tesina sandra.docx

7/25/2019 TESINA SANDRA.docx

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CARATULA

[NOMBRE DEL AUTOR] 1


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DEDICATORIA

A Dios y a la Virgen Mara,

Por la via y !aa "no e s"s

#o#en$os

A #i #are,

Por !reer en # y ser el e%e#&lo

e la #"%er '"e an(elo llegar a

ser)

A #i &are,

Por s" visi*n e +rinar#e "na

e"!a!i*n y or#a!i*n&roesional e !alia)

[NOMBRE DEL AUTOR] -


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AGRADECIMIENTO

A la Universia .n!a /ar!ila0o e la Vega y a $oo s" &ersonal o!en$e '"e

#e i#&ar$ieron s"s valiosos !ono!i#ien$os, los !"ales ay"aron en #i

e!elen$e or#a!i*n &roesional)

A #i a#ilia, #is &ares y (er#anos, '"e !on s" !ario, e%e#&lo ysa!ri3!ios (an sio &ilar "na#en$al &ara #i esarrollo &ersonal y

&roesional, ae#4s e s" a&oyo in!oni!ional a lo largo e #i !arrera)

A #is a#igas e sie#&re &or (a+er !on$ri+"io en la &ersona '"e soy a(ora

y s" a#is$a in!oni!ional '"e s"&era el $ie#&o y la is$an!ia)

5 a $oas las &ersonas '"e e "na " o$ra or#a #e a&oyaron en la

reali0a!i*n e es$e $ra+a%o)



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SUMARIO

Pg.

DEDICATORIA 3

AGRADECIMIENTO 4

SUMARIO 5

INTRODUCCIN 9

CAPITULO I

MARCO TEORICO

1.1.Antecedentes Histricos 11

1.2.Bses terics 1!

1.2.1. Concepo! "e c#$%e! "en#& 15

1.2.2. Teo$'#! "e p$o"(cc%)n "e c#$%e! "en#& 1*

1.2.3. Mo$+o&og'# "en#$%# 1*

1.2.4. E$(pc%)n "en#& 1,

1.2.4.1. Te-%"o! "e& "%ene 19

1.2.!. N#($#&e# "e& p$oce!o c#$%o!o 22

1.2.5.1. E&e/eno! p#$%c%p#ne! en e& p$oce!o c#$%o!o 231.2.5.2. Sen!%0%&%"#" "e& (!pe" o!pe"e$o 2*

1.2.5.3. E6%"enc%#! "e 7(e c#$%e! e! (n# en+e$/e"#"

In+ecc%o!# 28

1.2.*. #co$e! "e $%e!go "e c#$%e! 2,

1.2.*.1. #co$e! &oc#&e! 2,

1.2.*.2. #co$e! gene$#&e! 29



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1.2.8. #co$e! c#(!#&e! "e c#$%e! en n%:o! 3;

1.2.8.1. (!pe" "%ene 31

1.2.8.2. (!pe" !#&%6# 31

1.2.8.3. M%c$o+&o$# 32

1.2.8.4. S(!$#o! 33

1.2.8.5. T%e/po 34

1.2.,. Loc#&%#c%)n "e c#$%e! en "en%c%)n p$%/#$%# 34

1.2.9. C!%+%c#c%)n "e c#$%e! "en#& 35

1.2.9.1. C!%+%c#c%)n "e& D$. G$eene


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1.2.14.2. P$oecc%)n e!pec'+%c# 48

1.2.15. D%#gn)!%co @ $##/%eno opo$(no 4,

1.2.15.1. Re#0%&%#c%)n 49

1.2.15.2. Cep%&"o 49

1.2.15.3. $ec(enc%# "e& cep%&"o 5;

1.2.1*. Tcn%c#! "e cep%&"o 51

1.2.1*.1. Tcn%c# "e =#!! 51

1.2.1*.2. Tcn%c# o$%on#& 51

1.2.1*.3. Tcn%c# "e S%&&/#n /o"%+%c#"# 52

1.2.1*.4. Tcn%c# "e C#$e$! 52

1.2.1*.5. Tcn%c#! $eco/en"#"#! en n%:o! 53

1.2.18. Cep%&"o "e &eng(# 53

1.2.1,. P#!# "en#& 53

1.2.19. C&o$e%"%n# 55

1.2.2;. E!%/("o$ %ne$"en#& 55

1.2.21. P#&%&&o! 5*

1.2.22. %&o "en#& 5*

CAPITULO II

CASO CLINICO

2.1.Histori C"#nic !$

2.2.Di%nostico Pres&nti'o ()

2.*.E+,-enes Co-"e-entrios (!

2.3.1. An&%!%! "e p%e# po$ p%e# *5



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2.3.2. An&%!%! "e +oog$#+'#! *5

2.3.3. An&%!%! "e $#"%og$#+'#! pe$%#p%c#&e! *8

2.) Di%nstico De/initi'o ($

2.! P"n de Trt-iento ($

CAPITULO III

DISCUSION0 CONCLUSIONES RECOMENDACIONES

*.1.Disc&sin 1

*.2.Conc"&sin 2

*.*.Reco-endciones *

CAP3TULO I4RE5ERENCIAS BIBLIOGR65ICAS

ANE7OS 4

[NOMBRE DEL AUTOR] :


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INTRODUCCION

D($#ne ! ?&%/#! "c#"#!B !e #n p$o"(c%"o c#/0%o! no !)&o en p$e6#&enc%# "e

c#$%e! "en#&B !%no #/0%n en "%!$%0(c%)n @ e& p#$)n "e en+e$/e"#". L#

"eecc%)n "e &e!%one! "($#ne e#p# %n%c%#& e! #o$# (n $eo %/po$#ne en e&

p$oce!o "e& "%#gn)!%co c&'n%co. D#"# n#($#&e# "%n/%c# "e c#$%e! "en#&B e!

po!%0&e "eene$ @ con$o$ p$og$e!%)n "e en+e$/e"#" # $#6! "e& p$oce!o "e

$e/%ne$#&%#c%)n "e ! &e!%one! #ne! "e 7(e p$og$e!en # (n# c#6%"#".

En n(e!$o p#'!B c#$%e! "en#& e! (n# "e ! en+e$/e"#"e! "e /#@o$ p$e6#&enc%#B &o

7(e con&&e6# # 7(e &o! 'n"%ce! #(/enen "e #c(e$"o con e"#"B oc#!%on#n"o 7(e

po0c%)n "e /#@o$ e"#" !(+$# nece!%"#" "e $##/%eno con (n #&o co!oB e!o #

c#(!# "e& "e+%c%ene e!#"o "e !#&(" o$#& en &o! p$%/e$o! #:o! "e 6%"#B poc#

#cce!%0%&%"#" # &o! !e$6%c%o! "e !#&(" "e& e!#"o @ e& poco conoc%/%eno !o0$e

p$e6enc%)n "e en+e$/e"#"e! 0(co"en#&e!.

