Bettina Alonso - Academia.edu (original) (raw)

Papers by Bettina Alonso

Clinical Oral Investigations

Objectives The objective of the present narrative review was to evaluate the evidence of a possib... more Objectives The objective of the present narrative review was to evaluate the evidence of a possible association between periodontitis and COVID-19, and its biological plausibility, using as models the potential associations with cardiovascular diseases, diabetes, and some respiratory diseases. Methods A recent systematic review was used as main reference to explore the associations of periodontitis with different respiratory diseases, including COVID-19, following two focussed questions: a PECOS question, aimed to explore epidemiological evidence, and a PICOS question, designed to explore the evidence derived from intervention studies. In addition to that evidence, other relevant scientific documents, including consensus papers, were carefully selected and appraised. Findings Convincing evidence was found to support the association of periodontitis and cardiovascular diseases, diabetes, and some respiratory diseases. The biological plausibility behind those associations is based on ...

International Journal of Molecular Sciences

In search for natural products with antimicrobial properties for use in the prevention and treatm... more In search for natural products with antimicrobial properties for use in the prevention and treatment of peri-implantitis, the purpose of this investigation was to evaluate the antimicrobial activity of curcumin and xanthohumol, using an in vitro multi-species dynamic biofilm model including Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. The antimicrobial activities of curcumin (5 mM) and xanthohumol (100 μM) extracts, and the respective controls, were evaluated with 72-h biofilms formed over dental implants by their submersion for 60 seconds. The evaluation was assessed by quantitative polymerase chain reaction (qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). For the data analysis, comparisons were tested applying ANOVA tests with post-hoc Bonferroni corrections to evaluate the antimicrobial activity of both extracts. With qPCR, st...

Antibiotics

Multiple toothbrush designs have been developed to enhance dental biofilm removal and decrease ba... more Multiple toothbrush designs have been developed to enhance dental biofilm removal and decrease bacterial contamination and retention over time. Therefore, the aim of this clinical study was to compare the efficacy of a prototype of a new double-sided thermoplastic polyurethane-based toothbrush with that of a conventional nylon-bristle toothbrush. A crossover study was conducted in systemically healthy volunteers (n = 24) for two one-week periods plus one washout week. As outcome variables, plaque and gingival indices, total bacterial contamination of the toothbrushes by quantitative polymerase chain reaction (qPCR), and patient-reported outcomes were measured. Clinical and microbiological variables were analysed using a general linear model and Friedman and Wilcoxon signed-rank tests. No statistically significant differences between toothbrushes were detected neither for full-mouth PlI (p > 0.05) nor for GI (p > 0.05). Similarly, no statistically significant differences were d...

periodontitis: the use of systemic antimicrobials against the subgingival biofilm Objectives: The... more periodontitis: the use of systemic antimicrobials against the subgingival biofilm Objectives: The aim was to answer three relevant questions: can systemic antimicrobials be efficacious if the biofilm is not disrupted? Can the type of debridement of the subgingival biofilm impact upon the clinical outcomes of the adjunctive antimicrobial therapy? Is the efficacy of the adjunctive systemic antimicrobial therapy dependent on the quality of the debridement of the subgingival biofilm and the sequence debridement–antibiotic usage? Material and Methods: Relevant papers were searched, critically analysed and their data were extracted. Results: For the first question, studies assessing susceptibility of bacteria in biofilms, and clinical studies evaluating systemic antimicrobials as monotherapy, were reviewed. For the second question, clinical studies comparing systemic antimicrobials as adjuncts to non-surgical debridement or to periodontal surgery and clinical trials using systemic antibio...

International Journal of Dental Hygiene, 2016

Objective: To compare the effect of two newly formulated chlorhexidine (CHX) and cetylpyridinium ... more Objective: To compare the effect of two newly formulated chlorhexidine (CHX) and cetylpyridinium chloride (CPC) mouthrinses after scaling and root planing (SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. Methods: A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of ANOVA or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. Results: Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels (P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error-SE 2.21%] versus 49.39% [SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions (P = 0.022) of Capnocytophaga spp. Conclusions: Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP.

