Alejandra Herrera | Instituto Universitario De Tecnologia De Administracion Industrial (Iuta) (original) (raw)
Papers by Alejandra Herrera
The bacterial signaling mechanisms play a key role in the establishment and progression of period... more The bacterial signaling mechanisms play a key role in the establishment and progression of periodontal disease. Due to these circumstances it is crucial to deepen in the understanding of these mechanisms to try to provide novel therapeutic strategies. The objective of present narrative literature review was to make a critical analyze of the available evidence on the influence of Porphyromonas gingivalis (PG) and the quorum sensing expression in periodontal disease. Using the Ovid (MEDLINE) ScienceDirect, Hinari database we made a search. The current knowledge of these mechanisms offers the possibility of developing new and deep studies (theoretical and experimental) on the QS expression in patients presenting with periodontal disease allowing a novel research field not currently available. From its discovery the QS is discerned as a valuable research space in which we must to insist in a permanent way. The above mentioned evidence allows concluding that by the regulation of the expr...
Duazary, 2012
La gingivectomia consiste en la escision y eliminacion de tejido gingival, con el objetivo del co... more La gingivectomia consiste en la escision y eliminacion de tejido gingival, con el objetivo del corte de la pared de tejidos blandos de una bolsa para disminuir su profundidad. Corrige dicha discrepancia, y elimina tambien bolsas supra oseas, agrandamientos fibrosos o edematosos de la encia, transformacion de margenes redondeados o engrosados en la forma ideal, y abscesos periodontales supra oseos. Para este procedimiento quirurgico es necesario que el paciente tenga una encia insertada amplia, y dejar una zona funcionalmente adecuada para no eliminar la encia remanente y asi no correr el riesgo de eliminar toda la encia. Se reporta un caso clinico de un paciente femenino de 28 anos de edad que presenta inconformidad estetica por dejar apreciar gran cantidad de encia cuando sonrie y por consiguiente dientes con corona clinica corta. Se obtuvieron excelentes resultados esteticos en el tratamiento y en su evolucion. La finalidad de este reporte es presentar la gingivectomia como tratam...
Duazary, 2011
GingivalrecessionisdefinedasthelocationofgingivalmarginapicaltotheCEJoneormoreteeth.� This� defor... more GingivalrecessionisdefinedasthelocationofgingivalmarginapicaltotheCEJoneormoreteeth.� This� deformitycausesapicalusuallyrootsensitivity,� poorappearanceaestheticsandcariouscervicallesions� sothatPatientsmaywonderproceduresrootcoverage.� Therearetwomaingroupscausesofgingival� recession,� whichoriginatefromperiodontaldiseaseandtraumaticorigin,� isalsoconsidercertain� factorsandwereclassifiedaspredisposingfactorsandprecipitatingtriggers.� Gingivalrecessionsare� pathologicallycausedbythedestructionofconnectivetissuegingivawhichcausesadecreaseinflow� gingivalbloodlevel,�havedevelopedseveraltechniquesforthesamepurposewithintheflaparepedicled,�freegingival� graftepithelialized,�connectivetissuegraftingandtissueregenerationtour.�.�Theconditionsforsuccessinthetreatmentof�
Journal of Public Health Dentistry, 2020
OBJECTIVES Inappropriate prescription of antibiotics contributes to antibiotic resistance. Theref... more OBJECTIVES Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. METHODS In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. RESULTS The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). CONCLUSION The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.
Enfermedades infecciosas y microbiologia clinica (English ed.), 2019
Objective: To describe the bacterial profile of the supragingival biofilm of children with tempor... more Objective: To describe the bacterial profile of the supragingival biofilm of children with temporary dentition (CTD) and early mixed dentition (CEMD), with the next-generation sequencing (HOMINGS) technique. Method: A comparative descriptive study was carried out with 30 systemically healthy children aged between 5 and 7 years old from public schools in Cartagena-Colombia. All participants were caries-free applying the criteria of the International Caries Detection and Assessment System (ICDAS II) and had no caries experience according to the Decayed, Missing and Filled Teeth (DMFT) index. Supragingival biofilm samples were collected. Bacterial DNA was extracted and used for analysis using HOMINGS (Human Oral Microbe Identification using Next-Generation Sequencing) based on the sequencing of the V3-V4 region of the 16S rRNA gene using the Illumina MiSeq platform (V3-V4 primers). Results: A total of 360 species-specific and 65 genus-specific probes were identified. The bacterial genus most predominant in CTD were Streptococcus, Actinomyces, Veillonella and Fusobacterium (29.2% of all bacterial DNA present), while in CEMD the most predominant were Streptococcus, Leptotrichia, TM7 and Porphyromonas (24.5% of all bacterial DNA present). The bacterial species with the highest relative abundance in the oral biofilm microbiome from CTD were Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, while in CEMD they were S. sanguinis, Leptotrichia spp. HOT-417 and Leptotrichia spp. HOT-498. The Shannon diversity index was 2.77 (SD = 0.26) for CTD and 3.01 (SD = 0.39) for CEMD (p = 0.06). Conclusions: The analysis of the bacterial profile of the supragingival dental biofilm in children with DMFT, by means of HOMINGS showed low microbiological diversity both in presence and in relative abundance in terms of genus as well as bacterial species.
