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En los últimos años se ha incrementado el consumo de melatonina para ayudar a inducir el sueño, llegando a convertirse en la sustancia más frecuentemente consumida por la población infantil, con un incremento anual del 530%, y del 130% en la población adulta. En niños y adolescentes es especialmente preocupante ya que se ha popularizado el consumo de melatonina en golosinas (conocidas como gummies en inglés), dada su apariencia atractiva y gran variedad de sabores. Los autores realizamos una búsqueda de golosinas de melatonina en internet, hallando cincuenta y una marcas diferentes, de las cuales treinta y cinco contenían azúcar (68,6%). Según la marca, el contenido en azúcar por gominola varía entre 1.000 y 4.000 mg (este último equivale a un terrón de azúcar), mientras que el contenido en melatonina varía entre 0,5 a 10 mg.

El diagnóstico de riesgo de caries se ha implementado en la formación de los alumnos como herramienta de manejo de dicha enfermedad en la odontología actual. La evidencia científica determina que el tratamiento de la caries dental comienza en la modificación del biofilm, transformando los factores ambientales orales en favor de la salud. Esto se puede conseguir a través de un abordaje que disminuya los factores de riesgo e incremente los factores protectores contra la misma. Con la aplicación de protocolo CAMBRA se logra determinar el riesgo individual de caries, para poder prevenir, revertir y tratar la enfermedad. Por otro lado, la fluorescencia láser es un método complementario no invasivo que ayuda a diagnosticar lesiones iniciales de caries pudiendo llevarse a cabo actuaciones odontológicas de mínima intervención, preservando la mayor estructura dental posible. En la asignatura de Odontología Preventiva y Comunitaria los esfuerzos están encaminados a desarrollar una Odontología basada en la Salud, por lo que la implantación del diagnóstico de riesgo y la realización de tratamientos mínimamente invasivos son objetivos prioritarios.

At the beginning of the COVID-19 pandemic, strict measures of confinement and social distancing were taken. Dentists were considered essential personnel and their activity was restricted to emergency treatment. The present observational study aims to determine the situation of oral implantology practice in Spain during the initial period of the COVID-19 pandemic. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of three blocks of questions was sent to all members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 237 participants (14.3%) responded to the questionnaire. The majority of participants (60.8%) only attended emergencies during the first 9 months of the pandemic. Despite this, 77.2% reported having performed dental implant surgeries and 75.5% indicated that they performed non-essential treatments. The activity was fully recovered by 64.1% of the surveyed dentists. The majority of dentists (90.7%) considered that sufficient/adequate preventive measures were carried out at their workplace, which possibly contributed to the fact that 49.3% were not afraid of becoming infected. This concern was significantly and directly proportionally associated with the age of the surveyed dentists. The oral implant practice was affected to a greater extent during the first 9 months of the pandemic, especially in urban areas, with a greater impact on the workload of professionals with less specialised training in oral implantology., Sociedad Española de Implantes, Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub, Descuento UCM

El COVID-19 es una enfermedad ocasionada por el virus denominado Síndrome Respiratorio Agudo Severo-2 o, por sus siglas en inglés, Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), descubierto en diciembre de 2019 en Wuhan, China. Se trata de un síndrome respiratorio agudo muy contagioso, lo que hizo que se propagara a nivel mundial muy rápidamente. La situación cambió para la población mundial el 11 de marzo de 2020, cuando la Organización Mundial de la Salud (OMS) declaró el COVID-19 como una pandemia. En este sentido, los dentistas pospusieron los tratamientos dentales electivos, proporcionando asistencia odontológica únicamente en casos de urgencia, tal y como recomendó el Consejo General de Dentistas de España. Al mismo tiempo, muchos profesionales decidieron cerrar sus clínicas dentales y esperar hasta que la situación mejorara. Como profesionales sanitarios, los dentistas tuvieron un papel importante tanto en la prevención como en la propagación de la infección, así como en la atención que pudieron brindar durante este periodo. En este sentido, al inicio de la pandemia se registró un descenso del 38% en el número de pacientes que acudieron a las clínicas dentales comparado con el período pre-pandemia . En particular, la Implantología Oral fue una de las especialidades más afectadas, debido a la combinación de tratamientos quirúrgicos y protésicos, y a la generación de aerosoles . Objetivos. El objetivo principal de esta investigación ha sido analizar la influencia que ha tenido la pandemia de COVID-19 sobre la práctica de la Implantología Oral en España. De manera secundaria, se pretende realizar una revisión crítica de la literatura con el fin de establecer unos protocolos que tengan como objetivo la prevención y control de la diseminación de la infección en futuros brotes u otras pandemias ocasionadas por virus respiratorios. Material y métodos. Se trata de un estudio observacional transversal basado en la información recogida a través de una en