C(#n"o "eecc%)n "e &e!%one! "e /#nc#! 0nc#!B #!' co/o %"en%+%c#c%)ne/p$#n# "e ! &e!%one! no c#6%#"#! e!n %nc&(%"o! en e& p$oce!o "e "%#gn)!%co

c&'n%coB p$e6enc%)n p$%/#$%# "e c#$%e! "en#& @ (n $##/%eno opo$(no p(e"en

!e$ po!%0&e!B !e p(e"e e6%#$ p$og$e!%)n &e!%one! c#6%#"#! @ #!' pe$/%%$ (n con$o&

# co$o po "e en+e$/e"#".

L#! !(pe$+%c%e! oc&(!#&e! !on &o! &(g#$e! /! #+ec#"o! po$ ! c#$%e! en n%:o! @

#"(&o! "e0%"o # /o$+o&og'# e!pec%#& "e ! +o!#! @ +%!($#! @ "%+%c(" "e

e&%/%n#c%)n "e pc#. Po$ e!# $#)nB %/po$#nc%# "e "eecc%)n p$eco "e c#$%e!

!e # %nc$e/en#"o en &o! ?&%/o! #:o!. E! po$ e&&o nece!%"#" "e (n "%#gn)!%co "e

&e!%one! "e /#nc# 0nc# &e!%one! con #c%6%"#" "e c#$%e! no c#6%#"#! @ "eecc%)n

e/p$#n# "e /%c$oc#6%"#"e!.

[NOMBRE DEL AUTOR] ;


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CAPITULO I8

MARCO TEORICO

[NOMBRE DEL AUTOR]1


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I. MARCO TEORICO

1.1 Antecedentes Histricos

En e& !%g&o


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/e"%o #c%"oB !% no ne($o #&c#&%no @ !e "eno/%n# 7(ec%)n. C!e$n@e% @ Egge$!&($#

"e!#$$o&$on eo$'# en")gen# o "e& /e#0o&%!/oB "on"e !o!%enen 7(e c#$%e!

e! $e!("o "e (n# #&e$#c%)n "e n#($#&e# 0%o7('/%c# 7(e !e o$%g%n# en p(&p#

@ c(@o! $e!("o! !e /#n%+%e!#n en "en%n# @ e!/#&e. Le%/g$(0e$ "e!#$$o&

eo$'# o$g#no$op%c# "on"e #+%$/# 7(e c#$%e! e! (n# en+e$/e"#" "e o"o e&

)$g#no "en#&B @ no (n# !%/p&e "e!$(cc%)n &oc#&%#"# en !(pe$+%c%e. Ne(/#nn @

D% S#&6o "e!#$$o&n eo$'# 0%o+'!%c# "on"e e&&o! #+%$/#n 7(e # /#!%c#c%)n

%n"(ce e!c&e$o!%! po$ c#$g#! #p&%c#"#! !o0$e e& "%ene @ #(/en# $e!%!enc%#

"e& e!/#&e #ne &o! #gene! "e!$(c%6o! "e& /e"%o 0(c#&.11

E& 'n"%ce CPOD +(e "e!#$$o&"o po$ &e%nB P#&/e$ @ n(!on "($#ne (n e!("%o

"e& e!#"o "en#& @ nece!%"#" "e $##/%eno "e n%:o! #!%!ene! e!c(e!

p$%/#$%#! en #ge$!oHnB M#$@n"B EUAB en 1935. Se # con6e$%"o en e& 'n"%ce

+(n"#/en#& "e &o! e!("%o! o"ono&)g%co! 7(e !e $e#&%#n p#$# c(#n%+%c#$

p$e6#&enc%# "e c#$%e! "en#&.

Se:# p$e!enc%# "e c#$%e! #no p$e!ene co/o p#!#"#B p(e! o/# en c(en#

&o! "%ene! c#$%#"o! #!' co/o #/0%n $##"o!. E& 'n"%ce ceo" #"op#"o po$

G$(e00e& p#$# "en%c%)n e/po$#& en 1944. Se o0%ene con !(/#o$%# o#& "e

&o! )$g#no! "en#$%o! pe$o con!%"e$# !o&o &o! "%ene! e/po$#&e! c#$%#"o!B

e$#'"o! @ o0($#"o!B e& c(#& !e con!%"e$# 2; "%ene!.1

E& 'n"%ce ceo" !e (%&%# !o&o en "%ene! e/po$#&e!B ! ecepc%one! p$%nc%p#&e!

!onB &o! "%ene! e$#'"o! en n%:o! po$ $##/%eno "e o$o"onc%# o pe$"%"o! po$

#cc%"ene! #!' co/o co$on#! $e!#($#"#! po$ +$#c($#!.

E& 'n"%ce p#$# "%ene! e/po$#&e! e! (n# #"#p#c%)n "e& 'n"%ce COPD #

"en%c%)n e/po$#&B +(e p$op(e!o po$ G$(e00e& @ $ep$e!en# #/0%n /e"%# "e&

1 Lana$a %"lio E"aro =2


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o#& "e "%ene! e/po$#&e! c#$%#"o! c con e$#cc%one! %n"%c#"#! e @

o0($#c%one!. En 0#!e # (n e!("%o $e#&%#"o po$ &o! "oco$e! M$7(e %&%? MB

Ro"$'g(e C#!%&&o RAB Ro"$'g(e e$e JB E!$#"# Pe$e%$# GB A$oce A$(#g# A.

!o0$e

p$e6#&enc%# "e c#$%e! "en#& en 14; p#c%ene! "e * 12 #:o! en C&'n%c#

O"ono&)g%c# "e =#$$%o A"en$o KL# De/oc$#c%#B /(n%c%p%o Pe "e Rep?0&%c#

=o&%6#$%#n# "e


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E%!e o$# conco$"#nc%# # (n# %n6e!%g#c%)n $e#&%#"# po$ &o! Doco$e! M%$%#/ "e&

Soco$$o e$$e$# @ C#$&o E"(#$"o /e"%n# So&'! "e Le)n N%c#$#g(#B $e+e$ene #

p$e6#&enc%# "e c#$%e! "en#& en e!co$e! "e * # 12 #:o! "e e"#" 7(e o0(6%e$on

co/o $e!("o (n # p$e6#&enc%# "e c#$%e! con (n 89B e& c(#& e& !eo

/#!c(&%no +(e e& /! #+ec#"o con (n *3 e& c(#& en e"#" "e 9 #:o! !e

p$e!en) /#@o$ #+ec#c%)n e& %n!$(/eno 7(e #p&%c#$on +(e e& 'n"%ce CPO.4

En o$o e!("%o "e p$e6#&enc%# "e c#$%e! "en#& en e!co$e! "e * # 1; #:o! $e#&%#"o

po$ Doco$# =$en"# S##$ S#ne! "e P#p#n


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1.2 Bses Terics

1.2.1. Concetos de cries dent"

L# c#$%e! "en#& e! (n# "e ! en+e$/e"#"e! /! #n%g(#! "e (/#n%"#"Bpe$enece #& g$(po "e p#o&og'#! con /#@o$ #!# "e p$e6#&enc%# en

po0c%)nB #no %n+#n%& co/o #"(B "e& /(n"o #c(#&.1

E& $/%no Kc#$%e! p$o6%ene "e& 'nB !%gn%+%c# "e!co/pone$!e o ec#$!e #

pe$"e$ @ Kc#$%e! "en#& !e $e+%e$e # "e!$(cc%)n p$og$e!%6# @ &oc#&%#"# "e

&o! "%ene!.8

Conceto de cries se%9n :t;8

L# c#$%e! e! (n# en+e$/e"#" c#$#ce$%#"# po$ (n# !e$%e "e co/p&e-#!