Enfermedades Infecciosas y Microbiología Clínica, 2018
On-line el xxx Palabras clave: Biopelículas Dentición mixta Diente temporal Bacterias r e s u m e... more On-line el xxx Palabras clave: Biopelículas Dentición mixta Diente temporal Bacterias r e s u m e n Objetivo: Describir el perfil bacteriano del biofilm supragingival de niños con dentición temporal (NDT) y dentición mixta temprana (NDMT), con la técnica de secuenciación de próxima generación HOMINGS. Método: Se realizó un estudio descriptivo comparativo con 30 niños de 5 a 7 años de edad sistémicamente sanos de escuelas públicas de Cartagena (Colombia). Todos los participantes estaban libres de caries, según los criterios del Sistema Internacional de Detección y Evaluación de Caries (ICDAS II) y sin experiencia de caries según el índice de dientes cariados, perdidos y obturados (DCPO). Se recolectaron muestras de biofilm supragingival. Se extrajo el ADN bacteriano y se usó para su análisis mediante HOMINGS (identificación de microorganismos orales humanos utilizando secuenciación de próxima generación) basado en la secuenciación de la región V3-V4 del gen 16S rRNA con la plataforma Illumina MiSeq. Resultados: Se identificaron 360 especies específicas y 65 géneros específicos de las sondas: Streptococcus, Actinomyces, Veillonella y Fusobacterium (29,2% del total de ADN bacteriano presente), mientras que en el grupo de dentición mixta temprana se encontraban Streptococcus, Leptotrichia, TM7 y Porphyromonas (24,5% del ADN bacteriano presente). Las especies bacterianas con mayor abundancia relativa en el microbioma oral de biofilm de NDT fueron Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, mientras que en NDMT fueron S. sanguinis, Leptotrichia sp. HOT-417, Leptotrichia sp. HOT-498. El índice de diversidad de Shannon fue 2,77 (DE = 0,26) para NDT y 3,01 (DE = 0,39) para NDMT (p = 0,06). Conclusiones: El análisis del perfil bacteriano del biofilm dental supragingival en niños con NDMT mediante HOMINGS mostró baja diversidad microbiológica tanto en presencia como en abundancia relativa a nivel de género y de especies bacterianas.
Ciencia y Salud Virtual, 2014
El granuloma central de células gigantes (GCCG) es un proceso circunscrito, endofítico poco frecu... more El granuloma central de células gigantes (GCCG) es un proceso circunscrito, endofítico poco frecuente de la cavidad oral, también denominada épulis de células gigantes, osteoclastoma, granuloma reparativo de células gigantes, o hiperplasia de células gigantes, la mayor parte de las veces se desarrolla de manera asintomática y se detecta como un hallazgo radiográfico o por la expansión indolora del hueso afectado. En algunos casos se presenta con un comportamiento más agresivo, asociado a dolor, parestesia, perforación de corticales óseas e incluso ulceración de la mucosa. Siempre se debe realizar diagnóstico diferencial, enfocando sobre todo tres de ellos el tumor pardo del hiperparatiroidismo, el querubismo y el quiste óseo aneurismático. Se presenta caso clínico en paciente masculino de 14 años de edad, con diagnóstico de GCCG a nivel de molares inferiores derechos, el cual después de realizarse curetaje, presentó posterior recidiva de la lesión a los seis meses, por lo que se r...
Ciencia y Salud Virtual, 2013
La macroglosia se describe desde el siglo II como una patología congénita o adquirida. Que se deb... more La macroglosia se describe desde el siglo II como una patología congénita o adquirida. Que se debe al aumento de la cantidad de tejido lingual, en el cual se observa un alargamiento y ensanchamiento de la lengua de una manera desproporcionada hacia las estructuras dentoalveolares produciendo desplazamientos dentales, indentaciones y traumas a nivel lingual, además podemos encontrar características funcionales como obstrucciones de la vía aérea, lo que puede conducir a hipoventilación alveolar que luego pasa a hipoxia e hipercapnia. Sialorrea y capacidad para llevar la lengua al mentón o a la punta de la nariz. En la mayoría de los casos se presenta en los pacientes que están relacionados con otras patologías como linfangiomas, síndrome de Beckwith-Wiedemann y pacientes con trisomía 21 o síndrome de Down. Como una forma de corregir esta patología muchos autores describen diversos tratamientos quirúrgicos que permitan mejorías de funciones vitales como la deglución, fonación y respira...
Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral, 2015
ABSTRACT Resumo Cirurgia, radioterapia e quimioterapia são as modalida-des terapêuticas usadas no... more ABSTRACT Resumo Cirurgia, radioterapia e quimioterapia são as modalida-des terapêuticas usadas no tratamento de câncer bucal. Podem ser usadas isoladas ou conjuntamente. Radiação ionizante causa lesões nos tecidos normais localizados no campo de radiação. Isto se torna particularmente evi-dente nas regiões de cabeça, uma área complexa com-posta de várias estruturas diferentes que respondem di-ferentemente à radiação. As sequelas orais resultantes podem causar problemas substanciais durante e depois da terapia de radiação e são os maiores fatores de deter-minação na qualidade de vida dos pacientes. Dentre as complicações da radioterapia estão a xerostomia, osteor-radionecrose, mucosite e candidose. O acompanhamento odontológico sistemático pode minimizar os efeitos da radiação sobre os tecidos da cavidade bucal. Descritores: 1-Radioterapia; 2-câncer; 3-saúde oral. Abstract Surgery, radiotherapy and chemotherapy are therapeu-tic modalities used in the treatment of oral cancer. They can be used in isolation or in combination. Ionizing ir-radiation causes damage in normal tissues located in the field of radiation. This becomes particularly evident in the head and neck region, a complex area composed of several dissimilar structures that respond differently to radiation. The resulting oral sequelae may cause substan-tial problems during and after radiation therapy and are major factors in determining the patient's quality of life. Xerostomia, osteoradionecrosis, mucositis and candido-sis are some of radiotherapy's complications. Regular dental follow-up can to reduce the effects of radiation in the tissues of the oral cavity.
