised using digital panoramic images displayed on monitor and glossy paper respectively (p<0.01). The total percentage of teeth with periapical pathosis was four-fold higher when assessed with digital panoramic images displayed on glossy paper compared with periapical radiographs (p<0.01). Conclusions: Periapical radiographs allowed the assessment of a significantly higher percentage of teeth when comparing to digital radiography, which had a significantly lower potency in the assessment of periapical status of the teeth. Digital panoramic images displayed on a monitor resulted in a significantly higher percentage of appraised teeth compared to digital images displayed on glossy paper. Apical periodontitis was scored more often on paper than on screen, and more often on screen than in periapical radiographs.
Los trastornos temporomandibulares en pacientes esquizofrenicos: un estudio de casos-controles
(Medicina oral S L, 2005) Velasco-Ortega, Eugenio; Monsalve Guil, Loreto; Velasco Ponferrada, María del Carmen; Medel Soteras, Francisco Ramón; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS618: Investigación básica y clínica en implantologia oral
El objetivo del presente trabajo era valorar la prevalencia de trastornos témporomandibulares(TTM) en pacientes esquizofrénicos comparados con pacientes control. Diseño del estudio. El estudio se realizó en 50 pacientes esquizofrénicos ingresados en la Unidad de Psiquiatría del Hospital Universitario Virgen Macarena de Sevilla y se compararon con 50 pacientes adultos de los que acuden a recepción de la Facultad de Odontología de la Universidad de Sevilla, excluyendo de este último grupo aquellos pacientes que presentaban alguna patología sistémica en el momento de la exploración o en los seis meses previos a ésta. En ambos grupos se valoró la presencia de trastornos témporomandibulares según el protocolo de la OMS. Resultados y Discusión. Entre los pacientes esquizofrénicos, el 32% presentaban síntomas de trastornos témporomandibulares, sobre todo chasquidos o ruidos articulares (24%) y autocorreción de la dislocación (8%); mientras que en los pacientes control, la frecuencia era del 8%, que se correspondía con ruidos articulares. Estas diferencias eran significativas, lo que confirma que los TTM son más prevalentes entre los pacientes que sufren trastornos mentales. El estudio demuestra que el estado de la ATM era independiente de la edad de los pacientes. Los hombres presentaban mayor frecuencia de TTM en ambos grupos. No existía relación entre la presencia de TTM y el estado prostodóncico de los pacientes. Los hallazgos del presente trabajo demuestran una tendencia significativa entre un mayor número medio de dientes perdidos y la frecuencia de TTM en los pacientes sanos control. Conclusiones. Los pacientes esquizofrénicos constituyen una población de riesgo para los TTM porque presentan una mayor prevalencia y severidad de los mismos.
Impact of dental aesthetics on self-esteem in students at the Polígono Sur education permanent center in Seville, Spain
(Nature Research, 2025-05-03) Fernández-Cevallos, Adriana Dayaneira; Ribas Pérez, David; Arenas-González, Marcela; El Khoury Moreno, Luis; Torrejón Martínez, Julio; Rosel Gallardo, Eva; Castaño Seiquer, Antonio Luis; Universidad de Sevilla. Departamento de Estomatología
Self-esteem is a stable characteristic that is usually maintained from adolescence to adulthood. People with high self-esteem are mentally prepared to face different challenges in their lives with great confidence. Assess the influence of dental aesthetics on self-esteem in students at the Polígono Sur Education Permanent Center. A cross-sectional descriptive study with qualitative and quantitative variables in which 92 participants from the permanent education center located in the polígono sur of the city of Seville. To identify if there was a relationship between self-perception of dental aesthetics and self-esteem, two surveys were conducted in the educational center, one of them to determine a high or low psychosocial impact of dental aesthetics and the Rosenberg self-esteem scale, which evaluated the level of acceptance and respect that participants had for themselves. Demographic variables analyzed were gender, age, nationality, and occupation. To analyze categorical variables, contingency tables and the Pearson Chi-square test were used. Students did not have a low self-esteem in relation to a high psychosocial impact of dental aesthetics p > 0, 05 (0.069), but a high self-esteem indifferent to whether they had a high or low psychosocial impact of dental aesthetics. However, there were exceptions according to gender (p = 0.019) or nationality (p = 0.030). Self-esteem was not greatly affected by the psychosocial impact of dental aesthetics in the majority of students evaluated, but it was possible to state that there was a negative impact in the male gender and also by nationality.
