Odontología Vital

Microfiltración marginal en restauraciones con resinas Bulk Fill

In vitro study of marginal microleakage levels in restorations with Bulk Fill resins using the deproteinization technique prior to acid etching

Summary Introduction: Currently, the market offers Bulk Fill resins that are used with the monobloc or single-increment technique (up to 4 or 5 mm). These resins are characterized by a lower filler content and larger filler particles, improved translucency, and a different chemical structure of the monomers in the filler compounds, which-when placed in a single block-reduce polymerization stress. Objective:To evaluate the level of marginal microleakage of two Bulk Fill resins using the deproteinization technique prior to acid etching. Methods: This is an invitro study in which 64 extracted premolars underwent standardized cavity preparations. The teeth were randomly divided into four groups and subjected to a manual thermocycling process of 500 cycles. All samples were immersed in a 2% methylene blue solution for 24 hours. Microleakage was then observed with a stereomicroscope. Results: For the Aura Bulk Fill resin, microleakage in enamel was observed in 25% of the deproteinized samples and in 18.8% of the non-deproteinized samples. For the Filtek Bulk Fill resin, 31.3% of the samples exhibited microleakage in enamel with the deproteinization technique and 25.0% without deproteinization. No statistically significant differences were found. Conclusions: All samples presented microleakage, with similar levels in both brands of Bulk Fill resins, and no significant differences were observed with the application of the deproteinization technique.

Desarrollo profesional y tecnológico del turismo dental en Puerto Vallarta

Summary Introduction: The Universal Medical Travel agency of the United States (USA), promotes Mexico, Costa Rica and Colombia, as Latin American countries with high quality in dental services. Other countries in Latin America that offer dental tourism are Argentina, Brazil and Chile. Objective: The objective of this study is to describe the professional and technological development of dental practitioners in Puerto Vallarta. Method: For the analysis, 21 semi-structured interviews were conducted with dentists practicing in Puerto Vallarta, selected from a total population of 176 professionals listed in the National Statistical Directory of Economic Units (DENUE), as of November 2023 (INEGI, 2024). These interviews provided insights into key trends and challenges related to specialization and the adoption of advanced technologies in the dental field. Results: The results show a notable increase in the use of advanced technologies among dentists in Puerto Vallarta. Additionally, there is a marked rise in professional specialization, driven by the need to cater to an increasingly demanding international clientele as a result of the growth in medical tourism. Conclusions:The professional and technological development of dentists in Puerto Vallarta largely depends on the ongoing training and updates that practitioners seek and finance with their own resources. Dentists contribute to local economic growth through the foreign tourism they serve and the services and materials they consume. The Puerto Vallarta Dental Association has played a crucial role in enhancing the professional skills of affiliated dentists and those willing to participate in the activities it offers.

Analysis and Evaluation of Nasal Angles in Non-Surgical Rhinoplasty with Hyaluronic Acid

Abstract Background: Studies show the efficacy and safety of nasal reshaping with hyaluronic acid. However, there is little evidence on the clinical parameters modified to achieve an aesthetic improvement in the nasal profile. In aesthetic analysis, the nasolabial angle has often been used to evaluate the rotation of the nasal tip in non-surgical rhinoplasty, a parameter dependent on the position of the upper lip. The researchers declare no conflicts of interest. Objetive: The purpose of this study is to demonstrate the changes induced by non-surgical rhinomodelling in the nasal profile by measuring the nasolabial angle traced on soft tissues and the new nasal angle proposed by the authors. Additionally, the study highlights the efficacy and safety of nasal reshaping with hyaluronic acid. Methods: This is a prospective open-label study where the outcome of non-surgical rhinoplasty treatment with cannula (23G x 38 mm) was evaluated in 25 adult patients (treated in the areas of the nasal spine, columella, and supratip) using a maximum of 0,6 ml of hyaluronic acid. Results: Twenty-five patients participated in this study (22 women and 3 men) with an average age of 34 years. An average of 0.33 ± 0.11 ml of hyaluronic acid was infiltrated during the procedure. Twenty-two patients underwent this procedure for the first time during this study, while the other three had undergone between 1 to 3 previous procedures. Only two patients required a second intervention, using an average of 0.18 ml. Nasolabial angles before and after treatment were measured; on average, this increased from 89.3 ± 11.3° to 98.4 ± 8.2° (average change of 9.1 ± 7.3°). No complications were recorde. Conclusion: Statistically significant changes were observed when comparing the nasolabial angle measurements before and after the procedure, with an average increase of 9º, as determined through nasal profile analysis and subsequently tested in STATA 11 (P=0.0000). Additionally, given that the nasolabial angle may vary due to aging and modifications in perioral structures, it is necessary to measure another angle to assess nasal tip projection.