The society always is in force by patterns of aesthetic face that, for obvious reasons, give spec... more The society always is in force by patterns of aesthetic face that, for obvious reasons, give special importance to the components dento-maxilars. The dentistry in its different specialties is in charge to correct the anomalies that appear in those components as functionally as aesthetically. The orthodontics science specifically works, in the dental position, it refers to obtain a functional and aesthetic harmony, using mechanical forces and devices designed specially for this aim. Nevertheless, there are cases in which is necessary to use complementary periodontal surgical techniques due to the presence of denser alveolar crests (compared with the common and normal) that prevent the fast and efficient movement that the orthodontics science requires. For this, we have to apply the procedure known like flexicorticotomy that consists of realising a controlled fracture with bony expansion. For this purpose, we will use progressive bony expansors. Inmediately, we have to separate the cortical bone we need to obtain a furrow with diameter and the depth adapted to permit the dental movement more easily. In the present article, we report a clinical case in which a flexicorticotomy (in a too narrow crest) was made with the purpose of correcting interdental space concerning anteroinferior dental organs, which is aesthetically unacceptable for the patient. That is necessary to complete a successful work of the orthodontics treatment, suitable tissue regeneration and post-operative ideal without complications.
Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for t... more Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for the resolution of diseases that require the removal of the root apex. This procedure requires a retrograde filling to seal the opening created and that is why specific materials which provide a high biocompatibility are needed. The amalgam was widely used in the past for the many advantages it provides, but today is quite challenged by exposing patients in contact with it, used in retro-filling, to develop different conditions. When the particles are introduced into the tissues, the same body recognizes them as foreign and rejects them by forming a capsule of cells and fibrous tissue around the fragments isolating it and inducing its decomposition. Since its components are metals and the body is not able to destroy them, it dissociates and eliminates them. Silver is the most difficult to remove and it remains in form of salts, coloring the surrounding tissue forming the famous "silver amalgam pigmentation". In our case the patient underwent apicectomy with retrograde obturation with amalgam, which broke off a piece that was rejected inducing the pigmentation of mucogingival tissues and the expulsion through the gingival mucosa.
Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for t... more Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for the resolution of diseases that require the removal of the root apex. This procedure requires a retrograde filling to seal the opening created and that is why specific materials which provide a high biocompatibility are needed. The amalgam was widely used in the past for the many advantages it provides, but today is quite challenged by exposing patients in contact with it, used in retro-filling, to develop different conditions. When the particles are introduced into the tissues, the same body recognizes them as foreign and rejects them by forming a capsule of cells and fibrous tissue around the fragments isolating it and inducing its decomposition. Since its components are metals and the body is not able to destroy them, it dissociates and eliminates them. Silver is the most difficult to remove and it remains in form of salts, coloring the surrounding tissue forming the famous "silver amalgam pigmentation". In our case the patient underwent apicectomy with retrograde obturation with amalgam, which broke off a piece that was rejected inducing the pigmentation of mucogingival tissues and the expulsion through the gingival mucosa.
Periodontal disease progression involves multiple factors, including several oral microorganisms ... more Periodontal disease progression involves multiple factors, including several oral microorganisms of the bacterial biofilm or commensal pathogens in oral cavity, which trigger inflammatory immune response in the host. There are chemical tools that fight any possibility of colonization and infection by a microorganism. Oral antiseptics are useful especially after periodontal surgery where they are almost indispensable to control the noxa, but at in the same time, they should facilitate the healing process of the cut tissues. The objective of this paper was to describe a case in which the use of 0.12 % chlorhexidine as an oral antiseptic postoperatively favored no proper healing of mucosal tissues after free gingival grafting. As an alternative, mouthrinse with Calendula was prescribed, observing affected tissue healing within a few days. It is argued that in all post-operative surgical process, one should analyze risks and benefits and choose avoiding the possibility of postoperative infection or timely scarring. As an alternative, the calendula mouthrinse allowed timely cicatrization and it should be noticed that they have some antimicrobial properties and high-inductive ability for the tissue healing.
