Pedro Diz

University of Santiago de Compostela, Santiago, Galicia, Spain

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Publications (73)146.09 Total impact

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    ABSTRACT: Purpose The objective of this study was to analyze the feasibility of orthodontic treatment with fixed multibracket dental appliances (FMAs) in patients with Down syndrome (DS). Methods The study sample was formed of 25 patients with DS who underwent orthodontic treatment with FMAs. Dental and skeletal characteristics, aspects of FMA treatment, retainer use and recurrences were analyzed. Results were compared with a control group of healthy, age-, sex- and PAR index-matched individuals. Results All the controls underwent a single desensitization session, whereas 2–3 sessions were necessary in 11 patients with DS (p < 0.001). All the controls underwent bimaxillary treatment, compared with 11 patients with DS (p < 0.001). Only 8 patients with DS wore intermaxillary elastics, compared with 19 controls (p = 0.004). Complications were more common in patients with DS than in controls (p = 0.003), due particularly to traumatic ulcers development. There were more failures during the maintenance phase in patients with DS than in controls (p = 0.001). The mean duration of treatment was 37 months in patients with DS and 23 months in controls. More cemented retainers were used in the controls than in patients with DS (p = 0.050). Conclusions It is possible to perform orthodontic treatment with FMAs in patients with DS, although treatment may take longer than usual and the frequency of complications is higher than in controls.Implications for RehabilitationCertain dental characteristics of Down syndrome (DS) make these children firm candidates for orthodontic intervention.There is little literature available on orthodontic treatment in patients with DS, particularly with regard to the use of fixed appliances.This case–control study shows that it is possible to perform orthodontic treatment with fixed appliances in adequately selected patients with DS.However, in patients with DS orthodontic treatment may take longer than usual and the frequency of complications is higher than in the general population.
    No preview · Article · Jan 2016 · Disability and Rehabilitation

  • No preview · Article · Dec 2015 · Revista Portuguesa de Estomatologia
  • J. Limeres · M. Diniz · P. Diz
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    ABSTRACT: The role of the BDJ is to inform its readers of ideas, opinions, developments and key issues in dentistry - clinical, practical and scientific - stimulating interest, debate and discussion amongst dentists of all disciplines.
    No preview · Article · Oct 2015 · British dental journal
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    ABSTRACT: To quantify palatal bone thickness (PBT) in Down's syndrome (DS) patients in order to identify the best areas for miniscrew placement. The study group was formed of 40 DS patients (25 male and 15 female) with a mean age of 18.4±6.3 years (range, 9-40 years). A control group of 40 non-syndromic age- and sex-matched individuals was selected. Maxillary CBCT images were available for all participants. Coronal sections of the hard palate were selected at 4, 8, 16 and 24mm posterior to the distal wall of the incisive foramen. PBT measurements were performed at 20 selected points on these coronal sections at the midline and at 3 and 6mm to right and left of the suture. Overall, PBT was similar in DS and controls and it was not affected by age or sex. In both groups PBT decreased progressively with increasing distance from the posterior wall of the nasopalatine foramen in an anteroposterior direction, except along the median palatal suture. PBT along the suture was lower in DS than in controls in all the paracoronal image planes (P=0.02, 0.007, 0.01 and 0.02 at 4mm, 8mm, 16mm and 24mm, respectively, from the incisive foramen). PBT at the most anterior paramedian locations was also lower in DS than in controls (P=0.02 and 0.03, respectively, 3mm to the right and left of midline). In DS individuals, the most suitable area for miniscrew placement in terms of bone volume is the median palatal suture, irrespective of age or sex, as occurs in the general population, followed by the paramedian sites closest to the incisive foramen. Copyright © 2015 Elsevier Ltd. All rights reserved.
    No preview · Article · Jun 2015 · Archives of oral biology
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    ABSTRACT: Structured AbstractObjectives To define the morphometry of the hard palate in Down's syndrome (DS) on cone beam computed tomography (CBCT) images.Setting and Sample PopulationSantiago de Compostela University (Spain). The study group included 40 white DS individuals aged 10 to 40 years (mean = 18.8 ± 7.3 years), 25 males and 15 females. The control group consisted of 40 individuals matched for age and sex were selected.Material & Methods Nine measurements were taken on the CBCT images. Axial plane: anteroposterior length (aAPL) and arch length (aARL); sagittal plane: anteroposterior length (sAPL), maximum height (sMH) and sagittal arch (sAR); coronal plane: interdental width (cIDW), height (cHE), skeletal width (cSW) and coronal arch (cAR).ResultsaAPL, aARL, sAPL, sMH, sAR, cMH and cAR were comparable in the two groups. cIDW and cSW were greater in controls than in DS. We found no statistically significant differences between males and females with DS. In the controls, sAPL and sAR were greater in males than females. In DS, age only had a statistically significantly increasing effect on aAPL and sAPL. In the controls, age significantly affected sAR and cHE.Conclusion The hard palate is narrower in DS than in controls, but the anteroposterior measurements and the height of the vault are comparable in both groups.