Periodoncia Sociedad Espanola De Periodoncia, 2009

El riesgo de osteonecrosis de los maxilares (ONM) en pacientes en tratamiento con bisfosfonatos e... more El riesgo de osteonecrosis de los maxilares (ONM) en pacientes en tratamiento con bisfosfonatos es un problema que cada vez esta causando mas preocupacion a los profesionales de la cavidad oral. El mayor riesgo de osteonecrosis de los maxilares se ha observado en pacientes en tratamiento con bisfosfonatos por via intravenosa y con factores de riesgo medico (antecedentes de quimioterapia y/o radioterapia, consumo de corticoides, diabetes y la edad). Sin embargo, en la practica odontologica diaria son muchos los pacientes en tratamiento con bisfosfonatos por via oral para osteoporosis, sin factores de riesgo medico, que demandan tratamiento quirurgico oral. Aunque el riesgo de ONM en estos pacientes es bajo, es una entidad real. Por tanto, lo mas importante para el dentista en este momento, es poder aplicar un protocolo de actuacion. En este sentido, solicitar el Test CTX (C-terminal Crosslinking Telopeptide: telopeptido carboxiterminal de la cadena alfa 1 del colageno 1), podria ser util para realizar un plan de tratamiento odontologico con cierta seguridad en estos pacientes. Si bien, en la actualidad los resultados de este test deben ser considerados con cautela y no definitivos.

Adaptive divergence between freshwater and marine sticklebacks: insights into the role of phenoty... more Adaptive divergence between freshwater and marine sticklebacks: insights into the role of phenotypic plasticity from an integrated analysis of candidate gene expression. Evolution 64, 1029-1047.

Oral Oncology Supplement, 2007

Periodontology 2000, 2014

This is a review and update on acute conditions affecting the gingival tissues, including abscess... more This is a review and update on acute conditions affecting the gingival tissues, including abscesses in the periodontium, necrotizing periodontal diseases, and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, muco-cutaneous disorders, and traumatic and allergic lesions. A periodontal abscess is clinically important since it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth, and because bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly by the type of etiology, and there are clear differences between those affecting a previously existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, with individual evaluation of the need for systemic antimicrobial therapy. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases (NPD) present three typical clinical features: papilla necrosis, gingival bleeding, and pain. Although the prevalence of these diseases is not high, their importance is clear, since they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of NPD includes numerous factors that alter the host response and predispose to these diseases, including HIV infection, malnutrition, stress, and tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine, and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in non-responding conditions, and the best option is metronidazole. Once the acute disease is under control, definitive treatment should be provided, including the adequate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, are infectious diseases, muco-cutaneous diseases and traumatic or allergic lesions. In most cases, the gingival involvement is not severe, though they are common and may prompt a dental emergency visit. These conditions may have the appearance of an erythematous lesion, sometime erosive. Erosive lesions may the direct result of a trauma or the consequence of the breaking of vesicles and bullae. A proper differential

Journal of Evidence Based Dental Practice, 2012

Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chr... more Context. Scaling and root planing (SRP) is the gold standard treatment for most patients with chronic periodontitis. Nevertheless, in the last years, different therapeutic strategies have been proposed to improve the results of SRP and hence to avoid the need of periodontal surgical interventions in some patients with advanced periodontitis. They are based on modifications of standard therapies (such as enhancement of instrument tip designs), on development of new technologies (such as lasers), or development of alternative treatment protocols (eg, full-mouth disinfection). The purpose of this review is, therefore, to update the scientific evidence based on randomized clinical trials (RCT) evaluating these advanced nonsurgical therapies that have been published between January 2010 and March 2012. Evidence Acquisition. RCTs published between January 2010 and March 2012 have been selected. Previous systematic reviews were used as a start point. Three distinct aspects were evaluated independently: the modification of conventional instruments, the advent of new technologies, and the development of new treatment protocols. Evidence Synthesis. Twenty-two publications were selected: 4 were related to modifications of standard therapies (new tip designs and local anesthetics), 14 to new technologies (new ultrasonic devices, air abrasive systems, endoscope and lasers), and 4 to new treatment protocols. Conclusions. These technological advances and the development of new protocols may improve patient-related outcomes and cost-effectiveness, although they have not shown significant differences in efficacy when compared with conventional SRP.

Journal of Clinical Periodontology, 2013

Efficacy of a new mouth rinse formulation based on 0.07% cetylpyridinium chloride in the control ... more Efficacy of a new mouth rinse formulation based on 0.07% cetylpyridinium chloride in the control of plaque and gingivitis: a 6-month randomized clinical trial.