Acta odontológica venezolana
El tratamiento ortodóntico en pacientes ó personas adultas es "más cuidadosa y lenta" q... more El tratamiento ortodóntico en pacientes ó personas adultas es "más cuidadosa y lenta" que la de los jóvenes, ya que no se pueden realizar todos los movimientos deseados por riesgo a observarse efectos adversos, que el procedimiento no tuvo ninguna complicación y presento excelentes resultados. Palabras clave: ortodoncia correctiva, aumento de la cresta alveolar, expansión de tejido, procesos alveolares, procedimientos quirúrgicos ambulatorios. ABSTRACT Orthodontics in the adult patient, is "more careful and slower" than in young people, due to they can´t perform all the indicated movements trying to avoid side effects observed, such as loss of tooth roots, gingival recessions, of hence the importance of linking orthodontics with another disciplines such as oral
Acta odontológica venezolana
RESUMEN La biopelícula dental muestra una organización altamente compleja en relación a lo que se... more RESUMEN La biopelícula dental muestra una organización altamente compleja en relación a lo que se puede esperar de unos organismos que anteriormente se creían independientes y de poca capacidad de asociaciones. Tienen una forma de crecimiento y de sostenibilidad bastante avanzada y estructurada que facilita la supervivencia de los patógenos incluidos dentro de estas formas de asociación. El
Salud Uninorte
The amalgam tattoo is caused by deposition in the subepitelial connective tissue fragments amalga... more The amalgam tattoo is caused by deposition in the subepitelial connective tissue fragments amalgam iatrogenic procedures result of the operator. The depth at which they are housed residues of this material influences the clinical presentation of lesions can be identified radiographically fragments have diameters while reasonable, can be observed histologically amalgam particles as dark granules, solids and irregular arranged between collagen bundles and blood vessels. The present article describes the case of a patient who had amalgam pigmentation vestibular mucosa, caused by a portion of amalgam used as filling material in an apicoectomy of 11 made in advance. Given the clinical and radiographic considerations we chose to carry a second apicoectomy with retrograde obturation with MTA 11. During the surgical procedure was curetted and lost the inside of the mucoperiosteal flap to try to reduce the degree of pigmentation.
Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral, 2014
Gingival overgrowth is an oral condition generated by the use of fixed orthodontic appliances. It... more Gingival overgrowth is an oral condition generated by the use of fixed orthodontic appliances. It was initially described as a product of the allergic response of the host to Nickel, and recent studies showed that this metal induces fibroblast proliferation. However, the degree of bioaccumulation of this metal in the oral cavity is unknown. The aim of this study was to quantify the concentrations of nickel in samples of saliva, dental plaque, and gingiva of individuals with fixed orthodontic appliances with and without gingival overgrowth. The sample size was established according to historical trends, evaluating 24 individuals with active orthodontic treatment, which were classified in two groups: 12 with gingival overgrowth (Group A) and 12 without gingival overgrowth (Group B). Samples of gingival, stimulated saliva and dental plaque were obtained from each participant. Once the sample were processed, nickel concentrations were measured in [mg/L] by atomic absorption spectrophotometry (Thermo Scientific. Atomic absorption spectrometer iCE 3000, UK). Statistical analysis was performed using SPSS v20. The levels of Nickel in samples of stimulated saliva, dental plaque and gingiva were compared between individuals in group A and group B. There were significantly higher levels of nickel in gingiva samples in group A (mean = 0.61 mg/L vs. 0.36 mg/L, P = .001). However, no statistical difference was observed when comparing the concentrations of nickel in saliva between groups A and B (mean = 0.502 mg/L vs. 0.473 mg/L, P = .178, respectively). The use of fixed orthodontic appliances leads to different levels of bioaccumulation of nickel in gingiva when comparing both groups. High concentrations of this metal are probably associated with the origin of gingival overgrowth. Further studies are required to establish causation.
Revista Cubana de …, 2010
The society always is in force by patterns of aesthetic face that, for obvious reasons, give spec... more The society always is in force by patterns of aesthetic face that, for obvious reasons, give special importance to the components dento-maxilars. The dentistry in its different specialties is in charge to correct the anomalies that appear in those components as functionally as aesthetically. The orthodontics science specifically works, in the dental position, it refers to obtain a functional and aesthetic harmony, using mechanical forces and devices designed specially for this aim. Nevertheless, there are cases in which is necessary to use complementary periodontal surgical techniques due to the presence of denser alveolar crests (compared with the common and normal) that prevent the fast and efficient movement that the orthodontics science requires. For this, we have to apply the procedure known like flexicorticotomy that consists of realising a controlled fracture with bony expansion. For this purpose, we will use progressive bony expansors. Inmediately, we have to separate the cortical bone we need to obtain a furrow with diameter and the depth adapted to permit the dental movement more easily. In the present article, we report a clinical case in which a flexicorticotomy (in a too narrow crest) was made with the purpose of correcting interdental space concerning anteroinferior dental organs, which is aesthetically unacceptable for the patient. That is necessary to complete a successful work of the orthodontics treatment, suitable tissue regeneration and post-operative ideal without complications.
The bacterial signaling mechanisms play a key role in the establishment and progression of period... more The bacterial signaling mechanisms play a key role in the establishment and progression of periodontal disease. Due to these circumstances it is crucial to deepen in the understanding of these mechanisms to try to provide novel therapeutic strategies. The objective of present narrative literature review was to make a critical analyze of the available evidence on the influence of Porphyromonas gingivalis (PG) and the quorum sensing expression in periodontal disease. Using the Ovid (MEDLINE) ScienceDirect, Hinari database we made a search. The current knowledge of these mechanisms offers the possibility of developing new and deep studies (theoretical and experimental) on the QS expression in patients presenting with periodontal disease allowing a novel research field not currently available. From its discovery the QS is discerned as a valuable research space in which we must to insist in a permanent way. The above mentioned evidence allows concluding that by the regulation of the expr...