    No preview · Article · May 2015 · Orthodontics and Craniofacial Research
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    ABSTRACT: Mortality is linked to diagnostic intervals in certain cancers. As symptom perception is conditioned by tumour site, a specific study on oral cancer is needed. Studies' inclusion criteria: original data, symptomatic primary oral squamous cell carcinoma, exposure of interest: diagnostic interval or diagnostic delay. Outcome of interest: survival and disease stage. A meta-analysis was undertaken to investigate the relationship between intervals to diagnosis and TNM-stage and survival in oral cancer. About referral delay, the results present no heterogeneity and show a risk increase in mortality of 2.48 (1.39-4.42). The larger the diagnostic delay, the more advanced the stage at diagnosis. High quality studies reveal a higher risk increase than low quality studies: OR = 2.44 (95%CI 1.36-4.36) versus OR = 1.53 (95%CI 1.26-1.86). A longer time interval from first symptom to referral for diagnosis is a risk factor for advanced stage and mortality from oral cancer. This article is protected by copyright. All rights reserved. © 2015 Wiley Periodicals, Inc.
    No preview · Article · Mar 2015 · Head & Neck
  • M Diniz · M Cardoso · F Ascanio · J Limeres · P Diz

    No preview · Article · Jan 2015
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    ABSTRACT: Objectives: To identify websites with adequate information on oral cancer screening for healthcare professionals (HCPs) and to assess both their quality and contents. Study design: Websites were identified using Google and HON medical professional search engines using the terms "screening for oral cancer". The first 100 sites retrieved by each engine were analysed using the DISCERN questionnaire (reliability), the V instrument (contents on oral cancer) and further by the Flesch-Kinkaid Reading Grade Level and the Flesch Reading Ease (readability). Results: The overall rating showed minimal shortcomings in the quality of the information in the websites. The coverage and correctness of information on "visual examination" was rated as fair/good, whereas updating of contents resulted very variable (eg: 81% for visual examination and 18.2% for molecular biomarkers). These results permitted to rank the websites housing relevant information for oral cancer. Top ranking websites were affiliated to the Oral Cancer Foundation (USA), WHO Collaborating Centre for oral cancer (UK) whose webpage is entitled "Oral Cancer Education and Research", and the Clinical Guidelines maintained by the British Columbia Cancer Agency (Canada) and the British Dental Association (UK) respectively. Conclusions: There are web-based, HCP-addressed, resources on screening for oral cancer housing heterogeneous information both in quality and contents. The use of specific evaluation tools permits the selection of reliable websites on this topic with a potential to improve the existing educational gaps among HCPs.
    Full-text · Article · Dec 2014 · Medicina oral, patologia oral y cirugia bucal
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    ABSTRACT: The literature on tooth dimensions in subjects with Down syndrome (DS) is scarce. To our knowledge, no studies have yet been published in which the morphometry of the teeth in DS subjects has been determined using computed tomography. The study group consisted of 40 subjects with DS, aged 10 to 40 years. An age- and sex-matched control group was selected. Cone-beam computed tomography images were retrieved from the archive of the Santiago de Compostela University in Spain. The maxillary central incisors, canines, and first molars were evaluated. The following variables were analyzed: overall tooth length, crown height, root length, mesiodistal diameter, vestibular-palatine diameter, crown-to-root ratio, and cervical circumference. The teeth of subjects with DS were smaller than those of the controls, although the crown-to-root ratio was maintained. No clear sexual dimorphism was detected, but the root lengths of the incisors were greater in male subjects. Crown height, mesiodistal diameter, and crown-to-root ratio showed progressive reductions with age. There appeared to be a degree of "fluctuating dental asymmetry" with respect to vestibular-palatine diameter and cervical circumference. Our findings confirm microdontia of the permanent teeth and progressive reductions in tooth sizes with age in persons with DS. These variations might be relevant to orthodontic treatment planning. Copyright © 2014 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.
