Genetic study in patients operated dentally and anesthetized with articaine-epinephrine

Aims: In this study we wanted to figure out if there was a correlation between OPRM1 N40D, TRPV1 I316M, TRPV1 I585V, NOS3 −786T>C and IL6 −174C>G polymorphisms and the response to locally applied articaine-epinephrine anesthetic.

Methods: In this observational study, 114 oral cell samples of patients anesthetized with articaine-epinephrine (54 from men 60 from women), were collected from dental centers in Madrid (Spain). High molecular weight DNA was obtained from oral mucosa cells. The analysis of OPRM1 N40D (rs1799971), TRPV1 I316M (rs222747), TRPV1 I585V (rs8065080) and IL6 −174C>G polymorphism was performed through real-time PCR allelic discrimination using TaqMan probes. Polymorphism NOS3 −786T> C (rs2070744) was analyzed using RFLP-PCR.

Results: The studied polymorphisms are involved neither in the response to the anesthetic, nor in the intensity of perceived dental pain. However, in a subset of female patients we found that TRPV1 I316M was associated with a delayed onset of anesthesia.

Conclusions: There is no association among these polymorphisms and the time elapsed between the application of the anesthetic and the onset of its effect.

Manifestations in the Oral Mucosa of Erythromelalgia. A Case Report

Introduction:

Erythromelalgia or erythermalgia, is a peripheral paroxysmal vascular disease of the distal extremities, although it can also affect the face, ears and knees. It is characterized by increased skin temperature, erythema and intermittent episodes of burning pain. Likewise, it can also be characterized by lesions of the oral mucosa.

Case report:

Here we present the case of a 6-year old female with EM presenting ulcerative and scaly lesions in the oral cavity and whitish linear branching ulcerative lesions on the tongue. Fabry disease and rheumatoid conditions were ruled out and there were no mutations in SCN9A gene. Treatment with voltage-gated sodium channel blockers (oxcarbacepine-Trileptal®) and anticonvulsants (Perampanel-Fycompa®) did not improve pain symptoms, however, performing moderate physical activity, use of comfortable footwear, and local application of cold resulted in the restoration of patient´s quality of life

Conclusion:

To our knowledge, this report described for the first time, the successful treatment of ulcerative lesions of the oral mucosa in Erythromelalgia. We believe that the treatments described here (exercise, comfortable footwear and local application of cold) could improve the quality of life of Erythromelalgia patients.

Changes in crevicular cytokines after application of melatonin in patients with periodontal disease

Background

A clinical trial was designed to evaluate the effects of topical application of melatonin on the crevicular fluid levels of interleukins and prostaglandins and to evaluate changes in clinical parameters.

Material and Methods

A consecutive sample of 90 patients were recruited from the Health Centre of Pinos Puente in Granada, Spain and divided into 3 groups: 30 patients with diabetes and periodontal disease, who were given melatonin; 30 patients with diabetes and periodontal disease, who were given a placebo, and 30 healthy individuals with no history of systemic disease or clinical signs of periodontal disease, who were also given a placebo. The 30 patients with diabetes and periodontitis were treated with topical application of melatonin (1% orabase cream formula) for 20 days by. The rest of the patients with diabetes and periodontitis and healthy subjects were treated with a placebo of orabase cream. We measured the gingival index by exploring the percentage of standing teeth bleeding on probing. The periodontogram was performed with a Florida Probe.

Results

In the diabetic patients who were given topical melatonin, there was a statistically significant decrease in the two clinical parameters. By contrast, in diabetic patients who were given the topical placebo, there was no statistically significant variation.

Conclusions

In patients with diabetes and periodontal disease, treatment with topical melatonin was associated with a significant improvement in the gingival index and in pocket depth, and a statistically significant reduction in concentrations of interleukin-1β, interleukin-6 and prostaglandin E2 in gingival crevicular fluid.

Key words:Melatonin, periodontal disease, diabetes mellitus, interleukin-1β, interleukin-6, prostaglandin E2.