Duazary, 2012
La gingivectomia consiste en la escision y eliminacion de tejido gingival, con el objetivo del co... more La gingivectomia consiste en la escision y eliminacion de tejido gingival, con el objetivo del corte de la pared de tejidos blandos de una bolsa para disminuir su profundidad. Corrige dicha discrepancia, y elimina tambien bolsas supra oseas, agrandamientos fibrosos o edematosos de la encia, transformacion de margenes redondeados o engrosados en la forma ideal, y abscesos periodontales supra oseos. Para este procedimiento quirurgico es necesario que el paciente tenga una encia insertada amplia, y dejar una zona funcionalmente adecuada para no eliminar la encia remanente y asi no correr el riesgo de eliminar toda la encia. Se reporta un caso clinico de un paciente femenino de 28 anos de edad que presenta inconformidad estetica por dejar apreciar gran cantidad de encia cuando sonrie y por consiguiente dientes con corona clinica corta. Se obtuvieron excelentes resultados esteticos en el tratamiento y en su evolucion. La finalidad de este reporte es presentar la gingivectomia como tratam...
Duazary, 2011
GingivalrecessionisdefinedasthelocationofgingivalmarginapicaltotheCEJoneormoreteeth.� This� defor... more GingivalrecessionisdefinedasthelocationofgingivalmarginapicaltotheCEJoneormoreteeth.� This� deformitycausesapicalusuallyrootsensitivity,� poorappearanceaestheticsandcariouscervicallesions� sothatPatientsmaywonderproceduresrootcoverage.� Therearetwomaingroupscausesofgingival� recession,� whichoriginatefromperiodontaldiseaseandtraumaticorigin,� isalsoconsidercertain� factorsandwereclassifiedaspredisposingfactorsandprecipitatingtriggers.� Gingivalrecessionsare� pathologicallycausedbythedestructionofconnectivetissuegingivawhichcausesadecreaseinflow� gingivalbloodlevel,�havedevelopedseveraltechniquesforthesamepurposewithintheflaparepedicled,�freegingival� graftepithelialized,�connectivetissuegraftingandtissueregenerationtour.�.�Theconditionsforsuccessinthetreatmentof�
Journal of Public Health Dentistry, 2020
OBJECTIVES Inappropriate prescription of antibiotics contributes to antibiotic resistance. Theref... more OBJECTIVES Inappropriate prescription of antibiotics contributes to antibiotic resistance. Therefore, the objective of this study was to determine the awareness, attitudes, and intention to practice of dentists prescribing antibiotics in Colombia in order to design a virtual learning environment on this subject. METHODS In a descriptive study across seven cities, 700 dentists from different Colombian cities were requested to complete a validated questionnaire containing five sections: general information, awareness on antibiotic effectiveness and antibiotic resistance, attitudes regarding prescription decision, intention to practice concerning clinical cases, and complementary information. The level of awareness, attitudes, and intention to practice was determined and Chi-square test was used to determine the existence of significant differences among cities. RESULTS The majority of dentists showed a medium level regarding the number of correct answers on awareness (62.4 percent) and attitudes (88.7 percent) and a high level on intention to practice (91.7 percent). Common errors within the awareness section included the meaning of the term "antibiotic resistance" (35 percent) and most dentists were not convinced that such resistance could be derived from prescription of antibiotics (51.2 percent). In the attitudes section, only 45 percent declared that they prescribe antibiotics based mainly on symptoms, and the intention to practice section showed a significant percentage of unnecessary prescription (51 percent for pacemaker users) or absence of prescription (53.9 percent for ventricular septal defect) in antibiotic prophylaxis for infectious endocarditis (IE). CONCLUSION The dentists interviewed should be trained and made aware of antibiotic resistance, microbiological and clinical foundations, and current antibiotic prophylaxis guidelines.
Enfermedades infecciosas y microbiologia clinica (English ed.), 2019
Objective: To describe the bacterial profile of the supragingival biofilm of children with tempor... more Objective: To describe the bacterial profile of the supragingival biofilm of children with temporary dentition (CTD) and early mixed dentition (CEMD), with the next-generation sequencing (HOMINGS) technique. Method: A comparative descriptive study was carried out with 30 systemically healthy children aged between 5 and 7 years old from public schools in Cartagena-Colombia. All participants were caries-free applying the criteria of the International Caries Detection and Assessment System (ICDAS II) and had no caries experience according to the Decayed, Missing and Filled Teeth (DMFT) index. Supragingival biofilm samples were collected. Bacterial DNA was extracted and used for analysis using HOMINGS (Human Oral Microbe Identification using Next-Generation Sequencing) based on the sequencing of the V3-V4 region of the 16S rRNA gene using the Illumina MiSeq platform (V3-V4 primers). Results: A total of 360 species-specific and 65 genus-specific probes were identified. The bacterial genus most predominant in CTD were Streptococcus, Actinomyces, Veillonella and Fusobacterium (29.2% of all bacterial DNA present), while in CEMD the most predominant were Streptococcus, Leptotrichia, TM7 and Porphyromonas (24.5% of all bacterial DNA present). The bacterial species with the highest relative abundance in the oral biofilm microbiome from CTD were Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, while in CEMD they were S. sanguinis, Leptotrichia spp. HOT-417 and Leptotrichia spp. HOT-498. The Shannon diversity index was 2.77 (SD = 0.26) for CTD and 3.01 (SD = 0.39) for CEMD (p = 0.06). Conclusions: The analysis of the bacterial profile of the supragingival dental biofilm in children with DMFT, by means of HOMINGS showed low microbiological diversity both in presence and in relative abundance in terms of genus as well as bacterial species.