    No preview · Article · Dec 2014 · American Journal of Orthodontics and Dentofacial Orthopedics
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    ABSTRACT: Background Close to 50% of oral cancer (OC) patients still present in advanced stages of disease. Screening, in medicine and dentistry, is a strategy to identify an unrecognised disorder in individuals without signs and symptoms. There are several cancers that fit valid criteria for screening, but whether or not to screen a population for OC remains a dilemma. However, many screening programmes for OC and detection of potentially malignant disorders are described. Many of these have been conducted in Europe, but the feasibility of screening for OC has not been systematically addressed.MethodsA systematic review was conducted using the key words of interest. Based on our inclusion criteria, 16 European studies spanning three decades were selected from the published English literature. These studies were systematically analysed. The results were discussed with an expert EU consortium built with the task to promote the early detection of OC.ResultsThere were no consistent results or conclusions across the studies reviewed, largely as a result of there being a wide variety in the screening models and methods of data analysis adopted by each group. In nine of the studies reviewed, whilst descriptive findings from screening were presented, the authors had not attempted to analyse the outcomes. Additionally, only one study reported follow-up data of the screened population.Conclusions In order to uphold the benefits of screening, it is necessary to demonstrate an improvement in survival rates following early detection. No such randomised control trials (RCT) on OC have been undertaken in Europe. Undertaking such a RCT may be difficult in the European setting. However, the feasibility of screening for OPMDs by conventional oral examination has been demonstrated, supporting a strategy to adopt appropriate screening models, and further action from the European countries should be to demonstrate methods of halting their progression by tested interventions. We provide a brief guideline for future screening studies.
    No preview · Article · Oct 2014 · Journal of Oral Pathology and Medicine
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    ABSTRACT: Objective: To compare the results and the detection limits obtained with four different techniques to evaluate in vitro mono-species bacteraemia. Methods: Three species were assessed Aggregatibacter actinomycetemcomitans (Aa) y Porphyromonas gingivalis (Pg) and Streptococcus oralis (So). Blood from 9 periodontally healthy volunteers was contaminated with three concentrations [104, 102 and 101colony forming units (CFU)/ml] of each bacterial species. Samples were analysed by three culture techniques [direct anaerobic culturing (DAC), hemo-culture (BACTEC), and lysis-centrifugation (LC)] and a non-culture dependent approach [quantitative polymerase chain reaction (qPCR)]. The detection limit of each approach was defined as the lowest concentration in which bacterial growth or bacterial DNA was detected. BACTEC data was analysed by means of kappa index and intra-class correlation coefficient was used with the other techniques. Results: The detection limits were, for DAC, LC and BACTEC, 101 CFU/ml; for qPCR was 102 CFU/ml for Aa y Pg and 103 CFU/ml for So. DAC and LC were able to detect the three species at the different concentrations, with some difficulties in the identification of Pg. An excellent correlation for DAC was observed for concentrations 101 and 102 CFU/ml. qPCR showed and excellent correlation for 102 CFU/ml and ranked among the best techniques with 104 CFU/ml, allowing for the best quantification for Aa and Pg. BACTEC was not able to identify Pg in any of the performed experiments. Conclusion: The differences found among techniques suggest the need for using more than one: DAC and qPCR may present the best results for the proper identification and quantification of periodontal pathogens in blood.
    No preview · Conference Paper · Sep 2014
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    ABSTRACT: Background Many patients with disability require orthodontic treatment (OT) to achieve adequate oral function and aesthetic appearance. The cooperation of disabled patients and of their parents is central to the success of OT, as treatment can involve ethical dilemmas. The aim of this study was to analyze the motivation, expectations and overall satisfaction with OT among parents of patients with disabilities. Methods The parents of 60 disabled Spanish children with physical, mental and/or sensory impairment undergoing OT were surveyed on attitudes to OT and level of satisfaction with the outcomes. The survey consisted of 23 questions in 4 sections: attitude and adaptation, benefits, adverse effects, and level of satisfaction after completion of OT. A control group formed of the parents of 60 healthy children undergoing OT at the same institution were also surveyed. Results Parents of disabled children undergoing OT showed a high level of motivation and they are willing to collaborate in oral hygiene procedures. Adaptation to the removable appliances was poorer in disabled children but adaptation to fixed appliances was excellent. OT can provide a marked improvement in quality of life, social relationships and oral functionality in disabled children. Conclusions Among parents of disabled children undergoing OT, the perceived level of overall satisfaction was very high and expectations were often exceeded.