$e#cc%one! 7('/%c#! @ /%c$o0%o&)g%c#! 7(e $#en co/o $e!("o

"e!$(cc%)n +%n#& "e& "%ene !% e& p$oce!o #6#n# !%n $e!$%cc%)n.

Conceto de cries se%9n " Or%ni;cin M&ndi" de " S"&d


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%$$e6e$!%0&e 7(e /e"%#ne (n /ec#n%!/o 7('/%co0%o&)g%co "e!%neg$# &o!

e-%"o! "e& "%ene.2

1.2.2. Teor#s de " rod&ccin de " cries dent"

Teor# >&i-iorsitri o Acido%?nic

E!# !e en(nc%o # +%ne! "e& !%g&o IB M%&&e$ co/p$o0) /enc%on#n"o 7(e e!

(n p$oce!o 7(%/%op#$#c%#$%oB e! "ec%$B c#(!#"# po$ &o! c%"o! 7(e p$o"(cen

&o! /%c$oo$g#n%!/o! #c%")genoB e!o #ce 7(e "%!/%n(@# e& p "e pc#

"eno0#ce$%#n#B &o 7(e # !( 6e #(/en# p$o&%+e$#c%)n "e /%c$oo$g#n%!/o!

@ #c%6%"#" #c%")geno @B "e!p(! !e "e!c#&c%+%c# /o&c( "e& e!/#&e

+o$/n"o!e c#6%"#"e!.

D%co p$oce!o !e "%6%"e en "o! e#p#!F

1 De!c#&c%+%c#c%)n "e &o! e-%"o!2 D%!o&(c%one! "e& $e!%"(o "e!c#&c%+%c#"o

L# eo$'# "e M%&&e$ %ene #&g(n#! "e+%c%enc%#! co/oF

# No ep&%c# &o p$open!o "e c#$%e! en !%%o! e!pec'+%co!0 Con!%"e$# 7(e &o! o$g#n%!/o! %n6o&(c$#"o! !on /(co! @ /(@

6#$%#"o!c Apo@# %"e# "e %n+&(enc%#! !%!/%c#! en e& "%ene

1.2.*. Mor/o"o%# dentri

C(#n"o !e ep&o$#n ! co$on#! "en#$%#! !e p(e"en o0!e$6#$ 7(e e!#! !on

pe7(e:#! en co/p#$#c%)n con e& #/#:o "e &o! "%ene! pe$/#nene!

co$$e!pon"%ene!. Lo! e!pe!o$e! "e ! e!$(c($#!B #no e& e!/#&e co/o

"en%n#B !on /eno$e! @ c!%+%c#c%)n e! /eno$.

E& #/#:o "e c/#$# p(&p#$ @ "e &o! con"(co! $#"%c($e! !on

p$opo$c%on#&/ene g$#n"e! @ &o! c(e$no! p(&p#$e! !e p$o@ec#n 0#-o !

[NOMBRE DEL AUTOR]18


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c?!p%"e! "e +o$/# /#$c#"#. To"o e&&o "# &(g#$ # (n #6#nce $p%"o "e

c#$%e!B (n# 6e 7(e e!# !e %n%c%# @ # (n# #+ecc%)n p(&p#$ /! e/p$#n# 7(e

en e& #"(&o.

L# 0%+($c#c%)n $#"%c($ oc($$e en e& e$c%o ce$6%c#&B &o 7(e +#c%&%# p$og$e!%)n

"e ! %n+ecc%one! #c%# on# en 7(e !e enc(en$#n !%(#"o e& ge$/en "e&

"%ene pe$/#nene

Lo! "%ene! pe$/#nene! en e& n%:o p$e!en#n ! /%!/#! c#$#ce$'!%c#!

oc&(!#&e! 7(e en e& #"(&oB pe$o /! /#$c#"#!B p(e!o 7(e no # oc($$%"o

n%ng?n %po "e #0$#!%)n. Po$ &o gene$#&B ! co$on#! "e &o! "%ene!

pe$/#nene! !on "e $e! %po!F &o! %nc%!%6o!B &o! c#n%no! @ &o! /o$e!. Lo!

"%ene! %nc%!%6o! o "ene$o! %enen +o$/# "e e!cop&o p#$# +#c%&%#$ e& co$e

"e& #&%/eno. De$! "e &o! %nc%!%6o! #@ $e! p%e#! "en#&e! (%&%#"#! p#$#

"e!g#$$#$. L# p$%/e$#B e& c#n%noB 7(e !e !%?# -(!o po!e$%o$ #& %nc%!%6o e$#&B

%ene (n# ?n%c# c?!p%"e p(n%#g("#. De$! "e e!e e%!en "o! "%ene!

"eno/%n#"o! p$e/o$e!. Con "o! c?!p%"e! c#"# (no. De$! "e &o!

p$e/o$e! e!# en p$%/e$oB !eg(n"o @ e$ce$ /o$B 7(e %enen (n# !(pe$+%c%e

"e /#!%c#c%)n $e%6#/ene pn#B &o 7(e pe$/%e $%($#$ @ /o&e$ &o!

#&%/eno!.

L# co/%"# !e co$# con &o! "%ene! %nc%!%6o! +$on#&e!B !( #/#:o !e $e"(ce

po$ &o! c#n%no! @ p$e/o$e!B @ #"7(%e$e (n #/#:o "%ge$%0&e po$ &o! /o$e!.

L#! c?!p%"e! "e &o! /o$e! !(e&en e!#$ /(@ /#$c#"#! @ e& 0o$"e %nc%!#& "e

&o! %nc%!%6o! /(e!$# &o! &)0(&o! "e "e!#$$o&&o 7(e "#n e& #!peco #!e$$#"o

c#$#ce$'!%co "e &o! "%ene! /(@ -)6ene!. Lo! !($co! @ ! +o!#! !on

p$o+(n"o! @ $een%6o!.