Enfermedades Infecciosas y Microbiología Clínica, 2018
On-line el xxx Palabras clave: Biopelículas Dentición mixta Diente temporal Bacterias r e s u m e... more On-line el xxx Palabras clave: Biopelículas Dentición mixta Diente temporal Bacterias r e s u m e n Objetivo: Describir el perfil bacteriano del biofilm supragingival de niños con dentición temporal (NDT) y dentición mixta temprana (NDMT), con la técnica de secuenciación de próxima generación HOMINGS. Método: Se realizó un estudio descriptivo comparativo con 30 niños de 5 a 7 años de edad sistémicamente sanos de escuelas públicas de Cartagena (Colombia). Todos los participantes estaban libres de caries, según los criterios del Sistema Internacional de Detección y Evaluación de Caries (ICDAS II) y sin experiencia de caries según el índice de dientes cariados, perdidos y obturados (DCPO). Se recolectaron muestras de biofilm supragingival. Se extrajo el ADN bacteriano y se usó para su análisis mediante HOMINGS (identificación de microorganismos orales humanos utilizando secuenciación de próxima generación) basado en la secuenciación de la región V3-V4 del gen 16S rRNA con la plataforma Illumina MiSeq. Resultados: Se identificaron 360 especies específicas y 65 géneros específicos de las sondas: Streptococcus, Actinomyces, Veillonella y Fusobacterium (29,2% del total de ADN bacteriano presente), mientras que en el grupo de dentición mixta temprana se encontraban Streptococcus, Leptotrichia, TM7 y Porphyromonas (24,5% del ADN bacteriano presente). Las especies bacterianas con mayor abundancia relativa en el microbioma oral de biofilm de NDT fueron Streptococcus sanguinis, Rothia aeria, Gemella haemolysans, mientras que en NDMT fueron S. sanguinis, Leptotrichia sp. HOT-417, Leptotrichia sp. HOT-498. El índice de diversidad de Shannon fue 2,77 (DE = 0,26) para NDT y 3,01 (DE = 0,39) para NDMT (p = 0,06). Conclusiones: El análisis del perfil bacteriano del biofilm dental supragingival en niños con NDMT mediante HOMINGS mostró baja diversidad microbiológica tanto en presencia como en abundancia relativa a nivel de género y de especies bacterianas.
Ciencia y Salud Virtual, 2014
El granuloma central de células gigantes (GCCG) es un proceso circunscrito, endofítico poco frecu... more El granuloma central de células gigantes (GCCG) es un proceso circunscrito, endofítico poco frecuente de la cavidad oral, también denominada épulis de células gigantes, osteoclastoma, granuloma reparativo de células gigantes, o hiperplasia de células gigantes, la mayor parte de las veces se desarrolla de manera asintomática y se detecta como un hallazgo radiográfico o por la expansión indolora del hueso afectado. En algunos casos se presenta con un comportamiento más agresivo, asociado a dolor, parestesia, perforación de corticales óseas e incluso ulceración de la mucosa. Siempre se debe realizar diagnóstico diferencial, enfocando sobre todo tres de ellos el tumor pardo del hiperparatiroidismo, el querubismo y el quiste óseo aneurismático. Se presenta caso clínico en paciente masculino de 14 años de edad, con diagnóstico de GCCG a nivel de molares inferiores derechos, el cual después de realizarse curetaje, presentó posterior recidiva de la lesión a los seis meses, por lo que se r...
Ciencia y Salud Virtual, 2013
La macroglosia se describe desde el siglo II como una patología congénita o adquirida. Que se deb... more La macroglosia se describe desde el siglo II como una patología congénita o adquirida. Que se debe al aumento de la cantidad de tejido lingual, en el cual se observa un alargamiento y ensanchamiento de la lengua de una manera desproporcionada hacia las estructuras dentoalveolares produciendo desplazamientos dentales, indentaciones y traumas a nivel lingual, además podemos encontrar características funcionales como obstrucciones de la vía aérea, lo que puede conducir a hipoventilación alveolar que luego pasa a hipoxia e hipercapnia. Sialorrea y capacidad para llevar la lengua al mentón o a la punta de la nariz. En la mayoría de los casos se presenta en los pacientes que están relacionados con otras patologías como linfangiomas, síndrome de Beckwith-Wiedemann y pacientes con trisomía 21 o síndrome de Down. Como una forma de corregir esta patología muchos autores describen diversos tratamientos quirúrgicos que permitan mejorías de funciones vitales como la deglución, fonación y respira...
Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral, 2015
ABSTRACT Resumo Cirurgia, radioterapia e quimioterapia são as modalida-des terapêuticas usadas no... more ABSTRACT Resumo Cirurgia, radioterapia e quimioterapia são as modalida-des terapêuticas usadas no tratamento de câncer bucal. Podem ser usadas isoladas ou conjuntamente. Radiação ionizante causa lesões nos tecidos normais localizados no campo de radiação. Isto se torna particularmente evi-dente nas regiões de cabeça, uma área complexa com-posta de várias estruturas diferentes que respondem di-ferentemente à radiação. As sequelas orais resultantes podem causar problemas substanciais durante e depois da terapia de radiação e são os maiores fatores de deter-minação na qualidade de vida dos pacientes. Dentre as complicações da radioterapia estão a xerostomia, osteor-radionecrose, mucosite e candidose. O acompanhamento odontológico sistemático pode minimizar os efeitos da radiação sobre os tecidos da cavidade bucal. Descritores: 1-Radioterapia; 2-câncer; 3-saúde oral. Abstract Surgery, radiotherapy and chemotherapy are therapeu-tic modalities used in the treatment of oral cancer. They can be used in isolation or in combination. Ionizing ir-radiation causes damage in normal tissues located in the field of radiation. This becomes particularly evident in the head and neck region, a complex area composed of several dissimilar structures that respond differently to radiation. The resulting oral sequelae may cause substan-tial problems during and after radiation therapy and are major factors in determining the patient's quality of life. Xerostomia, osteoradionecrosis, mucositis and candido-sis are some of radiotherapy's complications. Regular dental follow-up can to reduce the effects of radiation in the tissues of the oral cavity.
The society always is in force by patterns of aesthetic face that, for obvious reasons, give spec... more The society always is in force by patterns of aesthetic face that, for obvious reasons, give special importance to the components dento-maxilars. The dentistry in its different specialties is in charge to correct the anomalies that appear in those components as functionally as aesthetically. The orthodontics science specifically works, in the dental position, it refers to obtain a functional and aesthetic harmony, using mechanical forces and devices designed specially for this aim. Nevertheless, there are cases in which is necessary to use complementary periodontal surgical techniques due to the presence of denser alveolar crests (compared with the common and normal) that prevent the fast and efficient movement that the orthodontics science requires. For this, we have to apply the procedure known like flexicorticotomy that consists of realising a controlled fracture with bony expansion. For this purpose, we will use progressive bony expansors. Inmediately, we have to separate the cortical bone we need to obtain a furrow with diameter and the depth adapted to permit the dental movement more easily. In the present article, we report a clinical case in which a flexicorticotomy (in a too narrow crest) was made with the purpose of correcting interdental space concerning anteroinferior dental organs, which is aesthetically unacceptable for the patient. That is necessary to complete a successful work of the orthodontics treatment, suitable tissue regeneration and post-operative ideal without complications.
Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for t... more Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for the resolution of diseases that require the removal of the root apex. This procedure requires a retrograde filling to seal the opening created and that is why specific materials which provide a high biocompatibility are needed. The amalgam was widely used in the past for the many advantages it provides, but today is quite challenged by exposing patients in contact with it, used in retro-filling, to develop different conditions. When the particles are introduced into the tissues, the same body recognizes them as foreign and rejects them by forming a capsule of cells and fibrous tissue around the fragments isolating it and inducing its decomposition. Since its components are metals and the body is not able to destroy them, it dissociates and eliminates them. Silver is the most difficult to remove and it remains in form of salts, coloring the surrounding tissue forming the famous "silver amalgam pigmentation". In our case the patient underwent apicectomy with retrograde obturation with amalgam, which broke off a piece that was rejected inducing the pigmentation of mucogingival tissues and the expulsion through the gingival mucosa.
Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for t... more Within the endodontic surgical procedures, apicectomy is recognized as a possible treatment for the resolution of diseases that require the removal of the root apex. This procedure requires a retrograde filling to seal the opening created and that is why specific materials which provide a high biocompatibility are needed. The amalgam was widely used in the past for the many advantages it provides, but today is quite challenged by exposing patients in contact with it, used in retro-filling, to develop different conditions. When the particles are introduced into the tissues, the same body recognizes them as foreign and rejects them by forming a capsule of cells and fibrous tissue around the fragments isolating it and inducing its decomposition. Since its components are metals and the body is not able to destroy them, it dissociates and eliminates them. Silver is the most difficult to remove and it remains in form of salts, coloring the surrounding tissue forming the famous "silver amalgam pigmentation". In our case the patient underwent apicectomy with retrograde obturation with amalgam, which broke off a piece that was rejected inducing the pigmentation of mucogingival tissues and the expulsion through the gingival mucosa.
Periodontal disease progression involves multiple factors, including several oral microorganisms ... more Periodontal disease progression involves multiple factors, including several oral microorganisms of the bacterial biofilm or commensal pathogens in oral cavity, which trigger inflammatory immune response in the host. There are chemical tools that fight any possibility of colonization and infection by a microorganism. Oral antiseptics are useful especially after periodontal surgery where they are almost indispensable to control the noxa, but at in the same time, they should facilitate the healing process of the cut tissues. The objective of this paper was to describe a case in which the use of 0.12 % chlorhexidine as an oral antiseptic postoperatively favored no proper healing of mucosal tissues after free gingival grafting. As an alternative, mouthrinse with Calendula was prescribed, observing affected tissue healing within a few days. It is argued that in all post-operative surgical process, one should analyze risks and benefits and choose avoiding the possibility of postoperative infection or timely scarring. As an alternative, the calendula mouthrinse allowed timely cicatrization and it should be noticed that they have some antimicrobial properties and high-inductive ability for the tissue healing.
