Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Osteoporosis is a chronic, silent, multifactorial and metabolic bone disease characterized by low bone mineral density and altered micro architecture, presenting a high fracture rate with minimal trauma or without trauma (hip, spine and forearms). Osteoporosis can occur in both sexes and in all ages; mainly considered a problem for postmenopausal women, with higher risk of fracture over 50 years old. This increases the morbidity, mortality and costs of the health system, considering it a significant public health issue. Healthy bone has equilibrium characteristics between bone formation by osteoblasts and bone resorption by osteoclasts. In osteoporosis this balance is altered, showing a greater tendency to resorption. The most important risk factors for osteoporosis are age, sex, genetic factors, early menopause, inadequate calcium intake, lack of exercise, alcoholism, and smoking; it can also be associated with some endocrine diseases, such as hyperparathyroidism, kidney failure chronic, liver disease, malabsorption and drugs, including oral glucocorticoids. The objective of this bibliographic review is to provide updated and specific information about osteoporosis in the jaws and its diagnostic methods, which allow the dentist and radiologist to recognize, prevent and / or refer to the specialist indicated cases that may arise with this condition.

Restoration of fractured anterior teeth presents a challenge to dental clinicians owing to its esthetic requirements and, more importantly, because of the young age of the patients. Thus, it is important to follow the most conservative protocol. Many professionals face the dilemma of whether or not to perform enamel beveling. This article briefly discusses the clinical perspective and evidence regarding this type of operative restoration procedure.

Introduction: Tooth development results from a highly coordinated epithelial-mesenchyme interaction in which mesenchyme cells originate the dental papilla and dental follicle, while ectodermal cells originate the enamel organ. Simultaneously, bone tissue is formed around the developing tooth, trapping it in a bony crypt. Tooth eruption requires the resorption of the coronal part of the bony crypt, followed by degradation of the lamina propria, most likely by metalloproteinases (MMPs) activity. Objectives:  The aim of this research was to determine MMP-2 expression in the dental germ cells (ameloblasts, odontoblasts, dental papilla and dental follicle) and surrounding tissues (alveolar bone and lamina propria) of rat molars throughout the eruptive process. Material and Methods: A total of 24 rats (4,6,9,11,14 and 16 days old) were used in this study. MMP-2 was detected through immunohistochemistry. A qualitative analysis was performed to investigate the expression of MMP-2 in the dental germ cells, lamina propria, and coronal and basal regions of the bony crypt. Results: MMP-2 expression was observed in the dental papilla cells, dental follicle, ameloblasts, odontoblasts and bone cells from the coronal and basal regions of the bony crypt. MMP-2 was also detected in the lamina propria during the mucosal penetration stage of tooth eruption. Conclusion: We conclude that MMP-2 may be important for the extracellular matrix rearrangement necessary for tooth development and secretion of its mineralized tissues.  We also conclude that MMP-2 may play a role in the extensive tissue remodeling during the intra-and-extra-osseous phases of the tooth eruption process.

The success of tissue engineering in combination with tissue regeneration depends on the behavior and cellular activity in the biological processes developed within a structure that functions as a support, better known as scaffolds, or directly at the site of the injury. The cell-cell and cell-biomaterial interaction are key factors for the induction of a specific cell behavior, together with the bioactive factors that allow the formation of the desired tissue. Mesenchymal Stem Cells (MSC) can be isolated from the umbilical cord and bone marrow; however, the behavior of Dental Pulp Stem Cells (DPSC) has been shown to have a high potential for the formation of bone tissue, and these cells have even been able to induce the process of angiogenesis. Advances in periodontal regeneration, dentin-pulp complex, and craniofacial bone defects through the induction of MSC obtained from tooth structures in in vitro-in vivo studies have permitted the obtaining of clinical evidence of the achievements obtained to date.

Conventional glass ionomer cements are used as dental provisional restorative materials, which present several advantages such as adhesion to the tooth mineral phase among others. On the other hand, the knowledge about biological property of glass ionomers shows various approaches and results. In this work, it was studied the in vitro biological response of human gingival fibroblasts in contact with commercial cements of glass ionomer: Mirafil® and Ionglass® and with their extracts, according to ISO 10993. The extracts of the cements, in which the cells were cultured, were adjusted at different concentrations ranging 0.1% to 100%. The cellular metabolic activity of gingival fibroblasts was measured using the Alamar Blue® reagent. The results showed a significant effect on the cellular metabolic activity correlated with the concentration of liberated ions (Al³+ and Ca²+) for both ionomers, as well as the pH variations of the culture media. This could mean that the cellular metabolic activity is substantially influenced by ions and pH of the cell culture.