Platelet-rich fibrin (PRF) is a second-generation platelet concentrate whose use in clinical practice has been widely disseminated. This has led to the development of several commercial protocols, creating great confusion as to the terminology and implications of each of them. This integrative review aims to identify the critical factors of each of the phases of the solid-based PRF matrix protocol and their possible influence on their macro- and microscopic characteristics. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS, and OpenGrey was carried out. The search was temporarily restricted from 2001 to 2022. After searching, 43 studies were included that met the established criteria. There were numerous factors to consider in the PRF protocol, such as the material of the blood collection tubes, the duration of phlebotomy, the parameters related to blood centrifugation, the time from centrifugation to dehydration of the fibrin clots and their dehydration into membranes, as well as the time to clinical use. These factors influenced the macro- and microscopic characteristics of the PRF and its physical properties, so knowledge of these factors allows for the production of optimised PRF by combining the protocols and materials., Depto. de Especialidades Clínicas Odontológicas, Fac. de Odontología, TRUE, pub, Descuento UCM

BACKGROUND // Caries Management by Risk Assessment (CAMBRA) is a questionnaire used to diagnose the patient’s overall caries risk. This study aimed to present a self-assessment questionnaire based on CAMBRA which, unlike the original, is completed by parents/caregivers, without the need for a dental examination, allowing a presumptive diagnosis to be established in children under seven years of age excluded from the oral health programme of the National Health System to establish individualised recommendations for caries risk and their early inclusion in preventive programmes of the Madrid Health Service (Madrid, Spain). METHODS // A cross-sectional observational study was carried out following STROBE guidelines using for the first time a self-assessment questionnaire based on CAMBRA in a population of children aged from three to six years from a nursery school in Madrid (Spain). The results were analysed using descriptive statistics and Fisher’s exact statistic was used to study the relationship between qualitative variables. RESULTS // The questionnaire was answered by the parents of 120 children (response rate=53.1%), of whom 40.8% presented a low a priori caries risk, 42.5% a moderate risk and 16.7% a high caries risk. CONCLUSIONS // The present study allow the identification of patients at risk of presenting and/or developing caries. However, future studies should evaluate its sensitivity and specificity by comparing it with a confirmatory diagnosis after a dental examination. Nevertheless, the modified CAMBRA questionnaire could be a useful tool for population screening, facilitating the access of the population at risk of caries and risk of exclusion to preventive and community plans., FUNDAMENTOS // Caries Management by Risk Assessment (CAMBRA) es un cuestionario de diagnóstico del riesgo global de caries dental. Este estudio tuvo como objetivo presentar un cuestionario de autoevaluación basado en CAMBRA que, a diferencia del original, es cumplimentado por padres/madres/cuidadores, sin necesidad de una exploración odontológica, permitiendo establecer un diagnóstico de presunción en menores de siete años excluidos del programa de salud oral del Sistema Nacional de Salud, con el fin de instaurar recomendaciones individualizadas al riesgo de caries y su inclusión precoz en programas preventivos del Servicio Madrileño de Salud (Madrid, España). MÉTODOS // Se llevó a cabo un estudio observacional transversal basado en las recomendaciones STROBE, empleando por primera vez un cuestionario de autoevaluación basado en CAMBRA en niños/as de tres a seis años de una escuela infantil de Madrid (España). Los resultados se analizaron mediante una estadística descriptiva y para el estudio de la relación entre variables cualitativas se utilizó el estadístico exacto de Fisher. RESULTADOS // El cuestionario fue respondido por padres de 120 niños, de los cuales, el 40,8% presentó, a priori, un riesgo de caries bajo, el 42,5% un riesgo moderado y el 16,7% un riesgo alto de caries. CONCLUSIONES // El presente estudio permite la identificación de pacientes en riesgo de presentar y/o desarrollar caries. No obstante, futuros estudios han de evaluar su sensibilidad y especificidad mediante su comparativa frente a un diagnóstico de confirmación tras una exploración odontológica. Pese a ello, el cuestionario CAMBRA modificado podría ser una herramienta útil para el cribado poblacional, facilitando el acceso de la población en riesgo de caries y en riesgo de exclusión a planes preventivos y comunitarios.