Lo! "%ene! (/#no! o"#6'# e!n e6o&(c%on#n"o. Lo! epe$o! en "en%c%)n

p%en!#n 7(e e& e$ce$ /o$ o /(e "e& -(%c%o "e!#p#$ece$ # /e"%"# 7(e e&



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/#%$ (/#no !e $e"(c# @ &o! #&%/eno! $e+%n#"o! e&%/%nen nece!%"#"

"e /o$e! #"%c%on#&e!.9

1.2.). Er&cin dent"

Lo! p$%/e$o! "%ene! 7(e e$(pc%on#nB &o! "%ene! e/po$#&e!B p$e!en#n

#&g(n#! c#$#ce$'!%c#! 7(e %enen $epe$c(!%)n !o0$e p$e!en#c%)n o

#6#nce "e c#$%e!.

Se "e!#$$o&n en e& /#%$ !(pe$%o$ e %n+e$%o$. A&$e"e"o$ "e !e# !e/#n#

"e "e!#$$o&&oB c#p# 0#!#& "e& $e6e!%/%eno ep%e&%#& "e c#6%"#" 0(c#&

o$%g%n# (n# e!$(c($# en +o$/# "e CB &/%n# "en#&B # &o $go "e &o!

/#%$e! !(pe$%o$ e %n+e$%o$. Ane$%o$/ene e!# &/%n# o$%g%n# 6#$%o! 0$oe! o

e!0oo! "en#$%o!B en n?/e$o! "e 1; po$ c#"# /#%$B 7(e +o$/#n &o!

p$%/o$"%o! "e &o! co/ponene! eco"$/%co! "e &o! "%ene!. Poco "e!p(!

!(pe$+%c%e p$o+(n"# "e &o! 0$oe! %n6#g%n# @ !e &&eg# #& pe$%o"o "e c#pe$(#

"e& "e!#$$o&&o "en#$%o.

A /e"%"# 7(e c#pe$(# "en#& c$ece @ !e p$o+(n"%# %n"en#c%)nB e&

"%ene #"op# e& #!peco "e c#/p#n# pe$%o"o "e c#/p#n#. L#! c&(!

/e!en7(%/#%c#! "e p#p% #"@#cene # c#p# "en#& %ne$n# !e

"%+e$enc%#n en o"ono0!o! pe$!%!e "($#ne o"# 6%"# "e& "%ene @

con!#ne/ene p$o"(ce p$e"en%n#B 7(e en (n# e#p# #ne$%o$ !e $#n!+o$/#

en "en%n#B ! c&(! $e!#ne! "e p#p% "en#& +o$/#n p(&p# "e& "%ene.

D($#ne %n+#nc%# oc($$en c#!% o#&%"#" "e &o! eco! 7(e !e $e+%e$en #

e$(pc%)n @ e& $ec#/0%o "en#$%o. S%/(&ne#/eneB !e p$o"(cen &o! c#/0%o!

/! "$#/%co! en &o! 0%o! #&%/en%c%o! "e o"# 6%"# "e& o/0$eB !e

; =LLO5D BAUM RALP 5 ols) Tra$ao e O&era$oria Den$al) M!/raill

.n$era#eri!ana

[NOMBRE DEL AUTOR]1:


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p#!# "e c#nc%# # (n# e#p# # (n# #&%/en#c%)n !%/%$ # "e e"#"

#"( en (no! poco! #:o!.

Lo! "%ene! e/po$#&e! @ pe$/#nene! "($#ne e& pe$%o"o "e e$(pc%)nB @

#!# 7(e #&c#n#n e& n%6e& oc&(!#&B no !on (%&%#"o! #c%6#/ene p#$#

/#!%c#c%)n.

Po$ e&&oB ! #c(/(c%one! "e pc# 7(e no !on e&%/%n#"#! po$ e& $oce con

&o! #&%/eno! n% con &o! p$oce!o! "e #(o&%/p%e#. L# $g# pe$/#nenc%# "e

#c(/(c%)n 0#ce$%#n# @ $e!o! #&%/en%c%o! "# &(g#$ # p$oce!o! "e

"e!/%ne$#&%#c%)n "e !(pe$+%c%e "en#$%# !eg(%"o! "e e#p#! "e

$e/%ne$#&%#c%)n.

1.2.).1. Te@idos de" diente

E& "%ene e! +o$/#"o po$ c(#$o e-%"o!F

1 E!/#&e2 Den%n#

3 P(&p#4 Ce/eno

Es-"te

E& e!/#&e e! e& e-%"o ee$%o$ "e& "%ene 7(e c(0$e o"# co$on# en !(

een!%)n #!# e& c(e&&oB en "on"e !e $ec%on# con e& ce/eno 7(e

c(0$e o"# $#'. E!# (n%)n "e& e!/#&e con e& ce/eno !e &/# c(e&&o

"e& "%ene. Se $ec%on# #/0%n po$ !( p#$e ee$n# con /(co!#

g%ng%6#& c(#& %ene %n!e$c%)n #no en e& e!/#&e co/o en e& ce/eno.

Po$ !( c#$# %ne$n# !e $ec%on# con "en%n# en o"# !( een!%)n.1;

1< =DR) ELQA? EDUARDO LO5A /ARA Man"al e O&era$oria Den$al 1 Po0a

ri!a Ver) Ao 2


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E!e e-%"o e! (n p$o"(co "e eo$#c%)n "e c&(! e!pec%#&e! &/#"#!

#/e&o0!o!. E& e!/#&e 7(e # !(+$%"o (n $#(/#%!/o o (n# &e!%)n

c#$%o!# no e! c#p# "e $egene$#$!e n% e!$(c($#& n% +%!%o&)g%c#/ene. Lo!

#/e&o0!o! "e!#p#$ecen (n# 6e 7(e e& "%ene # eco e$(pc%)n "e

#' %/po!%0%&%"#" "e $egene$#c%)n "e e!e e-%"o.

COMPOSICINF e& e!/#&e e! e& e-%"o /! "($o "e& o$g#n%!/o @ e!o !e

"e0e # 7(e 7('/%c#/ene e! con!%(%"o po$ 9* "e /#e$%#&

%no$gn%coB 0#-o +o$/# "e c$%!#&e! "e #p#%#B 4 "e #g(#B p$oe'n#!B

&'p%"o! @ c#$0o%"$#o! #"e/! "e !#&e! "e c#&c%o @ +o!+o$o.

COLORF


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P&" dentri

E! e& con-(no "e e&e/eno! %!o&)g%co! ence$$#"o! "en$o "e c/#$#p(&p#$. E!# $ec%)n con "en%n# en o"# !( !(pe$+%c%e @ con e&

+o$#/en #p%c#& en $#'.