Digital Workflow from Planning to Rehabilitation of a Dental Implant: A Clinical Case Report

ABSTRACT Introduction: Dental implants represent a valid option in modern dentistry, and their long-term success depends on precise planning. A digital workflow combines the analysis of 3D models and images, and cone-beam computed tomography is a prerequisite for planning. Objective: To demonstrate the effectiveness of the digital workflow in treatment planning and execution to obtain predictable and high- quality results in the rehabilitation of simple cases of single tooth loss, proposing a protocol for its incorporation as standard practice for undergraduate students in the University’s dental clinic. Method: The treatment was performed on a 24-year-old systemically healthy patient with a fixed prosthesis in the 4-5 to 4-7 area, localized gingivitis and marginal misfit, and a Seibert class I residual ridge with the possibility of rehabilitation using a guided dental implant. The prosthesis was removed, indicating individual abutment crowns. Tomography indicated the need to use connective tissue on the buccal side to improve the prosthetic profile of the ridge, for which the modified roll technique was applied. Bone densification was chosen to ensure primary stability, thus enabling immediate loading with a provisional crown on the same day as the surgery. Results: The fully digital workflow facilitated the execution of the surgical procedure safely and accurately, allowing recognition of the operator’s position with respect to the patient’s anatomical structures at all times, thus obtaining predictable results. Conclusions; Confidence in planning is essential, and the fully digital workflow is especially beneficial when the treatment is performed by undergraduate students. This translates into benefits for both the future professional and the patient.

Traditional silver diamine fluoride as an alternative in the management of dental caries in children: effectiveness and aesthetic limitations. Literary review

Resumen Introducción: El fluoruro diamino de plata (FDP) es un compuesto que se emplea en odontología para combatir la caries dental, el cual contiene fluoruro e iones de plata, los cuales actúan eliminando bacterias y fortaleciendo el esmalte dental mediante su remineralización. Su uso es beneficioso en niños y en pacientes con necesidades especiales. Una de sus particularidades es que produce una coloración negra en las lesiones donde se aplica. Objetivo: Analizar la eficacia y limitaciones estéticas del fluoruro diamino de plata tradicional en la detención de caries en niños. Metodología: Se realizó una revisión bibliográfica en PubMed, Scielo y ResearchGate sobre el fluoruro diamino de plata. Se incluyeron estudios publicados entre 2019 y 2024, en inglés y español, como revisiones de literatura, disertaciones, series de casos y estudios observacionales. Resultados: De los 48 registros que se identificaron, se excluyeron 40, quedando 8 estudios elegibles. Estos demuestran que el fluoruro diamino de plata es eficaz para detener la caries, sin embargo, su limitación más importante es la pigmentación negra. Las recomendaciones finales ofrecen pautas para su uso en odontopediatría. Conclusiones: El fluoruro diamino de plata (FDP) es eficaz para detener la caries en niños, aunque su pigmentación negra puede afectar su aceptación.

Abstract Introduction:Silver diamine fluoride (SDF) is a compound used in dentistry to combat tooth decay. It contains fluoride and silver ions, which act by eliminating bacteria and strengthening tooth enamel through remineralization. Its use is beneficial for children and patients with special needs. One of its peculiarities is that it produces a black coloration in the lesions where it is applied. Objective:To analyze the efficacy and aesthetic limitations of traditional silver diamine fluoride in stopping caries in children. Methodology: A bibliographic review was conducted in PubMed, SciELO and ResearchGate on silver diamine fluoride. Studies published between 2019 and 2024, in English and Spanish, were included, such as literature reviews, dissertations, case series and observational studies. Results: Of the 48 records identified, 40 were excluded, leaving eight eligible studies. These findings demonstrate that silver diamine fluoride is effective in stopping caries, but its most important limitation is its black pigmentation. The final recommendations provide guidelines for its use in pediatric dentistry. Conclusions: Silver diamine fluoride (SDF) is effective in stopping caries in children, although its black pigmentation may affect its acceptance.