El diagnóstico de riesgo de caries se ha implementado en la formación de los alumnos como herramienta de manejo de dicha enfermedad en la odontología actual. La evidencia científica determina que el tratamiento de la caries dental comienza en la modificación del biofilm, transformando los factores ambientales orales en favor de la salud. Esto se puede conseguir a través de un abordaje que disminuya los factores de riesgo e incremente los factores protectores contra la misma. Con la aplicación de protocolo CAMBRA se logra determinar el riesgo individual de caries, para poder prevenir, revertir y tratar la enfermedad. Por otro lado, la fluorescencia láser puede ayudar a diagnosticar lesiones de caries que no se observan a simple vista pudiendo llevarse a cabo actuaciones odontológicas de mínima intervención, preservando la mayor estructura dental posible En la asignatura de Odontología Preventiva y Comunitaria los esfuerzos están encaminados a desarrollar una Odontología basada en la Salud, por lo que la implantación del diagnóstico de riesgo y los tratamientos mínimamente invasivos van encaminados a su logro y mantenimiento

At the beginning of the COVID-19 pandemic, strict measures of confinement and social distancing were taken. Dentists were considered essential personnel and their activity was restricted to emergency treatment. The present observational study aims to determine the situation of oral implantology practice in Spain during the initial period of the COVID-19 pandemic. This is a crosssectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of three blocks of questions was sent to all members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 237 participants (14.3%) responded to the questionnaire. The majority of participants (60.8%) only attended emergencies during the first 9 months of the pandemic. Despite this, 77.2% reported having performed dental implant surgeries and 75.5% indicated that they performed non-essential treatments. The activity was fully recovered by 64.1% of the surveyed dentists. The majority of dentists (90.7%) considered that sufficient/adequate preventive measures were carried out at their workplace, which possibly contributed to the fact that 49.3% were not afraid of becoming infected. This concern was significantly and directly proportionally associated with the age of the surveyed dentists. The oral implant practice was affected to a greater extent during the first 9 months of the pandemic, especially in urban areas, with a greater impact on the workload of professionals with less specialised training in oral implantology.

Background Oroantral communication (OAC) is the opening between the maxillary sinus and the oral cavity, which constitutes a gate for the mucosal infection in the maxillary sinus. On the other hand, an OAF develops when the OAC does not close spontaneously, remains manifest and is epithelialized. Several methods have been proposed to solve these situations, however, they are associated with increased postoperative morbidity and/or higher associated costs and require some experience of the surgeon to perform them. To overcome these disadvantages, the use of Platelet-Rich Fibrin (PRF) is proposed. The present study aims to perform a systematic review of the literature, collecting cases in which PRF was used in the treatment of OACs/OAFs. Materials and methods An electronic search of the MEDLINE database (via PubMed) and Web of Science was performed using the following MeSH terms (Medical Subjects Headings): (oroantral communication OR oroantral fistula OR buccosinusal communication) AND (platelet-rich fibrin OR prf OR fibrin mesh). The criteria used were those described by the PRISMA® Statement. The search was not time-restricted and was updated to April 2021. Results After searching, 11 articles were included that met the established criteria. In these, PRF was used alone or in combination with bi- or trilaminar techniques achieving complete resolution in 100% of cases (n = 116). Conclusions With the limitations of this study, it can be established that PRF can be used alone for the treatment of OACs/OAFs up to 5 mm and, in larger defects, it is advisable to combine it with bi- or trilaminar techniques. PRF is an effective therapeutic option, with minimal associated postoperative morbidity compared to other techniques and allows the position of the mucogingival junction to be preserved. Its combination with bone grafting improves the starting point before the replacement of the missing tooth with a dental implant.