Prevalence of oral infections in chronic kidney disease patients: a cross-sectional study
(Wiley-Blackwell, 2024) Palmeira, Eduarda; de Liz Perez-Losada, Flor; Díaz-Flores-García, Víctor; Segura-Sampedro, Juan J.; Segura Egea, Juan José; López-López, José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
Objectives: The purpose of this investigation was to analyze the prevalence of apical periodontitis (AP) and periodontal disease (periodontitis) (PD) in Chronic kidney disease (CKD) patients in relation to their treatment phase. Subjects and methods: In this cross-sectional study, 188 patients with CKD were divided into two groups: patients without dialysis (WD group, n = 53) and patients on dialysis (DP group, n = 135). Panoramic radiographs were used to diagnose AP. The presence of periodontal disease was evaluated radiographically assessing alveolar bone loss. Student's t-test, chi-squared test, and logistic regression analysis were used to determine the significance of differences between groups. Results: In the WD group, 55% of patients had at least one tooth with AP, whereas in the DP group 67% had at least one tooth with AP (OR = 2.11; 95% CI = 1.09-4.08; p < 0.05). PD was more prevalent in the DP group (78%) than in the WD group (36%) (OR = 6.26; CI 95% = 3.13-12.52; p < 0.01). Conclusions: Oral infections are more prevalent in the advanced stages of CKD. The treatment of PD and AP should be incorporated in the treatment planning of patients with CKD.
La radiografía de trazado en el diagnóstico de las fístulas dentarias. presentación de un caso clínico
(Ergon, 2000) Jiménez Rubio-Manzanares, Alicia; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
Una de las posibles evoluciones que puede seguir el proceso inflamatorio periapical es hacia la supuración. Si el absceso periapical drena pus activamente, éste se abre paso entre los tejidos a través de un trayecto de drenaje formándose una fístula que desemboca en un estoma a nivel de la mucosa oral o, más rara vez, de la superficie cutánea. En estos casos, la radiografía de trazado con gutapercha es una técnica de diagnóstico complementario muy útil, consistente en la introducción de una punta de gutapercha a través del sinus fistuloso y la toma de una radiografía para el rastreo de la fístula. En este trabajo se revisan brevemente las fístulas de origen dentario, se aborda el estudio detallado de la técnica de la radiografía de trazado y se presenta un caso clínico que ilustra la importancia de esta técnica diagnóstica. Se concluye que el protocolo diagnóstico de toda fístula dentaria debe incluir siempre la toma de una radiografía de trazado con gutapercha.
La protección cuspidea en la restauración del diente tratado endodonticamente
(Ergon, 1998) Jiménez Rubio-Manzanares, Alicia; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
En la reconstrucción del diente endodonciado se plantean tres problemas fundamentales: el reemplazo de la estructura dentaria perdida, la retención del material restaurador y el refuerzo de la estructura dentaria remanente. Uno de los problemas más frecuentes que hay que resolver es el de las cúspides muy debilitadas, para las que las tensiones oclusales y la expansión de fraguado o térmica del material restaurador aumentan la posibilidad de su fractura. La «protección cuspídea» o «cobertura cuspídea», entendida como la reducción de la cúspide debilitada hasta permitir cubrirla con el material restaurador, garantiza en estos casos una forma de resistencia adecuada y una mayor longevidad de la restauración. En este trabajo se analizan las indicaciones, las ventajas y la técnica de la protección cuspídea en la restauración de los dientes endodonciados.
Evaluación de las prácticas clínicas de endodoncia mediante tests de muestra de tareas del tipo “Escala de calificación “
(Ergon, 2003) Segura Egea, Juan José; Cisneros-Cabello,Rafael; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
El aprendizaje de la endodoncia exige no sólo la adquisición de conocimientos teóricos sino lograr una serie de objetivos en el ámbito psicomotor que se concretan en la adquisición de habilidades y destrezas bien determinadas. Sin embargo, los sistemas de evaluación que actualmente se siguen para valorar a los alumnos respecto a esta materia se basan, fundamentalmente, en exámenes orales o escritos que evalúan, básicamente, la consecución de los objetivos del ámbito cognoscitivo. Ello se debe, probablemente, a la dificultad que entraña valorar la adquisición de habilidades especializadas por los alumnos. En este trabajo proponemos un método de evaluación de las prácticas clínicas de endodoncia basado en los tests de realizaciones del tipo «resultados-habilidades» (performance achievement tests). Dentro de ellos, presentamos los tests de «muestra de tareas» como los más adecuados para la evaluación de dichas prácticas, abordando su elaboración y diseño y desarrollando ejemplos de los mismos.