Peri-implant and Paracrestal Inflammatory Biomarkers at Failing Versus Surviving Implant Sites in a Beagle Dog Study

PURPOSE

This study sought to quantify three biochemical mediators of inflammation (tumor necrosis factor alpha [TNF-α], superoxide anion [SOA], and myeloperoxidase [MPO]) by analyzing crestal (peri-implants) and paracrestal gingival biopsy samples obtained from an experimental study on beagle dogs treated with implants inserted immediately into fresh sockets with circumferential defects.

MATERIALS AND METHODS

In 10 beagle dogs, 4 roughened titanium implants (3.8 mm wide × 8 mm high) were placed in the distal sockets of the third and fourth premolars, where a circumferential defect (5 mm wide and 5 mm deep) had been previously created by trephination. After varying follow-up periods, ranging from 80 to 190 days, the dogs were explored clinically to assess implant survival, peri-implant pocket depth, and implant stability. The levels of three biochemical mediators of inflammation (MPO, TNF-α, and SOA) were investigated using the crestal and paracrestal gingival biopsy samples with ELISA tests.

RESULTS

It was found that 37.5% of the implants were either absent or mobile. Higher levels of the inflammatory mediators were found in the crestal samples than in the paracrestal samples. The final implant stability values were significantly correlated with the final probing depth (r = -0.83, P < .01), but neither of the clinical measures were significantly correlated with any biochemical marker. The risk of implant failure was significantly proportional to the level of MPO (odds ratio: 1.1) and TNF-α (odds ratio: 1.1) in both the crestal and paracrestal regions.

CONCLUSION

All the inflammatory mediators studied were higher in the crestal areas than in the paracrestal regions, but only the values of MPO and TNF-α were significant predictors of implant failure.

Accuracy in the legal age estimation according to the third molars mineralization among Mexicans and Columbians

Objectives

This study aims to assess the accuracy of age estimation according to two cut-off points of Demirjian's developmental stages (G and H) in the wisdom teeth, using panoramic radiographs from Colombian and Mexican teenagers.

Study design

The degree of maturation of the third molars was classified according to Demirjian in 8 stages (from A to H) by a blinded trained assessor. The sensitivity, specificity and efficacy of two cut-off points (G and H) were calculated for both samples.

Results

The orthopantomographies of 316 subjects, 171 Colombians (54.1%) and 145 Mexicans (45.9%), were analyzed. The stage H was found to be the best threshold for detecting juveniles (because the high specificity) in all the third molars assessed. The specificity was higher for lower third molars than for upper third molars, but no asymmetrical discrepancy was noted.

Conclusions

The stage H is the best cut-off point for detecting the adulthood when a high-specificity test is required.

Oral health-related quality of life in 6- to 12-year-old schoolchildren in Spain

BACKGROUND

There is a lack of large epidemiological studies researching the major factors of the oral well-being in schoolchildren.

AIMS

To quantify the impact of the different clinical conditions related to caries and periodontal and dento-facial anomalies on the quality of life captured by the Child-OIDP.

DESIGN

A standardized epidemiological study was conducted on 2041 Spanish schoolchildren, aged 6-12 years, to assess caries and periodontal and dento-facial disease. Data on oral health-related quality of life were collected using the Child-OIDP. Bivariate and multivariate analyses were performed to evaluate the modulating factors in the perceived oral well-being.

RESULTS

The prevalence of impact in this sample was 45.7%, mostly for eating (24.3%) but also for smiling (16.2%); however, 72.5% of the subjects had at least one type of normative needs, mainly for periodontal treatment (52.3%), followed by caries (32.3%) and orthodontic treatments (20.6%). The main predictors of the impact on quality of life were perceived dental treatment needs, caries, and periodontal diseases. Also, some demographic (age and gender) and behavioural factors (consumption of sweets) modulated the impact on several domains. Moreover, subjects who rated their general health as good or very good reported a significantly better oral well-being than their counterparts.