Dental anomalies can produce alterations in dental shape, number, size, and structure, affecting function and aesthetics. The objective of this study is to determine the frequency and location of teeth number anomalies in healthy Costa Rican children between 6 and 12 years old. An observational and retrospective study was carried out with 157 panoramic radiographs of the patients of the pediatric dentistry and orthodontics clinic of the University of Costa Rica between the years 2015-2017. Hyperdontias and hypodontias were the anomalies observed.  Data were analyzed using a Fisher exact test with a significance level of 5% . The results showed that the overall frequency  of dental anomalies  was 8.3%, 4.5% were hyperdontias and 3.8% hypodontias. Double or multiple hyperdontia and hypodontia were also found. The difference between sex was not significant (p= 0.145). Supernumeraries were more frequent in maxilla and hypodontias in mandible. Mesiodens was the most frequently found supernumerary teeth. Mandibular second premolars were the most commonly missing teeth.

Introduction: the bony atrophy of the maxillary ridge is always a limitation to install dental implants. The Ridge Split procedure proves to be a successful technique to perform the management of horizontal defects, increasing the dimensions of the atrophic ridge to immediately install dental implants. Aim: to describe the clinical use of the Ridge Split technique as a treatment for bone augmentation in the horizontal direction of the atrophic maxilla. Case presentation: the case of a female patient of 61 years of age, partially edentulous, who seeks to recover her upper teeth was presented. The clinical examination shows only two teeth and the radiographic-tomographic examination showed severe bone resorption and pneumatization of the maxillary sinuses. It is planned to install two implants to make an over denture, using the Ridge Split technique and immediate installation of the implants. Five months later, a tomographic control was performed evidencing a horizontal increase of the alveolar ridge and it was rehabilitated with an overdenture, with which the patient's aesthetic and functional compliance was achieved. Conclusion: the presented case reveals that this technique increases the bone ridge in horizontal direction and allows to install the implants simultaneously. It is a predictable, safe and comfortable treatment, and shortens the treatment time, making it a viable alternative for the management of alveolar bone defects.

Dental pain is usually managed by clinical interventions and pharmacological coadjuvants such as NSAIDs. However, its perception and modulation is mediated by different nociceptive mechanisms and these strategies can be insufficient. The multimodal analgesia refers to the use of 2 or more analgesic drugs that attenuate or blockade different mechanisms of pain, obtaining a greater clinical effect. Within this concept, pharmacological synergism plays a leading role, combining different molecules in lower doses to diminish also side effects. Since there are no standard prescriptions to be use in all the patients, multimodal approaches allow the clinician to make responsible effective combinations, individualizing analgesia as the pathway to success.

Dental trauma, mainly from the anterior area of the mouth in the incisor teeth at the level of the radicular third, has the extraction of the dental organ as an elective treatment, depending on the severity of the lesion and the site where it presented. This paper reports two cases: one in a young 13-year-old male patient with dental trauma in central incisors, and another in an 18-year-old female patient with radicular reabsorption in central incisors. Both were treated using trans-endodontic implants on teeth 2.1 and 1.1-2.2 each case, respectively. The treatment approach proposed for each case provided good functional and esthetic outcomes. Clinical and radiographic results after 1 year were successful.

Reactive attachment disorder (RAD) is an early childhood mental health disease characterized by impaired social interactions and communication abilities, and neurological deficits in the child’s developing brain. This disorder can significantly affect the pediatric patient’s behavior in the dental setting. An uncooperative 9-year-old Mexican girl, who was residing in a temporary home, was referred by a general dental practitioner to the Postgraduate Pediatric Dental Clinic with her caretaker, requesting dental examination and treatment. The patient presented with a previous diagnosis of RAD with intellectual/social disability. With the psychiatrist’s guidance, an exhaustive oral prophylaxis was carried out in the initial appointments, followed by diverse restorative treatments under the continuous application of behavioral management techniques. These restorative procedures included resin restorations and pit-fissure sealants, under local anesthesia and rubber-dam isolation, on the first four permanent molars. The entire treatment was completed in six weeks. The patient and her caretaker were provided with detailed educational and motivational strategies for improving the patient´s oral hygiene, and they also received nutritional advice. For control reviews and the reinforcement of preventive habits, future appointments were carefully scheduled. An interdisciplinary pediatric collaboration between the dentist, nurse, and psychiatrist was fundamental for improving the patient’s oral health and general welfare.