Barodontalgia and its implications for Navy divers and dentists: a narrative review
(Board, 2024) Javier García-Torres; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
Background: One of the responsibilities of Spanish Navy Dentists is to carry out dental examinations to military divers. Diving is considered an elite activity and carries a high risk of different pathologies, including barodontalgia which is an oral pain induced by atmospheric pressure changes. This study aims to conduct a narrative review on barodontalgia and its implications for divers and Navy dentists. Material and methods: A search was carried out in Pubmed-MEDLINE, Embase and Scielo for all types of articles that explained and related barodontalgia to divers and their diving activities. Results: Barodontalgia is a rare pathology, but with a higher incidence in the military environment than in the civilian one, being more frequent in upper teeth. Its etiopathogenesis is related to how the tooth reacts to pressure changes. Depending on the time of onset and type of pain during the activity, it can be classified in different ways. The diagnosis is complicated due to the impossibility to reproduce in the dental office the conditions in which it first appeared. Conclusions: Military dentists must know about barodontalgia and its relationship with other oral pathologies, in order to avoid its appearance in military divers.
Expression and immunohistochemical localization of leptin in human periapical granulomas
(Medicina oral S L, 2015) Martín González, Jenifer; Carmona-Fernández, Antonio; Pérez Pérez, Antonio; Sánchez Jiménez, Flora; Sánchez Margalet, Víctor; Segura Egea, Juan José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Bioquímica Médica y Biología Molecular e Inmunología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS151: Bioquímica Medica
ackground: Leptin, initially described as an adipocyte-derived hormone to regulate weight control, is expressed in normal and inflamed human dental pulp, being up-regulated during pulp experimental inflammation. Leptin receptor (LER) has been identified in human periapical granulomas. The aim of this study was to analyze and characterize the expression of leptin in human periapical granulomas. Material and methods: Fifteen periapical inflammatory lesions were obtained from extracted human teeth and teeth which underwent periapical surgery. After their morphological categorization as periapical granulomas and gradation of the inflammatory infiltrate, they were examined by immunohistochemistry using human leptin policlonal antibodies. Leptin mRNA expression was also determined by quantitative real-time PCR (qRT-PCR) and the amount of leptin protein was analyzed by immunoblot. Results: All periapical lesions exhibited the characteristic of chronic granulomatous inflammatory process with inflammatory infiltrate grade III. Leptin+ cells were detected in 13 periapical granulomas (86.6%). The median number of Leptin+ cells in periapical granulomas was 1.70 (0.00-7.4). Amongst the inflammatory cells in the periapical granulomas, only macrophages were reactive to leptin antibodies. Western blot analysis revealed the presence in all samples of a protein with apparent molecular weight of approximately 16 kDa, corresponding to the estimated molecular weights of leptin. The expression of leptin mRNA was confirmed by qRT-PCR analysis and the size of the amplified fragment (296 bp for leptin and 194 bp for cyclophilin) was assessed by agarose gel electrophoresis. Conclusions: For the first time, it has been demonstrated that human periapical granuloma expresses the adipokine leptin.
Efecto del hipoclorito sódico, el glutaraldehído y la clorhexidina sobre la viabilidad celular y la capacidad de adherencia a sustratos del macrófago
(Ergon, 1999) Segura Egea, Juan José; Jiménez Rubio-Manzanares, Alicia; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia
En este trabajo se estudia el efecto «in vitro» de tres irrigadores endodóncicos, el hipoclorito sódico al 5,25%, el glutaraldehído al 1% y la clorhexidina al 0,12%, sobre la viabilidad y la adherencia a sustratos del macrófago, célula implicada en la respuesta inflamatoria periapical. Los macrófagos se obtuvieron de ratas Wistar mediante lavado peritoneal. La capacidad de adherencia se determinó incubándolos en tubos de polipropileno a 37˚C en atmósfera de CO2 al 5%. Los tres irrigadores inhibieron la adherencia de los macrófagos de forma dosis-dependiente, siendo las dosis inhibitorias semimáximas (IC50) 0,021% para la clorhexidina, 0,026% para el glutaraldehído y 0,22% para el hipoclorito sódico. Las tres sustancias podrían alterar la función macrofágica a nivel periapical si se extruyen por el foramen apical durante la preparación biomecánica de los conductos, por lo que dicha contingencia debe evitarse.