CONCLUSIONS

Pain and aesthetic-related domains (i.e., problems when eating or smiling) are the major components of the oral health-related quality of life perceived by Spanish schoolchildren. Perceived treatment needs as well as dental and periodontal status were the strongest predictors of oral well-being.

The role of personality traits in self-rated oral health and preferences for different types of flawed smiles

Symmetric, aligned and luminous smiles are usually classified as 'beautiful' and aesthetic. However, smile perception is not strictly governed by standardised rules. Personal traits may influence the perception of non-ideal smiles. We aimed to determine the influence of personality traits in self-rated oral health and satisfaction and in the aesthetic preference for different strategically flawed smiles shown in photographs. Smiles with dark teeth, with uneven teeth, with lip asymmetry and dental asymmetry were ordered from 1 to 4 as a function of the degree of beauty by 548 participants, of which 50·7% were females with a mean age of 41·5 ± 17·6 years (range: 16-89 years). Self-assessment and oral satisfaction were recorded on a Likert scale. Personality was measured by means of the Big Five Inventory (extraversion, agreeableness, conscientiousness, neuroticism and openness), and the Life Orientation Test was used to measure optimism and pessimism. Of the four photographs with imperfect smiles, dental asymmetry was the most highly assessed in 63% of the sample, and the worst was lip asymmetry, in 43·7% of the sample. Some personality traits (above all conscientiousness and openness) were significantly correlated with the position assigned to the photographs with dental and lip asymmetry or with misaligned teeth. The extraversion, agreeableness and openness traits were correlated with the self-perceptions of oral health and aesthetics of the participants. Dental asymmetry seems to be better tolerated than lip asymmetry. Personality traits are weakly but significantly correlated with the aesthetic preference and oral health values, conscientiousness and openness being the most relevant domains in this sense.

Clinical and sociodemographic predictors of oral pain and eating problems among adult and senior Spaniards in the national survey performed in 2010

BACKGROUND

Pain and chewing difficulties have been identified as the strongest predictors of oral disadvantage. The aim of this study is to analyze and quantify the sociodemographic, behavioural and clinical factors modulating the oral pain and eating difficulties reported by Spanish adults and elderly Spanish people in the last National Oral Health Survey performed in 2010.

STUDY DESIGN

Data concerning pain and chewing difficulties were acquired on a Likert‑scale format from a representative sample of the Spanish general population with ages between 35-44 years (n=391) and 65‑74 years (n=405). Risk factors were identified using bivariate analysis, after which the crude association between risk factors (sociodemographic, behavioural and clinical) and outcome variables (pain and eating problems) was assessed by adjusted odds ratios, calculated by means of multivariate logistic regression.

RESULTS

Eating problems and oral pain were mainly associated with prosthetic and caries treatment needs as clinical predictors, but female sex was also seen to be a relevant and significant risk factor for suffering pain and eating restrictions. Paradoxically, after taking into account all the aforementioned predictors, the adults had an almost two‑fold higher risk of reporting pain or eating difficulties than the elderly subjects.

CONCLUSIONS

In agreement with the results from the last national oral health survey, prosthetic and caries treatment needs should be considered key factors in determining the oral well‑being of the Spanish population. In sociodemographic terms, the women and adults were seen to be at a significantly higher risk of suffering pain and eating restrictions.

Electromyographic and patient-reported outcomes of a computer-guided occlusal adjustment performed on patients suffering from chronic myofascial pain

Objectives: Muscular hyperactivity is a potential source of symptoms in patients with temporal-mandibular disorders. An adequate occlusal adjustment may relieve such symptoms. This study aims to measure the effect of shortening the protrusive disclusion time (DT) and balancing the center of occlusal forces (COF) on the EMG recordings and assess the pain reported by chronic patients one month after the computer-guided occlusal adjustment. Study Design: The sample studied comprised 34 patients suffering from chronic facial pain in which the EMG activity of both masseters was recorded by electromyography. By selective grinding we alleviated all the occlusal interferences during the mandibular protrusion from the habitual closure position in order to establish an immediate posterior disclusion and an equilibration of the COF. Results: At follow-up 76.5% of the patients reported no facial pain. Moreover, the EMG activity and protrusive DT were significantly reduced, and occlusal and muscular function were significantly more symmetric than at baseline. Conclusions: According to this EMG study, this computer-guided occlusal adjustment is able to reduce the activity of the masseters and the self-reported muscular pain of patients one-month after treatment.