P$e!en# c(#$o +(nc%one!

o$/#%6# Sen!o$%#& N($%%6# De+en!#

Ce-ento

E! (n e-%"o "($o c#&c%+%c#"o 7(e $ec(0$e "en%n# en !( po$c%)n

$#"%c($B e! /eno! "($o 7(e e& e!/#&eB pe$o /! "($o 7(e e& (e!o

$ec(0$e 'n%/#/ene $#' "e& "%ene "e!"e e& c(e&&o "on"e !e (ne con

e& e!/#&e #!# e& p%ceB en "on"e p$e!en# (n o$%+%c%o 7(e e! e& #g(-e$o

#p%c#&. S( co&o$ e! #/#$%&&eno @ !( !(pe$+%c%e e! &%ge$#/ene $(go!#5.

COMPOSICINF

M#e$%# %no$gn%c# 55

M#e$%# o$gn%c# @ #g(# 45

UNCIONES

P$oege "en%n# "e $#'

%-# #& "%ene en !( !%%o.



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1.2.!. Nt&r"e; de" rocesos crioso

E& p$oce!o c#$%o!o co/%en# con "e!/%ne$#&%#c%)nB en e& c(#& e& e!/#&e

@# no e! e& /#e$%#& !)&%"o @ #/o$+o 7(e epe$%/en# "%!o&(c%)n %$$e6e$!%0&e.

S% no (n# /#$% "e "%+(!%)n 7(e !e co/pone "e c$%!#&e! $o"#"o! po$ (n#

/#$% "e #g(#B p$oe'n#! @ &'p%"o! 7(e e7(%6#&e "e 1; # 15 "e& 6o&(/en "e&

e!/#&e #!%/%!/oB po!ee con"(co! $e%6#/ene g$#n"e! po$ &o! c(#&e!

p#!#n #/0#! "%$ecc%one! c%"o!B /%ne$#&e!B +&(o$($o! @ o$#! !(!#nc%#!.

L# #c%6%"#" 7('/%c# /e#0)&%c# "e &o! o$g#n%!/o! "ee$/%n#n (n# !e$%e "e

$e#cc%one! 7('/%c#! co/p&e-#! 7(e con"(cen # "e!$(cc%)n "e &o! e-%"o!

"e& "%ene po$ #cc%)n "e &o! c%"o! 7(e e!o! p$o"(cen @ 7(e !e enc(en$#n

#&o-#"o! en pc# "eno0#ce$%#n#B 7(e !%e/p$e e! p$e!ene en 0oc#.

E!o! c%"o! !on c#p#!e! "e "%!o&6e$ e& e!/#&eB "e!%neg$#c%)n "e&

e!/#&e pe$/%e pene$#c%)n "e o$#! 0#ce$%#! en "en%n#.

A& /%!/o %e/po !e p$e!en# $e/%ne$#&%#c%)n. Lo! "o! +en)/eno! oc($$en

"e /#ne$# !%/(&ne# @ "%n/%c#B p$%/e$o !e "%!(e&6en &o! /%ne$#&e! /!

%n!o&(0&e! @ en con!ec(enc%#B !e +o$/#n c$%!#&e! /! g$#n"e! @ /!

$e!%!ene! # "%!o&(c%)n.

L# !eg(n"# e#p# "e& p$oce!o c#$%o!o e! p$oe)&%!%!. L# e$ce$# e#p# e!

%n6#!%)n /%c$o0%#n#B en "on"e !e $ec%on# 6%$(&enc%# "e ! 0#ce$%#!

#c%")gen#! @ #c%"($%c#! $e!%"ene! "e pc# "eno0#ce$%#n# con !(c#p#c%"#" p#$# !%ne%#$ "%!%no! %po! "e po&%!#c$%"o! %n$#ce&($e! @

e$#ce&($e!. Con e& %e/poB c#$%e! o$%g%n# (n# c#6%"#" o #g(-e$oB en

e!$(c($# "e& "%ene.

L# een!%)n "e c#$%e! p$o"(ce %n+ecc%)n "e& e-%"o "e c#6%"#" p(&p#$

7(e #& +%n#& con"(ce # +o$/#c%)n "e #0!ce!o!B 7(e !% no !e "e%ene p(e"en



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&&eg#$ # #+ec#$ #& /#%$. S% !e o0!$(@e en$#"# en c#6%"#" p(&p#$B !e

p$o"(ce (n "o&o$ !e6e$o # /e"%"# 7(e #(/en# p$e!%)n "e &o! g#!e!.

En /(co! c#!o! e& "%ene !e p(e"e $##$ con e$#p%# "e& con"(co $#"%c($

7(e e&%/%n# e& /#e$%#& %n+ec#"o 7(e !e enc(en$# en e&. En c#!o! /!

g$#6e! e& )$g#no "en#$%o !e e$#e.

1.2.!.1. E"e-entos rticintes en e" roceso crioso

L# c#$%e! "en#& e! (n# en+e$/e"#" #!oc%#"# # 6#$%o! +#co$e! e& c(#&

!on %/p$e!c%n"%0&e! p#$# 7(e &e!%)n !e %n%c%e. E!o! +#co$e! !on e&

!(!$#o o$#&B &o! /%c$oo$g#n%!/o!B !(!cep%0%&%"#" "e& (!pe" @ "e&

%e/po.

S&strto or"

L# "%e#B p(e"e +#6o$ece$ o no c#$%e!B @# 7(e &o! #&%/eno! p(e"en

$e#cc%on#$ con !(pe$+%c%e "e& e!/#&e o !e$6%$ co/o !(!$#o p#$# 7(e

&o! /%c$oo$g#n%!/o! c#$%ogn%co! +o$/en pc# 0#ce$%#n# o c%"o!.

L# c$e#c%)n "e c%"o! e! e& $e!("o "e& /e#0o&%!/o 0#ce$%#no "e &o!

%"$#o! "e c#$0ono +e$/en#0&e!B !%n e/0#$goB !e "e0en con!%"e$#$ &o!

!%g(%ene! +#co$e!.

Crcter#stics /#sics de "os "i-entos

A"e!%6%"#"B &o! #&%/eno! peg#-o!o! !e /#n%enen en con#co con &o!

"%ene! "($#ne /#@o$ %e/po @ po$ e&&o !on /! c#$%ogn%co!. Lo!

&'7(%"o! %enen (n# /'n%/# #"e$enc%# # &o! "%ene!B @ en con!ec(enc%#B

!on /eno! c#$%ogn%co!.

[NOMBRE DEL AUTOR]2-


24/76

L co-osicin -ic de "os "i-entos

E!o +#6o$ece c#$%e!. A&g(no! #&%/eno! con%enen !#c#$o!# @ e!# e!en p#$%c($ c#$%ogn%c# po$ !( # ene$g'# "e %"$)&%!%! 7(e !

0#ce$%#! p(e"en (%&%#$ p#$# !%ne%#$ g&(c#no! %n!o&(0&e!.

Tie-o de in%estin

L# %nge!%)n "e #&%/eno! con %"$#o! "e c#$0ono "($#ne ! co/%"#!

p$o6oc# (n# c#$%ogen%"#" /eno$ 7(e %nge!%)n "e e!o! #&%/eno! en$e

co/%"#!.