Acta odontológica venezolana
El tratamiento ortodóntico en pacientes ó personas adultas es "más cuidadosa y lenta" q... more El tratamiento ortodóntico en pacientes ó personas adultas es "más cuidadosa y lenta" que la de los jóvenes, ya que no se pueden realizar todos los movimientos deseados por riesgo a observarse efectos adversos, que el procedimiento no tuvo ninguna complicación y presento excelentes resultados. Palabras clave: ortodoncia correctiva, aumento de la cresta alveolar, expansión de tejido, procesos alveolares, procedimientos quirúrgicos ambulatorios. ABSTRACT Orthodontics in the adult patient, is "more careful and slower" than in young people, due to they can´t perform all the indicated movements trying to avoid side effects observed, such as loss of tooth roots, gingival recessions, of hence the importance of linking orthodontics with another disciplines such as oral
Acta odontológica venezolana
RESUMEN La biopelícula dental muestra una organización altamente compleja en relación a lo que se... more RESUMEN La biopelícula dental muestra una organización altamente compleja en relación a lo que se puede esperar de unos organismos que anteriormente se creían independientes y de poca capacidad de asociaciones. Tienen una forma de crecimiento y de sostenibilidad bastante avanzada y estructurada que facilita la supervivencia de los patógenos incluidos dentro de estas formas de asociación. El
Salud Uninorte
The amalgam tattoo is caused by deposition in the subepitelial connective tissue fragments amalga... more The amalgam tattoo is caused by deposition in the subepitelial connective tissue fragments amalgam iatrogenic procedures result of the operator. The depth at which they are housed residues of this material influences the clinical presentation of lesions can be identified radiographically fragments have diameters while reasonable, can be observed histologically amalgam particles as dark granules, solids and irregular arranged between collagen bundles and blood vessels. The present article describes the case of a patient who had amalgam pigmentation vestibular mucosa, caused by a portion of amalgam used as filling material in an apicoectomy of 11 made in advance. Given the clinical and radiographic considerations we chose to carry a second apicoectomy with retrograde obturation with MTA 11. During the surgical procedure was curetted and lost the inside of the mucoperiosteal flap to try to reduce the degree of pigmentation.
Revista Clínica de Periodoncia, Implantología y Rehabilitación Oral, 2014
Gingival overgrowth is an oral condition generated by the use of fixed orthodontic appliances. It... more Gingival overgrowth is an oral condition generated by the use of fixed orthodontic appliances. It was initially described as a product of the allergic response of the host to Nickel, and recent studies showed that this metal induces fibroblast proliferation. However, the degree of bioaccumulation of this metal in the oral cavity is unknown. The aim of this study was to quantify the concentrations of nickel in samples of saliva, dental plaque, and gingiva of individuals with fixed orthodontic appliances with and without gingival overgrowth. The sample size was established according to historical trends, evaluating 24 individuals with active orthodontic treatment, which were classified in two groups: 12 with gingival overgrowth (Group A) and 12 without gingival overgrowth (Group B). Samples of gingival, stimulated saliva and dental plaque were obtained from each participant. Once the sample were processed, nickel concentrations were measured in [mg/L] by atomic absorption spectrophotometry (Thermo Scientific. Atomic absorption spectrometer iCE 3000, UK). Statistical analysis was performed using SPSS v20. The levels of Nickel in samples of stimulated saliva, dental plaque and gingiva were compared between individuals in group A and group B. There were significantly higher levels of nickel in gingiva samples in group A (mean = 0.61 mg/L vs. 0.36 mg/L, P = .001). However, no statistical difference was observed when comparing the concentrations of nickel in saliva between groups A and B (mean = 0.502 mg/L vs. 0.473 mg/L, P = .178, respectively). The use of fixed orthodontic appliances leads to different levels of bioaccumulation of nickel in gingiva when comparing both groups. High concentrations of this metal are probably associated with the origin of gingival overgrowth. Further studies are required to establish causation.
Revista Cubana de …, 2010
The society always is in force by patterns of aesthetic face that, for obvious reasons, give spec... more The society always is in force by patterns of aesthetic face that, for obvious reasons, give special importance to the components dento-maxilars. The dentistry in its different specialties is in charge to correct the anomalies that appear in those components as functionally as aesthetically. The orthodontics science specifically works, in the dental position, it refers to obtain a functional and aesthetic harmony, using mechanical forces and devices designed specially for this aim. Nevertheless, there are cases in which is necessary to use complementary periodontal surgical techniques due to the presence of denser alveolar crests (compared with the common and normal) that prevent the fast and efficient movement that the orthodontics science requires. For this, we have to apply the procedure known like flexicorticotomy that consists of realising a controlled fracture with bony expansion. For this purpose, we will use progressive bony expansors. Inmediately, we have to separate the cortical bone we need to obtain a furrow with diameter and the depth adapted to permit the dental movement more easily. In the present article, we report a clinical case in which a flexicorticotomy (in a too narrow crest) was made with the purpose of correcting interdental space concerning anteroinferior dental organs, which is aesthetically unacceptable for the patient. That is necessary to complete a successful work of the orthodontics treatment, suitable tissue regeneration and post-operative ideal without complications.