Reducción cerrada en fracturas nasales: descripción paso a paso y breve revisión de la literatura

Resumen Introducción: las fracturas de los huesos nasales representan una de las lesiones faciales más prevalentes en adultos, atribuibles en gran medida a la posición anatómica prominente y expuesta de la nariz. Estas fracturas constituyen aproximadamente el 40 % de todas las fracturas faciales y son con frecuencia el resultado de eventos de alto impacto, como accidentes automovilísticos, traumas que se relacionan con el deporte y violencia interpersonal. Debido al papel integral de la nariz, tanto en la estética facial como en la función respiratoria, el manejo de las fracturas nasales es fundamental para garantizar resultados óptimos en la apariencia cosmética y en la restauración funcional. Objetivo: El objetivo de este artículo es presentar una guía paso a paso para la realización de una reducción nasal cerrada, utilizando el caso clínico de un paciente con fractura nasal como ejemplo, junto con una breve revisión de la literatura sobre la eficacia, las consideraciones estéticas y funcionales y el momento adecuado para la intervención. Presentación del caso: un paciente masculino de 47 años se presentó al servicio de urgencias con una fractura del hueso nasal sufrida durante una agresión. Tras evaluarlo, se consideró que la fractura era adecuada para manejarla mediante reducción cerrada. Se proporciona una descripción detallada, paso a paso, de la técnica de reducción cerrada para fracturas nasales, que se realizó en el paciente como ejemplo. Los cuidados posoperatorios incluyeron el uso de férulas internas y externas, así como un régimen de antibióticos y medicamentos antiinflamatorios. Conclusión: La reducción nasal cerrada es un procedimiento ampliamente utilizado y efectivo en el tratamiento de fracturas de huesos nasales, en especial cuando se realiza poco después de la lesión. El procedimiento es mínimamente invasivo y puede ofrecer resultados satisfactorios, tanto estéticos como funcionales. Sin embargo, su éxito depende de factores como el momento de la intervención y la experiencia del cirujano. Aunque la reducción cerrada es efectiva para la mayoría de las fracturas simples, los casos más complejos pueden requerir intervenciones quirúrgicas adicionales, como la osteotomía nasal, en particular si ya ha ocurrido la fusión ósea. El manejo de las fracturas nasales es una habilidad fundamental que deben poseer los cirujanos maxilofaciales, debido a la prevalencia de estas lesiones en contextos de emergencia.

Abstract Introduction: Nasal bone fractures represent one of the most prevalent facial injuries in adults, mainly attributable to the nose’s prominent and exposed anatomical position. These fractures constitute approximately 40% of all facial fractures and are frequently the result of high-impact events, such as motor vehicle collisions, sports-related trauma, and interpersonal violence. Given the nose’s integral role in facial aesthetics and respiratory function, managing nasal fractures is fundamental to ensure optimal outcomes in cosmetic appearance and functional restoration. Objective: This paper aims to present a step-by-step guide for performing a closed nasal reduction, using the clinical case of a patient with a nasal fracture as an example, along with a brief literature review on efficacy, aesthetic and functional considerations, and appropriate timing for intervention. Case presentation:A 47-year-old male patient presented to the emergency department with a nasal bone fracture sustained during an assault. Upon evaluation, the fracture was deemed suitable for management through closed reduction. A detailed step-by-step description of the closed reduction technique for nasal fractures, performed on the patient as an example, is provided. Post-procedure care included the use of internal and external splints, as well as a regimen of antibiotics and anti-inflammatory medications. Conclusion:Closed nasal reduction remains a widely used and effective procedure in the treatment of nasal bone fractures, particularly when performed early after injury. The procedure is minimally invasive and can yield satisfactory aesthetic and functional outcomes. However, its success depends on factors such as the timing of the intervention and the surgeon’s experience. While closed reduction is effective for most simple fractures, more complex cases may require additional surgical interventions, such as nasal osteotomy, particularly if bone fusion has already occurred. The management of nasal fractures is an elementary skill that maxillofacial surgeons must have, given the prevalence of these injuries in emergency settings.