Key words:Myofascial pain, occlusal adjustment, electromyography, T-Scan III, occlusal interferences.

Comparison of Clinical and Histologic Outcomes of Zirconia Versus Titanium Implants Placed in Fresh Sockets: A 5-Month Study in Beagles

Purpose: This study evaluated the clinical and histomorphometric results of titanium (Ti) and custom-made zirconia (Zr) implants placed into fresh extraction sockets in beagles that did not receive oral hygiene attention or a softened diet during postoperative healing. Materials and Methods: The roughness of the Ti and Zr implant surfaces was assessed by confocal microscopy. In eight beagle dogs, four implants each (two Ti and two Zr) were placed in the distal sockets of the third and fourth premolars with the implant shoulder at the bone crest and subjected to submerged healing. Standardized radiographs were taken after placement and 5 months after placement (at sacrifice). Histologic and histomorphometric measurements were performed on nondecalcified histologic sections. The main outcome measures included implant survival, bone-implant contact (BIC), and bone loss on the buccal and lingual plates. Results: Topographic analysis showed significant differences between the Zr and Ti surfaces. Roughness was higher for Ti than for Zr implants, kurtosis was close to 3 for Ti, and skewness was negative for Zr. After 5 months, the mean BIC was similar for the Zr (57.0% ± 15.2%) and Ti (56.5% ± 14.4%) implants, and the most severe bone loss site was observed on the buccal wall. The risk of failure was significantly higher for the Zr (43.8%) than for the Ti (12.5%) implants. Conclusion: The implant failure rate for the Zr implants was 3.5 times higher than that of the Ti implants. This may be partially explained by the less favorable topography of the Zr implants, which had, on average, significantly lower roughness (Ra = 0.85 ± 0.04 μm), negative skewness of the surface profile (-1.56 ± 0.27), and higher kurtosis (7.88 ± 1.99).

[Pain assessment using the Facial Action Coding System. A systematic review]

Self-reporting is the most widely used pain measurement tool, although it may not be useful in patients with loss or deficit in communication skills. The aim of this paper was to undertake a systematic review of the literature of pain assessment through the Facial Action Coding System (FACS). The initial search found 4,335 references and, within the restriction «FACS», these were reduced to 40 (after exclusion of duplicates). Finally, only 26 articles meeting the inclusion criteria were included. Methodological quality was assessed using the GRADE system. Most patients were adults and elderly health conditions, or cognitive deficits and/or chronic pain. Our conclusion is that FACS is a reliable and objective tool in the detection and quantification of pain in all patients.

State anxiety and depression as factors modulating and influencing postoperative pain in dental implant surgery. A prospective clinical survey

Objetives: To determine whether preoperative state anxiety and depression modulate or influence objective and subjective postoperative pain following dental implant insertion. Study Design: Prospective, clinical study with 7-day follow-up of a sample of 105 subjects who preoperatively completed the state anxiety questionnaire (STAI-E) and Beck Depression Inventory (BDI) and postoperatively, at 2 and 7 days, recorded objective pain with the Semmes-Weinstein mechanical esthesiometer (SW test) and subjective pain with the Visual Analog Scale (VAS). Results: 85.6% and 81.5% of patients, respectively, recorded no signs of state anxiety or depression. The correlation between anxiety and depression for both maxillary bones was the lower (P=0.02). The correlation between subjective and objective pain at 2 and 7 days, and the anatomic regions intervened, was statistically significant in the mandible at day 7 (P<0.01), and highly significant (P<0.001) for the other variables. The correlation between state anxiety and objective pain at day 7 was nearly statistically significant (P=0.07). Conclusions: The correlation between state anxiety and depression, and objective and subjective pain at day 7 was not statistically significant. A strong correlation was found between objective and subjective pain in the immediate postoperative period.