5rec&enci de in%estin

A& con!(/%$ +$ec(ene/ene #&%/eno! c#$%ogn%co! %/p&%c# /#@o$ $%e!go

7(e e& con!(/o e!po$"%co.

E" H de " "c dentocterin

E! /(@ %/po$#ne p#$# +o$/#c%)n "e c#$%e! # %nge!%)n "e

#&%/eno!B #/0%n "epen"e "e& p %n"%6%"(#& "e &o! #&%/eno!B e&

conen%"o "e g&(co!# "e e!o! @ e& +&(-o p$o/e"%o " !#&%6#.

Microor%nis-os

E& S$epococc(! /(#n! e! e& /%c$oo$g#n%!/o "e /#@o$ poenc%#&

c#$%ogen%coB #(n7(e #/0%n !on %/po$#ne! &o! S$epococc(!

!#&%6#$%(!B S. /%&&e$%B S. !#ng(%! S. /%%!B S. %ne$/e"%o(!B L#co0#c%&&(!

#c%"op%&(!B L. c#!e%B L. #c%no/@ce! L. 6%!co(! @ L. #n%no/@ce! L.

n#e!&(n"%%B en$e o$o!. De &o! /%c$oo$g#n%!/o! /enc%on#"o!B #&g(no!

%enen g$#n %/po$#nc%#B co/o &F

S$epococc(! /(#n!



25/76

Co&on%#n en p#$%c($ ! +%!($#! "e &o! "%ene! @ ! !(pe$+%c%e!

%ne$p$o%/#&e!. P$o"(ce "e$#n#!#! @ +$(c#n#!#!. E!#! en%/#!

/e#0o&%#n &o! po&%!#c$%"o! e$#ce&($e!B &o c(#& +#6o$ece

p$o"(cc%)n "e c%"o. E! (n /%c$oo$g#n%!/o #c%")geno po$7(e p$o"(ce

c%"o &c%coB e& c(#& %ne$6%ene en "e!/%ne$#&%#c%)n "e& "%ene e!

#c%")+%&o po$7(e p(e"e !o0$e6%6%$ @ "e!#$$o&$!e en (n p 0#-oB @

#/0%n e! #c%"($%co po$7(e e! c#p# "e !eg(%$ gene$#n"o #c%"o con (n

p 0#-o.2

E!pec%e "e L#co0#c%&&(!

E! p$o"(co$ "e c%"o &c%co .A&g(n#! cep#! !%ne%#n po&%!#c$%"o!

e$#ce&($e! e %n$#ce&($e! # p#$%$ "e !#c#$o!#. No %n%c%#n c#$%e! en

!(pe$+%c%e! &%!#! pe$o %ene g$#n #c%6%"#" en "en%n#.

E!pec%e "e Ac%no/%ce!

L# e!pec%e "e #c%no/%ce!B !o0$e o"o A. 6%!co!(!B p$e"o/%n#n en

pc# "eno0#ce$%#n# "e $#'. A"e/! "e !e$ #c%")genoB p$e!en#

+%/0$%#! 7(e +#c%&%#n #"e!%)n @ cong$eg#c%)n #/0%n p(e"e

gene$#$ po&%!#c$%"o! %n$#ce&($e! @ e$#ce&($e! # p#$%$ "e !#c#$o!#

@ %ene #c%6%"#" p$oeo&'%c# /o"e$#"#.


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27/76

En conc$eoB !#&%6# %ene g$#n c#p#c%"#" "e #/o$%g(#c%)n p(e! #@("#

# ne($#&%#$ &o! c%"o! p$o"(c%"o! en pc# "eno0#ce$%#n# !( #&o

conen%"o "e c#&c%o @ +o!+#o #@("# # /#nene$ e!$(c($# "e& "%eneB

#!' co/o # $e/%ne$#&%#c%)n "e &e!%one! %nc%p%ene! po$ c#$%e!.2

1.2.!.*. E'idenci de &e " cries dent" es &n en/er-edd

in/ectocont%ios

Le0e$ @ Roen!e%n en 1,*8 @ M%&$ en 1,9;B "e"(-e$on &o! p$%nc%p%o!

+(n"#/en#&e! %/p&%c#"o! en e& "e!#$$o&&o "e c#$%e! "en#&. En !(+#/o!# eo$'# 7('/%c# p#$#!%#$%#B M%&$ !(g%e$e 7(e ! 0#ce$%#!

0(c#&e! con6%e$en &o! c#$0o%"$#o! "e "%e# en c%"o!B 7(e !on

c#p#ce! "e !o&(0%&%#$ e& +o!+#o "e c#&c%o "e& e!/#&e @ p$o"(c%$ &e!%)n

c#$%o!#.

Epe$%/eno! %n'c%#&e! "e/o!$#$on 7(e $##! &%0$e! "e g$/ene! e$#n

c#p#ce! "e "e!#$$o&$ c#$%e! "en#& c(#n"o !e %n+ec#0#n con 0#ce$%#!.

L#! e6%"enc%#! "e $#n!/%!%0%&%"#" "e c#$%e! "en#& p$o6%enen "e

e!("%o! $e#&%#"o! en /!e$. An%/#&e! &%0$e! "e c#$%e! "en#& no

"e!#$$on en+e$/e"#" #(n c(#n"o !e &e! "%e$# (n# "%e# #/ene

c#$%ogn%c#. E&&o !o&o oc($$'# c(#n"o e!o! #n%/#&e! e$#n p(e!o! en

con#co con #n%/#&e! 7(e !% p$e!en#0#n c#$%e! "en#&.12

Po!e$%o$/ene !e co/p$o0) 7(e c(#n"o &o! e!$epococo! #%!"o! "e

&e!%one! c#$%o!#! en $##!B e$#n %noc("o! en c#6%"#" 0(c#& "e

#n%/#&e! &%0$e! "e g$/ene!B e!o! e$#n c#p#ce! "e "e!#$$o&$

en+e$/e"#". L# %/po$#nc%# "e "%e# co/%en# # o/#$!e en

con!%"e$#c%)nB #& o0!e$6#$ 7(e co&on%#c%)n @ p$o"(cc%)n "e c#$%e! po$

12 ($$&IJJ)ii&eia)org)



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29/76


30/76

Se p%en!# 7(e "e0e e%!%$ (n# p$e"%!po!%c%)n gen%c# po$7(e !e #

6%!o 7(e #@ %n"%6%"(o!B 7(e pe!e # !( /# %g%ene @ 0%o!

#&%/en%c%o!B !on /! p$open!o! # e&.

E!$!

L# p$e!%)n "e 6%"# "%#$%#B "%!/%n(@e $e!%!enc%# # ! en+e$/e"#"e!

@ po$ con!%g(%ene !e e! /! p;$pen!o #& "e!#$$o&&o "e c#$%e! @ #

en+e$/e"#" pe$%o"on#&.