Immediate implants present a high risk of early failure. To avoid this, preventive antibiotics (PAs) are prescribed; however, their inappropriate administration leads to antimicrobial resistance. The present study aims to clarify whether the prescription of PAs reduces the rate of early failure of immediate implants and to establish guidelines to avoid the overprescription of these drugs. An electronic search of the MEDLINE database (via PubMed), Web of Science, Scopus, LILACS and OpenGrey was carried out. The criteria described in the PRISMA® statement were used. The search was temporarily restricted from 2010 to 2021. The risk of bias was analysed using the SIGN Methodological Assessment Checklist for Systematic Reviews and Meta-Analyses and the JBI Prevalence Critical Appraisal Tool. After searching, eight studies were included that met the established criteria. With the limitations of this study, it can be stated that antibiotic prescription in immediate implants reduces the early failure rate. Preoperative administration of 2–3 g amoxicillin one hour before surgery followed by 500 mg/8 h for five to seven days is recommended. It is considered prudent to avoid the use of clindamycin in favour of azithromycin, clarithromycin or metronidazole in penicillin allergy patients until further studies are conducted.

Background: Despite the development of society and the educational progress achieved at the university education level, women continue to face obstacles that hinder their professional development. This study aims to determine whether there are gender differences in a representative sample of professionals dedicated to Oral Implantology in Spain. Material and Methods: This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of two blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. Results: A total of 303 participants (20.8%) responded to the questionnaire, of which 219 were men (72.3%) and 84 women (27.7%). Up to the age of 40 years, women predominate, whereas men predominate from the age of 51 years onwards, which is influenced by a greater number of years of experience in implant placement and a higher number of implants placed per year. Despite this, women have a higher level of training in Oral Implantology, as a greater proportion are trained through master’s degrees. Conclusions: The greater representation of men in the study is associated with the ageing of the sample. The results obtained from the present study anticipate the trend of a greater presence of the female gender in Oral Implantology in Spain in the coming years.

Current patterns of preventive antibiotic prescribing are encouraging the spread of an timicrobial resistance. Recently, the Spanish Society of Implants (SEI) developed the first clinical practice guidelines published to date, providing clear guidelines on how to prescribe responsible and informed preventive antibiotic therapy (PAT) based on the available scientific evidence on dental implant treatments (DIs). The present document aims to summarise and disseminate the recom mendations established by this expert panel. These were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were analysed using the Scottish Intercollegiate Guidelines Network (SIGN) checklist templates and ranked according to their level of evidence. They were then assigned a level of recommendation using the Grading of Recommendations, Assessment, Development and Evaluation system (GRADE). Guidelines were established on the type of PAT, antibiotic and dosage of administration in the placement of DIs without anatomical constraints, in bone augmentation with the placement of DIs in one or two stages, placement of immediate DIs, sinus elevations, implant prosthetic phase, as well as recommendations in patients allergic to penicillin. Therefore, the PAT must be adapted to the type of implant procedure to be performed.