Key words:Anxiety, depression, postoperative pain, dental implants.

Action of melatonin on squamous cell carcinoma and other tumors of the oral cavity (Review)

Melatonin (MLT; N-acetyl-5-metoxy-tryptamine) is a hormone that is principally synthesized in the pineal gland. MLT has been shown to exhibit a variety of functions. The hormone, which is a free radical scavenger, plays an immunomodulatory role, stimulates the proliferation and synthesis of type I collagen and promotes bone formation. Moreover, MLT exerts oncostatic activity through several biological mechanisms, including antiproliferative functions, stimulation of anticancer immunity, modulation of oncogene expression and anti-inflammatory, antioxidant and antiangiogenic effects. In addition, MLT inhibits human cancer cell growth in culture, and previous clinical studies have also confirmed its anticancer properties in vivo. With regard to the underlying mechanisms of MLT in tumor processes, including oral cavity tumors such as epidermoid carcinoma, knowledge of the role played by the MT1 and 2 membrane receptors, MT3 and the calmodulin cytosolic binding sites, as well as the nuclear receptors of the RZR/ROR family, is increasing. It has been hypothesized that exogenous restoration of MT1 (MTNR1A) expression inhibits the growth of oral squamous cell carcinoma cells lacking the expression of the receptor. The tumor suppressing functions of MLT and the presence of the MT1 receptor in various tumors indicate that the receptor may play a pivotal role in oral carcinogenesis. The current review discusses the clinical significance of MLT in oral cancer.

Effect of gingival application of melatonin on alkaline and acid phosphatase, osteopontin and osteocalcin in patients with diabetes and periodontal disease

Objectives: To assess the effect of topical application of melatonin to the gingiva on salivary fluid concentrations of acid phosphatase, alkaline phosphatase, osteopontin, and osteocalcin. Study Design: Cross-sectional study of 30 patients with diabetes and periodontal disease and 30 healthy subjects. Diabetic patients were treated with topical application of melatonin (1% orabase cream formula) once daily for 20 days and controls with a placebo formulation. Results: Before treatment with melatonin, diabetic patients showed significantly higher mean salivary levels of alkaline and acid phosphatase, osteopontin and osteocalcin than healthy subjects (P < 0.01). After treatment with melatonin, there was a statistically significant decrease of the gingival index (15.84± 10.3 vs 5.6 ± 5.1) and pocket depth (28.3 ± 19.5 vs 11.9 ± 9.0) (P < 0.001). Also, use of melatonin was associated with a significant reduction of the four biomarkers. Changes of salivary acid phosphatase and osteopontin correlated significantly with changes in the gingival index, whereas changes of alkaline phosphatase and osteopontin correlated significantly with changes in the pocket depth. Conclusions: Treatment with topical melatonin was associated with an improvement in the gingival index and pocket depth, a reduction in salivary concentrations of acid phosphatase, alkaline phosphatase, osteopontin and osteocalcin.

Key words:Melatonin, diabetes mellitus, alkaline phosphatase, acid phosphatase, osteopontin, osteocalcin.

MTNR1A receptor expression in normal and pathological human salivary glands

AIM

To analyze and compare the expression of MTNR1A receptor in normal and pathological major and minor salivary glands.

MATERIALS AND METHODS

Twenty samples of major and minor salivary glands and 10 with Warthin's tumor were studied. Expression of the MTNR1A receptor (goat polyclonal antibody raised against a peptide mapping at the N-terminus of MEL-1A R of human origin) was analyzed.