En+e$/e"#"e! %ne$c($$ene!

S( $##/%eno "%!/%n(@e e& +&(-o !#&%6#& c(#n"o #7(e& %nc&(@e

/e"%c#/eno! #n%co&%n$g%co! $#!o$no! g#!$o%ne!%n#&e!B !e"#ne!B

#n%%!#/'n%co! #+ecc%one! #&$g%c#!B ne($o&p%co! #&e$#c%one!

ne($o&)g%c#!B $#"%oe$#p%# #/0%n #(/en# e& $%e!go "e c#$%e! en e&

p#c%ene.

G&n"(! en"oc$%n#!

Son p$e"%!ponene! ! #&e$#c%one! "e p#$#%$o%"e! #c?# !o0$e e&

C#&c%o @ e! %/po$#ne !% oc($$e "($#ne +o$/#c%)n "e& "%ene

%$o%"e! e& %pe$%$o%"%!/o #(/en# e6o&(c%)n "e c#$%e!

1.2.. 5ctores c&s"es de cries en nios

Lo! +#co$e! c#(!#&e! "e c#$%e! "en#& #no p#$# &o! "%ene! p$%/#$%o!

co/o p#$# &o! !ec(n"#$%o! !on &o! /%!/o!B !%n e/0#$goB !e # %n"%c#"o en

e!("%o! 7(e e%!en "%+e$enc%#! en$e n%:o! pe7(e:o! @ &o! #"(&o!B co/o en

e& c#!o "e !#&%6#.

L# c#$%e! "en#& e! (n# en+e$/e"#" 0#ce$%#n# /(&%+#co$%#& 7(e p#$# !(

%n!#c%)n nece!%# %ne$#cc%)n "e $e! +#co$e! 0!%co!.

[NOMBRE DEL AUTOR]-


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e@e!B 1982F (!pe"B /%c$o+&o$# @ e& !(0!$#o. A &o! c(#&e! NeH0$(n

19,, #g$ego e& c(#$o +#co$F %e/po. En !( e%o&og'# e%!en %ne$#cc%one!

%nep&%c#0&e! "e +#co$e! #&e! co/oF %n+ecc%)n po$ S$epococc(! M(#n!B

e"(c#c%)n "e /#"$e o c(%"#"o$B enc%# /#e$n# p$o&ong#"#B e& e!$!B

#(oe!%/#B e!$(c($# +#/%&%#$ @ !oc%#& (%&%#c%)n "e& 0%0e$)n %/p$egn#"o en

/%e& o #?c#$ co/o $e-#ne o p#$# 7(e & 0e0e !e "(e$/# +$ec(enc%# "e

#&%/en#c%)n "e& n%:o o con!(/o "e #&%/eno! o 0e0%"# #(c#$#"#! en$e

o$o!.

1.2..1. H&esed diente

L# "o&enc%# !e /#n%+%e!# !o0$e e!$(c($# "($# "e &o! "%ene!B @ p#$#

7(e e!o oc($$#B e! nece!#$%o 7(e e& e!/#&e !e o$ne !(!cep%0&e "e !e$

"e!$(%"o po$ &o!c%"o! o po$ !( p$op%# con+%g($#c%)n #n#)/%c# co/o en

&o! c#!o! "e &o! !($co!B +%!($#! @ p(no!. E& poenc%#& "e $e!%!enc%# "e&

e!/#&e (/#no e! #&$e"e"o$ "e (n p "e 5.2 # @ Co&. 19,2.

Lo! "%ene! "ec%"(o! !#no! /eno! /%ne$#&%#"o! 7(e &o! pe$/#neneB

po$ e&&o !e$n /! !(!cep%0&e!B @# 7(e $e!%!enc%# "e& e!/#&e e!

/eno$ # (n p /! #&o @ +$#ncoB "ee$/%n#n"o 7(e en (n# #c%"%+%c#c%)n

/! +$#nc#B p(e"en oc($$%$ &e!%one! /! +c%&/ene en e& e!/#&e.14

E& "%ene !e$ !(!cep%0&e c(#no /#@o$ !e# e& n?/e$o "e !($co! @

+%!($#! @# 7(e e!#! en &o! "%ene! "ec%"(o!B !on /! p$o+(n"o! @$een%6o! #!' #/0%n co/o &o! "e+eco! e!$(c($#&e! p$e!ene!B #!'

co/o c(#no /#@o$ p#$# e& p "e poenc%#& "e $e!%!enc%# p

Q$e!%!enc%# "e e!/#&e.

1.2..2. H&esed s"i'

16 =R"i0 Reynalo e @ig"eireso Sal$er, An$onio @e$elle, Myai .??AO)

Oon$ologa &ara el +e+e>

[NOMBRE DEL AUTOR]-1


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L# !#&%6# !eg$eg#"# po$ ! g&n"(! !#&%6#$e! /#@o$e!F p#$)%"#!B

!(0/#%$e! @ !(0&%ng(#&e!B -(no con ! g&n"(! /eno$e!B !on

$e!pon!#0&e! "e &(0$%c#c%)n "e 0oc# @ &o! "%ene!B %ne$6%n%en"o

!%gn%+%c#%6#/ene en e& p$oce!o "e gene$#c%)n "e c#$%e! NeH0$(nB

19,,.

E& 6#&o$ no$/#& "e +&(-o p#$# e& n%:o e!co$ e! "e , /& "e !#&%6# po$ 5

/%n. C(#n"o e! #c%6#"oB !(/%n%!$#"o (n 6o&(/en /e"%o "e !#&%6# po$

"'# en$e 1;;; # 15;; /&. Se p(e"e #+%$/#$ 7(e c(#no /#@o$ !e# e& +&(-o

!#&%6#& /eno$ e! po!%0%&%"#" "e 7(e e& n%:o #"7(%e$# c#$%e!.*

L# !#&%6# %ene (n p#pe& c$'%co en e& p$oce!o c#$%o!o @# 7(e 0#$$e e&

!(!$#o @ #/pon# e& c%"o "e pc#B +$en#n"o e& p$oce!o c#$%o!o @

!%en"o e!enc%#& p#$# e& p$oce!o "e $e/%ne$#&%#c%)n.

L# !#&%6# %ene 6#$%#! #cc%one! @ +(nc%one! "en$o "e e&! ene/o!F

P$oecc%)n "e ! c&(! "e /(co!#

A@("# # +o$/#$ e& 0o&o #&%/en%c%o

Acc%one! 0#ce$%c%"#! e %n/(no&)g%c#! 7(e #@("#n # p$oege$ #&

%n"%6%"(o

L#! en%/#! !#&%6#$e! %enen ! +(nc%one! "e $eno6#c%)n "e $e!%"(o!