    Full-text · Article · Aug 2014 · BMC Oral Health
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    ABSTRACT: Background: The efficacy of various partial-mouth recording (PMR) systems is analyzed in the evaluation of periodontal status, using index teeth and different combinations of quadrants. Methods: The study group was formed of 108 adults aged 25 to 65 years old. A full-mouth examination (FME) was performed in all participants to determine the periodontal probing depth (PD) and clinical attachment level (CAL) at six sites per tooth. The results of PMR using the Ramfjord teeth, the Community Periodontal Index of Treatment Needs teeth, and the four quadrants individually and combined in pairs were compared to the results obtained with FME. Results: Concordance with FME in terms of the prevalence of patients with PD ≥4 mm, CAL ≥2 mm, and CAL ≥4 mm was lowest with examination of single quadrants and highest with combinations that included one superior and one inferior quadrant. Conclusions: PMR systems, particularly with combinations of a superior plus an inferior quadrant, could be useful to evaluate periodontal status based on PD and CAL. This tool could be useful for epidemiologic surveys on periodontal status.
    No preview · Article · Nov 2013 · Journal of Periodontology
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    ABSTRACT: Objectives: The objective of this study was to analyse the antibacterial and antiplaque activity of three edible toothpastes with the widest worldwide distribution: KidScents™, which contains essential oils; Browning B&B™, with medicinal plants; and Wysong Probiodent™, which contains probiotics. Study Design: The study group was formed of twenty healthy volunteers (dental students) with a good oral health status. Using a balanced randomisation system, all volunteers performed toothbrushing with four products (the three edible toothpastes and water) at intervals of one week. Bacterial vitality in the saliva was analysed by epifluorescence microscopy and plaque regrowth was evaluated using the Turesky-Quigley-Hein plaque index. Results: Bacterial vitality in the saliva was significantly higher after toothbrushing with water (positive control) than with the three toothpastes (P=0.002, P=0.003 and P<0.001, respectively). The plaque index was significantly higher after using these three toothpastes than after toothbrushing with water (P=0.047, P=0.032 and P<0.001, respectively). Conclusions: The three edible toothpastes analysed have some antimicrobial activity but favour plaque regrowth. Key words:Edible toothpaste, dental plaque, oral bacteria.
    Full-text · Article · Aug 2013 · Medicina oral, patologia oral y cirugia bucal
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    ABSTRACT: Purpose: Despite the controversy about the risk of developing bacterial endocarditis of oral origin, numerous Expert Committees in different countries continue to publish prophylactic regimens. To date, the literature is unclear about the role of antimicrobial prophylaxis in the prevention of bacteremia following dental procedures. The aim of this study was to evaluate the efficacy of prophylactic dosage with Amoxicillin (AMX), Clindamycin (CM), a Chlorhexidine (CHX) mouthwash, and a combination of a CHX mouthwash and amoxicillin-clavulanate (AMX-CLV) in the prevention of bacteremia following dental extractions. Methods: A study group composed by 100 adults who required dental extractions under general anaesthesia were randomly assigned to: control group (receiving no prophylaxis), AMX group (receiving 2 g AMX i.v.), CM group (receiving 600 mg CM i.v.), CHX group (receiving a single 0.2% CHX mouthwash for 30 seconds) and CHX/AMX-CLV group (receiving a CHX mouthwash and 1000/200mg AMX-CLV i.v.). Venous blood samples were collected from each patient at 30 seconds, 15 minutes and 1 hour after tooth extractions. Samples were inoculated in BACTEC plus aerobic and anaerobic blood culture bottles, and were processed in the Bactec 9240. The subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques. Results: The prevalences of BDE in the control group, AMX group, CM group, CHX group and CHX/AMX-CLV group were 96/46/85/79/5% at 30 seconds, 64/11/70/29/0% at 15 minutes, and 20/4/22/7/0% at 1 hour later. Streptococci were the most frequently identified bacteria in all groups (40-65%). Conclusions: Amoxicillin and a chlorhexidine mouthwash reduce the risk of bacteremia following dental extractions. Clindamycin prophylaxis was non effective. The new antimicrobial regimen combining a CHX mouthwash and amoxicillin-clavulanate showed the highest efficacy in reducing the prevalence and duration of bacteremia following dental extractions.