RESULTS

The excretory ducts of major salivary glands demonstrated intense intracytoplasmic positivity but scant cytoplasmic membrane positivity for MTNR1A. The studied Warthin's tumors showed intense cytoplasmic positivity for MT1 receptor in all cylindrical epithelial cells lining spaces and a less intense positivity in basal cells. The lymphoid component accompanying the tumor was negative for MT1 receptor.

CONCLUSION

Intense intracytoplasmic positivity for the MTNR1A receptor in the excretory ducts of human major and minor salivary glands and Warthin's tumor was found. The intense expression of MTNR1A receptors observed in this study in the excretory ducts of major and minor salivary glands may be related to salivary regulation.

MT1 melatonin receptor expression in Warthin's tumor

We contribute the first immunohistochemical study of MT1 melatonin receptor in Warthin's tumor and normal parotid gland. All 14 Warthin's tumors studied showed intense cytoplasmic positivity for MT1 receptor in all cylindrical epithelial cells lining spaces and a less intense positivity in basal cells. The lymphoid component accompanying the tumor was always negative for MT1 receptor. The parotid structure surrounding the tumor showed intense cytoplasmic positivity in all cells lining excretory ducts (lobar and lobulillar), with a lesser and focal positivity in cells of the acinar component. The biological activity of MT1 receptor in epithelial cells lining parotid excretory ducts may resemble its activity in Warthin's tumor cells. Hence, we propose Warthin's tumor as a useful positive control in immunohistochemical studies of MT1 melatonin receptor.

Role of melatonin in cancer treatment

Melatonin has revealed itself to be a pleiotropic and multitasking molecule. The mechanisms that control its synthesis and the biological clock processes that modulate the circadian production of melatonin in the pineal gland have been well-characterized. A feature that characterizes melatonin is the variety of mechanisms it employs to modulate the physiology and molecular biology of cells. Research has implicated the pineal gland and melatonin in the processes of both aging and age-related diseases. The decline in the production of melatonin with age is thought to contribute to immunosenescence and potential development of neoplastic diseases. Melatonin has been shown to inhibit growth of different tumors under both in vitro and in vivo conditions. There is evidence that the administration of melatonin alone or in combination with interleukin-2 in conjunction with chemoradiotherapy and/or supportive care in cancer patients with advanced solid tumors, has been associated with improved outcomes of tumor regression and survival. Moreover, chemotherapy has been shown to be better tolerated in patients treated with melatonin.

Validation of the oral health impact profile (OHIP-20sp) for Spanish edentulous patients

Objectives: The purposes of this study are to validate the indicator of Oral Health Impact Profile for edentulous patients (OHIP-20sp) in the Spanish population and to analyze the factorial construct of the prosthetic well-being. Study Design: A total of twenty-one (n=21) edentulous patients wearing mandibular implant-over dentures on Locator® (LO) and twenty (n=20) with complete dentures (CD) were retrospectively evaluated in this study. All participants were recruited consecutively and were treated in the previous academic year 2009-2010 by professors of the University of Salamanca. Reliability analyses and validity tests were performed in order to evaluate the psychometric properties of OHIP-20sp employing two different total score methods (additional and simple count). A retrospective evaluation of the impact of the prosthetic treatment was captured with an evaluative instrument derived from OHIP-20, and named POST-OHIP-13. Results: The reliability coefficient (Cronbach’s alpha = 0.91) has shown a high internal consistency. Item-total correlations coefficients ranged from 0.46 and 0.81. Five factors, named as disability, functional comfort, psychosocial impact, pain-discomfort and functional limitations were identified as principal components of the construct, explaining almost 85% of the variance. The 48% of the sample felt at least one impact in an occasional or more frequently manner (generally food packing). The global transition judgment of the prosthetic treatment using the POST-OHIP-13 was significantly higher in group LO than in the CD group. Conclusions: OHIP-20 seems to be a reliable and valid indicator to measure oral impact and satisfaction in the Spanish edentulous population. The underlying construct is comprised by 5 factors named as disability, functional comfort, psychosocial impact, pain-discomfort and functional limitations.

Key words:Oral health-related quality of life, edentulous, satisfaction, validation.