As the population ages, more and more patients with orthopaedic prostheses (OPs) require dental implant treatment. Surveys of dentists and orthopaedic surgeons show that prophylactic antibiotics (PAs) are routinely prescribed with a very high frequency in patients with OPs who are about to undergo dental procedures. The present study aims to determine the need to prescribe prophylactic antibiotic therapy in patients with OPs treated with dental implants to promote their responsible use and reduce the risk of antimicrobial resistance. An electronic search of the MEDLINE database (via PubMed), Web of Science, LILACS, Google Scholar, and OpenGrey was carried out. The criteria used were those described by the PRISMA® Statement. No study investigated the need to prescribe PAs in patients with OPs, so four studies were included on the risk of infections of OPs after dental treatments with varying degrees of invasiveness. There is no evidence to suggest a relationship between dental implant surgeries and an increased risk of OP infection; therefore, PAs in these patients are not justified. However, the recommended doses of PAs in dental implant procedures in healthy patients are the same as those recommended to avoid infections of OPs.

Background: The replacement of maxillary posterior teeth often challenges the clinician due to bone resorption after dental exodontia and low bone quality. Currently, attempts are being made to shorten treatment times by pla cing implants simultaneously to sinus lift procedures in borderline cases, which can lead to complications such as displacement of implants into the maxillary sinus. Clinical Case: a 54-year-old patient who was planned for complete rehabilitation of the maxilla through a fixed implant-supported prosthesis on 6 implants. At the level of the 3rd sextant, a sinus lift was performed with a lateral window approach (Caldwell-Luc type) and the simultaneous placement of two implants, one of which migrated into the sinus. The implant was displaced after 4 months when the second stage (uncovering) implant surgery was performed for the connection of the healing abutments. The implant was removed a week after the migration, since it had moved to the tuberosity area in the sinus and the lateral window had been performed in a more mesial posi tion, so the patient was recommended to sleep on the right side to achieve the displacement of the implant to a more favourable area, removing it after a week through the same approach. Discussion: Surgical strategies for the removal of a migrated implant are essentially divided into two main approa ches: endoscopic transoral and endoscopic transnasal (and combined). Conclusions: In case of intra-operative migration of the implant into the sinus, it is recommended to remove it as soon as possible to avoid a possible sinus pathology of iatrogenic origin.

The prescription of preventive antibiotics in dental implant treatments reduces the incidence of early failures. This study has focused mainly on the influence of amoxicillin, which is contraindicated in penicillin-allergic patients. The present systematic review aimed to determine whether penicillin-allergic patients have a higher risk of implant failure compared to non-allergic patients. An electronic search was performed on Medline and Web of Science using the following MeSH terms: (penicillin allergy OR clindamycin OR erythromycin OR azithromycin OR metronidazole) AND (dental implant OR dental implant failure OR dental implant complications). The criteria employed were those described in the PRISMA® Declaration. Only five articles were included that analyzed the failure rates of implants placed in penicillin-allergic patients who were prescribed clindamycin compared to non-allergic patients who were prescribed amoxicillin. With the limitations of this study, it is not possible to state that penicillin allergy per se constitutes a risk factor for early dental implant failure as most of the studies included self-reported allergic patients. Clindamycin has been associated with a significantly elevated risk of failure and an up to six times increased risk of infection. Immediate implants also have a 5.7 to 10 times higher risk of failure.

The prescription of preventive antibiotics (PA) in oral implantology is a controversial issue. The study aimed to determine the prescribing habits of PA in professionals dedicated to oral implantology in various treatments in healthy and at-risk patients. This is a cross-sectional observational study based on the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. An electronic survey consisting of 4 blocks of questions was sent to members of the Spanish Society of Implants. The data were analyzed using descriptive analysis. A total of 303 participants (20.8%) responded to the questionnaire. One percent never prescribed PA, 55.4% prescribed them always, and 43.6% prescribed them sometimes. Ninety-six percent administered them preoperatively, while 92.4% administered them postoperatively. The most commonly used antibiotic is amoxicillin followed by amoxicillin with clavulanic acid (875/125 mg). Clindamycin is the most commonly administered antibiotic in patients with allergies. Professionals dedicated to oral implantology frequently prescribe PA in both healthy and at-risk patients, especially perioperatively. Immediate implant placement, sinus lifts, bone regeneration, and multiple implant placement are the treatments in which PA are most commonly prescribed, as well as in patients with heart valve prostheses or a history of bacterial endocarditis and immunodeficiency.