    No preview · Article · Aug 2013 · European Heart Journal
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    ABSTRACT: Bisphosphonates have been associated with a serious adverse reaction known as bisphosphonate-related osteonecrosis of the jaws (BRONJ). The aim of this study was to describe its clinical characteristics in patients with dental implants who were taking bisphosphonates orally. We made a retrospective multicentre study in 3 hospitals in Galicia, Spain. The medical records and clinical and radiological follow-up of the oral cavity were reviewed for those patients given bisphosphonates and diagnosed with BRONJ after the placement of dental implants within the previous 3 years. The series comprised 9 white patients (mean age 66 years). The bisphosphonates were alendronate (n=6), ibandronate (n=2), and risedronate (n=1), and the most common indication was osteoporosis (n=7). The mean interval between the initiation of treatment and the onset of BRONJ lesions was 60 months. Most of the lesions were located around the mandibular implants (n=8). The mean interval between placement of dental implants and the onset of BRONJ was 34 (range 1-96) months. After treatment 7/9 patients recovered completely. The prevalence of BRONJ secondary to treatment with bisphosphonates taken orally after placement of dental implants may be higher than expected in a particular geographical region, but to date specific risk factors have not been identified. Clinical characteristics and the outcomes of treatment of lesions are similar to those seen in patients with BRONJ that is unrelated to placement of dental implants.
    No preview · Article · Jul 2013 · British Journal of Oral and Maxillofacial Surgery
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    ABSTRACT: OBJECTIVES: To identify the 100 most cited articles published in dental journals. MATERIALS AND METHODS: A search was performed on the Institute for Scientific Information (ISI) Web of Science for the most cited articles in all the journals included in the Journal Citation Report (2010 edition) in the category of "Dentistry, Oral Surgery, and Medicine". Each one of the 77 journals selected was analyzed using the Cited Reference Search tool of the ISI Web of Science database to identify the most cited articles up to June 2012. The following information was gathered from each article: names and number of authors, journal, year of publication, type of study, methodological design, and area of research. RESULTS: The number of citations of the 100 selected articles varied from 326 to 2050. All articles were published in 21 of the 77 journals in the category. The journals with the largest number of the cited articles were the Journal of Clinical Periodontology (20 articles), the Journal of Periodontology (18 articles), and the Journal of Dental Research (16 articles). There was a predominance of clinical research (66 %) over basic research (34 %). The most frequently named author was Socransky SS, with 9 of the top 100 articles, followed by Lindhe J with 7. The decades with most articles published of the 100 selected were 1980-1989 (26 articles) and 1990-1999 (25 articles). The most common type of article was the case series (22 %), followed by the narrative review/expert opinion (19 %). The most common area of study was periodontology (43 % of articles). CONCLUSIONS: To our knowledge, this is the first report of the top-cited articles in Dentistry. There is a predominance of clinical studies, particularly case series and narrative reviews/expert opinions, despite their low-evidence level. The focus of the articles has mainly been on periodontology and implantology, and the majority has been published in the highest impact factor dental journals. CLINICAL SIGNIFICANCE: The number of citations that an article receives does not necessarily reflect the quality of the research, but the present study gives some clues to the topics and authors contributing to major advances in Dentistry.
    No preview · Article · Jun 2013 · Clinical Oral Investigations
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    ABSTRACT: Objective: To investigate whether there is a relationship between the oral hygiene habits of individuals with severe disability the carer's personal appearance and interest in oral health. Patients and methods: The study group was formed of 60 disabled persons and their respective carers who came for the first time to consultation in the Special-Needs Dentistry Unit of the University of Santiago de Compostela, Spain. All the carers answered a standardised questionnaire of 28 questions divided into four sections: disabled individual's demographic data, disabled individual's general medical details, social aspects of the carer (personal appearance of the carer and interest in oral health), and disabled individual's oral hygiene habits. The personal appearance of the carers and their interest in the disabled individual's oral health were evaluated using independent scales designed specifically for the study, with five binary items in each scale. Results: The carer's personal appearance and interest in the disabled individual's oral health showed a statistically significant relationship with the individual's oral hygiene habits, particularly with respect to the frequency and duration of toothbrushing, need for physical restraint during toothbrushing, use of a manual toothbrush and use of toothpaste. Conclusions: The carer's personal appearance and interest in the disabled individual's oral health are good indicators of the oral hygiene habits of an individual with severe disability. Consideration should be given to the inclusion of these aspects as a complementary element of the dental record.
    No preview · Article · Jun 2013 · International Journal of Dental Hygiene

  • No preview · Article · May 2013 · Revista Espa de Cardiologia

  • No preview · Article · May 2013 · Revista Espanola de Cardiologia