Europe's oldest jaw: evidence of oral pathology

Atapuerca, in the north of Spain, is the archaeological site where the oldest hominid remains within Europe have been found. In 2008 a jaw fragment, corresponding to the symphyseal area, was discovered in the area called the 'Elephant's pit'. Its age has been estimated at 1.2 million years and it is considered to be the oldest human fossil found in Europe and is from the lower Pleistocene. This work analyses the dental and skeletal damage to the specimen, detected in a macroscopic study of possible horizontal and vertical bone loss at the level of support of the remaining teeth. The limited presence of dental scale, the pattern of destruction and the decreased bone density due to increased marrow spaces suggest the presence of possible periodontal disease.

A retrospective study of the risk factors for ridge expansion with self-tapping osteotomes in dental implant surgery

PURPOSE

To analyze the risk factors associated with the survival of self-threading implants placed with the ridge expansion technique using self-tapping osteotomes after at least 24 months.

MATERIALS AND METHODS

This retrospective study followed patients for at least 2 years in whom implants had been inserted by means of the ridge expansion technique. The patient was taken as the unit of analysis, and the loss of any implant as a result of mobility at any time during the follow-up period was considered as a failure. A number of patient variables were recorded: sociodemographic (age/sex), anatomical (bone quantity/quality, expansion zone), infection history (prior antibiotic therapy for active infection), prosthodontic (type of provisional prosthesis and type of definitive rehabilitation), and surgical (number of surgical stages, the use of biomaterials or atraumatic maxillary sinus elevation). Risk factors were expressed as values of relative risk (RR) and the odds ratio.

RESULTS

Seventy-four patients (157 implants) were followed over a mean period of 38.8 ± 7.7 months. Most patients (91.9%) did not lose any implants, and failures occurred mainly after implant loading (5.4%). Sociodemographic factors (sex and age) were not associated with a significant risk of implant failure. However, the existence of previous local infection (RR = 34.0), the use of an immediate fixed provisional prosthesis (RR = 15.0), and type D3 bone (RR = 5.1) were seen to be the main risk factors involved in this technique for the period assessed.

CONCLUSIONS

The risk of failure when implants are placed using self-tapping osteotomes was highest in patients who had active local infection; immediate provisionalization and less dense bone were also associated with additional risk of failure.

The occupational role of dental conditions among a consecutive sample of Spanish workers

OBJECTIVES

To assess the occupational impact of the mouth in terms of days of work loss in the last year and the perception of the working performance disturbance because of the oral conditions.

STUDY DESIGN

A consecutive sample (n=269) of the Regional Government staff of the province of Granada (Spain) was recruited. Participants were asked about work loss related to health problems in the past 12 months, capturing the aetiological entities, the frequency of the work absent and the total days loss. Also subjects reported if they believed that mouth affects their occupational performance, and if they have perceived difficulties for carrying out work because of the mouth. Data on sociodemographic, behavioural and clinical factors were also gathered. Chi-squared test, Odds ratio (OR) and relative risk (RR) of perceived occupational role were used to quantify the effect of the modulating factors.

RESULTS

Almost 40% of individuals were absent from work during the last year spending on average 5.4 days for recovering. Colds and musculoskeletal pathology were the major causes of sick leave. Dental disease caused short work absences (4 days on average) only in 2.8% of participants. However most of workers (62.5%) considered mouth to influence their occupational performance, mainly because of the pain-related events (61.7%), but only 4.1% of workers reported difficulties in carrying out their work in the past 12 months. Females (RR=1.3), participants attending regular dental visits (RR=1.4) and denture wearers (RR=2.5) were shown to have significantly higher risk of perceiving an occupational role of the mouth. Those workers reporting that mouth influences their work have significantly poorer oral health than counterparts.

CONCLUSIONS

Most workers considered that mouth influences their occupational performance but dental disease has demonstrated to be a minor occupational cause of sick leave in terms of prevalence and magnitude of work loss.