Journal of Clinical Periodontology, 2008

Objectives: The aim was to answer three relevant questions: can systemic antimicrobials be effica... more Objectives: The aim was to answer three relevant questions: can systemic antimicrobials be efficacious if the biofilm is not disrupted? Can the type of debridement of the subgingival biofilm impact upon the clinical outcomes of the adjunctive antimicrobial therapy? Is the efficacy of the adjunctive systemic antimicrobial therapy dependent on the quality of the debridement of the subgingival biofilm and the sequence debridement-antibiotic usage? Material and Methods: Relevant papers were searched, critically analysed and their data were extracted. Results: For the first question, studies assessing susceptibility of bacteria in biofilms, and clinical studies evaluating systemic antimicrobials as monotherapy, were reviewed. For the second question, clinical studies comparing systemic antimicrobials as adjuncts to non-surgical debridement or to periodontal surgery and clinical trials using systemic antibiotics with periodontal surgery were evaluated. For the third question, a previous systematic review was updated. Conclusion: If systemic antimicrobials are indicated in periodontal therapy, they should be adjunctive to mechanical debridement. There is not enough evidence to support their use with periodontal surgery. Indirect evidence suggests that antibiotic intake should start on the day of debridement completion, debridement should be completed within a short time (preferably o1 week) and with an adequate quality, to optimize the results.

Estudios recientes han evaluado la posible relacion entre la periodontitis y ciertos nutrientes i... more Estudios recientes han evaluado la posible relacion entre la periodontitis y ciertos nutrientes involucrados en el metabolismo oseo y en la regulacion de la respuesta del hospedador, tales como la vitamina D, el calcio, el magnesio, los antioxidantes y los acidos grasos poliinsaturados. La ausencia de niveles optimos de dichos nutrientes se ha asociado con la perdida de hueso y colageno y con el estimulo de la respuesta inmunoinflamatoria, lo que podria incrementar la susceptibilidad del individuo a padecer la enfermedad o incluso la severidad de la periodontitis. El objetivo de esta revision es analizar la existencia de una relacion causal entre los niveles nutricionales deficitarios y las enfermedades periodontales, a traves de su evaluacion en estudios de intervencion. Los estudios de intervencion que evaluan la relacion causal entre la administracion via oral de nutrientes esenciales y las enfermedades periodontales son muy limitados; el estudio se restringe a los acidos grasos ...

Oral health & preventive dentistry, 2020

PURPOSE No information is available on the perception of the quality of care in patients treated ... more PURPOSE No information is available on the perception of the quality of care in patients treated for periodontitis. The purpose of this article was to assess how periodontitis-affected patients perceive the quality of periodontal treatment (PT) and to measure the factors which may influence it. MATERIALS AND METHODS 306 subjects who completed PT were invited to participate. Questionnaires and visual analogic scales (VAS) evaluating perception of quality of care, symptoms, and oral health related quality of life (OHRQoL) were handed out. Oral and periodontal indicators were collected before and after treatment. The impact of different factors on perception of quality was assessed with a regression model. RESULTS Quality evaluation was high yet unrelated for both patients and clinicians (p = 0.983). Quality was negatively influenced by the number of residual oral infections (p < 0.001), patient's age (p = 0.07) and presence of residual pain at completion of PT (p = 0.02). Profe...

El herpes oral recurrente es una infeccion cronica causada por el virus del herpes simple Tipo. I... more El herpes oral recurrente es una infeccion cronica causada por el virus del herpes simple Tipo. I. Uno de cada tres sujetos seropositivos para el VHS-I desarrolla episodios periodicos de reactivacion del virus, con aparicion de lesiones herpeticas orales, que suelen asentar en el area labial y/o peribucal. Ciertos procedimientos odontologicos pueden suponer un trauma para los tejidos bucales, que actuan como desencadenantes de un episodio de herpes oral recurrente. Estas lesiones suelen presentar un curso benigno y curar sin secuelas, sin embargo se han descrito complicaciones de diversa magnitud, tanto a nivel de tejidos blandos como duros, asociados a episodios herpeticos. Igualmente la presencia de una lesion herpetica activa supone un riesgo de infeccion cruzada, tanto para el profesional como para el paciente. La terapia farmacologica antirretroviral ha demostrado ser efectiva en la prevencion y profilaxis de la aparicion de episodios de herpes oral recurrente, asi como en su t...