Audit of dental reports (II): first phase-II study in a Spanish faculty of dentistry
(Medicina oral S L, 2008) Ríos-Santos, J.V.; Martin García, Pilar; Segura Egea, Juan José; Fernández Palacín, Ana; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares
As a measure for correction of deficiencies registered through an audit of dental records in the Comprehensive Dentistry Clinic of the Dentistry Faculty of the University of Seville, we elaborated a new format for dental records which was used in 70 patients, carrying out a monitoring audit (Phase V) by applying the same quality criteria and criteria for data collection used in the initial audit (Phase III). We calculated the indices of fulfilment of 46 quality criteria, extending fulfilment percentage to 41 criteria, while statistically significant differences were found in 25 criteria. The standard prefixed as appropriate (75 %) was reached in 29 criteria (against the 12 criteria in which such standard was reached in the first dental audit). It is essential that faculties of dentistry develop systems for dental record revision which may help students achieve the competence of registering dental-care steps appropriately, teachers identify and give response to educational problems, and clinic administration prevent and correct conflicts, at the same time that they all ensure quality in service provision, ease relations with customers and protect users against legal vulnerability.
Dental audit (I): exact criteria of dental records; results of a phase-III study
(Medicina oral S L, 2018) Martin García, Pilar; Ríos-Santos, J.V.; Segura Egea, Juan José; Fernández Palacín, Ana; Bullón Fernández, Pedro; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. Departamento de Medicina Preventiva y Salud Pública; Universidad de Sevilla. CTS941: Patología Dentaria, Operatoria Dental y Endodoncia; Universidad de Sevilla. CTS312: Análisis de la Demanda Sanitaria; Universidad de Sevilla. CTS113: Investigación Etiología y Patogenia Periodontal, Patología Oral y Enfermedades Musculares
Objective: Evaluating the quality of dental records in the Faculty of Dentistry of the University of Seville (Spain). We attempted to collect and/or develop identifiable elements of dental care used to evaluate its appropriateness, as well as to measure its level of filling-in between 1999 and 2004 (Phase III of the record audit). Method: The 46 criteria used to evaluate dental care are shown, measuring--in 50 dental records randomly chosen within a 5-year-time period--their level of filling-in (Phase III of a health audit). Results: A low level of filling-in was observed in all quality criteria defined. No record was found to be free from errors. A maximum of 36 criteria out of 46 was fulfilled (mean of 20.8). Conclusions: The standard of appropriate filling-in was only met in 12 criteria (75%), the results being poor, due to the importance which clearly deficient aspects related to diagnosis and treatment plan have in the process of patient care. For such reason, we suggest a remedial action (Phase IV) developing a new model of dental record and its subsequent re-evaluation (Phase V), which will be subject to analysis in the second part of this paper.
Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus. A systematic literature review
(Medicina oral S L, 2016) Pérez-Losada, Flor de Liz; Jané-Salas, Enric; Sabater-Recolons, María del Mar; Estrugo-Devesa, Albert; Segura Egea, Juan José; López-López, José; Universidad de Sevilla. Departamento de Estomatología; Universidad de Sevilla. CTS941: Patología dentaria, operatoria dental y endodoncia
Background: Diabetes and periodontal disease share common features in terms of inflammatory responses. Current scientific evidence suggests that treatment of periodontal disease might contribute to glycemic control. The objective of the study is a review of the last three years. Material and methods: A literature search was performed in the MEDLINE (PubMed), Cochrane, and Scopus databases, for articles published between 01-01-2013 and 30-06-2015, applying the key terms "periodontal disease" AND "diabetes mellitus". The review analyzed clinical trials of humans published in English and Spanish. Results: Thirteen clinical trials were reviewed, representing a total of 1,912 patients. Three of them had samples of <40 patients, making a total of 108 patients and the remaining ten samples had >40 patients, representing a total of 1,804. Only one article achieved a Jadad score of five. Seven articles (998 patients, 52.3% total), presented a statistically significant decrease in HbA1c (p<0.05) as a result of periodontal treatment. In the six remaining articles (representing 914 patients, 47.8% of the total), the decrease in HbA1c was not significant. Patient follow-up varied between 3 to 12 months. In three articles, the follow-up was of 3, 4, and 9 months, in two 6 and 12 months. Conclusions: The majority of clinical trials showed that radicular curettage and smoothing, whether associated with antibiotics or not, can improve periodontal conditions in patients with diabetes mellitus. However, few studies suggest that this periodontal treatment improves metabolic control. However, there is no clear evidence of a relation between periodontal treatment and improved glycemic control in patients with type 2 diabetes mellitus.

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