#&%/en%c%o! po$ ! #cc%one! !o&(0%&%#ne! 7(e po!ee

L# cope$o%"#!# /#n%ene e& "e!#$$o&&o 0#ce$%#no "en$o "e &o!

p#$one! %"e#&e!

1.2..*. Micro/"or



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L# /%c$o+&o$# !e o$%g%n# "e (n# /#$% g&%cop$oe%c# "on"e e&

co/ponene 0#ce$%#no !e +%-#B co&on%# @ c(#n"o e! c#$%ogn%co @

o$g#n%#"o !e p(e"e con6e$%$ en (n# +(ene gene$#"o$# "e c#$%e!.

Lo! !$epococc(! /(#n!B no !on (!(#&/ene "eec#0&e! en 0oc#! "e

n%:o! #ne! "e e$(pc%)n "e p%e#! "en#$%#!. E!("%o! 7(e #n (%&%#"o

$##! "e !e$o%po!B p&!/%"o! @ cep#! con pe$+%&e! p#$%c($e! "e DNAB

!(g%e$en #!oc%#c%)n "e g$/ene! "e /#"$e en 0oc# "e !(! %-o!B

)!e# &o! n%:o! #"7(%e$en +$ec(ene/ene e& !$epococc(! /(#n! "e !(!

/#"$e!.*

En /e"%"# 7(e /#"($# pc# !e 6#n c$e#n"o con"%c%one! %ne$n#!

7(e pe$/%en #g$eg#c%)n "e o$#! e!pec%e! /! !e&ec%6#! 7(e

$e7(%e$en "e n($%ene! e!pec'+%co! o g$#"o! "%6e$!o! "e o%gen#c%)nB @#

7(e e& o'geno e! &e#& p#$# /(c#! 0#ce$%#!.

L# p$%/e$# o "e co&on%#c%)n $e"(ce concen$#c%)n p#$# e&

e!#0&ec%/%eno "e 0#ce$%#! #n#e$o0%#! "e e!pec%e "e #c%no/%ce!.

Un# !eg(n"# o "e co&on%#c%)n !e e!#0&ece$ #7(e&! 7(e $e7(%e$en

#(n /eno! o'genoB /! c%"o! @ "e$%6#"o! "e /e#0o&%#c%)n

p$oe%c#B 6e%&&one#!B 0#c%&o!B g$#/neg#%6o! @ e!p%$o7(e#!.15

L# c#6%"#" o$#& e! (n /e"%o eco&)g%co "e c#$#ce$'!%c#! ?n%c#! en e&

c(e$po (/#noB @# 7(e e! en con#co con e& ee$%o$B $ec%0e p$o"(co!

7('/%co! "%6e$!o! #&%/eno! @ po!ee (n &'7(%"o "e co/po!%c%)n

co/p&e-# co/o e! !#&%6#.

17 =@ernano Es!o+ar M"o0) Oon$ologa Pei4$ri!a &)&) 1

[NOMBRE DEL AUTOR]--


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C#"# (n# "e ! !(pe$+%c%e! "e &o! "%ene! po!ee "%!%no! g$#"o! "e

!(!cep%0%&%"#" # c#$%e! !eg?nF /o$+o&og'#B #$c#"# e 7(e e!n

!%(#"o!B & po!%c%)n en #$c#"# ec.

En "en%c%)n e/po$#&B /#@o$ +$ec(enc%# "e c#$%e! e!# en &o! p$%/e$o! @

!eg(n"o! /o$e!B !eg(%"o! "e &o! c#n%no! e %nc%!%6o! !(pe$%o$e!. Lo!

%nc%!%6o! %n+e$%o$e! $#$# 6e p$e!en#n c#$%e!B @# 7(e !( $ec%)n con &eng(#

@ &o! c%$c(%o! "e "%!$%0(c%)n "e !#&%6# +#6o$ece (n# "e+en!# n#($#&.

P$%/e$#/eneB c#$%e! p(e"e 6e$!e co/o (n# on# op#c# 0n7(ec%n#B

&/#"# K/#nc# 0nc# 7(e e!o !e "e0e # (n p$oce!o "e

"e!/%ne$#&%#c%)n !%n c#6%#c%)n /%c$o!c)p%c#. L#! &e!%one! "e #6#nce $p%"o

p$e!en#n (n co&o$ 0nco #/#$%&&eno. L# !(pe$+%c%e !e o0!e$6# op#c# c(#n"o

e! !ec#.

L# p$og$e!%)n @ !(!cep%0%&%"#" "e c#$%e! en e& n%:oB e! gene$#&/eneB /!

$p%"# 7(e en e& #"(&o.

1.2.F. C"si/iccin de " cries dent"

1.2.F.1. C"si/iccin de" Dr. Greene 4rdi-n B"c

=c> p#"$e "e ope$#o$%# "en#& c!%+%co en 5 g$(po! ! on#!

"en#&e! #+ec#"#! po$ c#$%e!B #!' co/oB ! c#6%"#"e! "epen"%en"o "e&

&(g#$ "on"e !e enc(en$#n.

Seg?n !( &oc#&%#c%)n

CLASE IF !on ! 7(e !e enc(en$#n en c#$#! oc&(!#&e! "e

p$e/o$e! @ /o$e!B en +o!e#! @ !($co!B #"e/! en e& c'ng(&o

"e "%ene! #ne$%o$e! @ en &o! "e+eco! e!$(c($#&e! "e o"o! &o!

"%ene!.



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CLASE IIF !e enc(en$#n en c#$#! p$o%/#&e! "e /o$e! @

p$e/o$e! CLASEIIIF Se enc(en$#n en c#$#! p$o%/#&e! "e "%ene!

#ne$%o$e! !%n &&eg#$ #& c'ng(&o %nc%!#&. CLASE I


37/76

L# "en%n# c#$%o!# p(e"e #p#$ece$ en (n# g#/# "e co&o$e!B "e!"e

#/#$%&&o #!# p#$"o o neg$o en #no 7(e "en%n# no$/#& e! "e co&o$

#/#$%&&o c$o o c$e/#B @ %ene (n# con!%!enc%# "($# @ &%!# #& ep&o$#$. 2

C#$%e! "e p(&p#

L# c#$%e! &&eg# # p(&p# pe$o e!# con!e$6# !( 6%#&%"#". E& !'no/#

p$%nc%p#& e! e& "o&o$ e!pon#neo o %n"(c%"o. E& "o&o$ e!pon#neo !e

c#$#ce$%# po$7(e no !e p$o"(ce po$ #&g(n# c#(!# ee$n#B !%no po$

conge!%)n "e p(&p# 7(e p$e!%on# &o! ne$6%o! p(&p#$e!B &o! c#(!#&e!

7(e"#n co/p$%/%"o! con$# p#$e" "e c/#$# p(&p#$. E!e "o&o$

#(/en# "($#ne ! noce!B #& /#nene$ c#0e# en po!%c%)n

o$%on#&B #@ /#@o$ #+&(enc%# !#ng('ne#.

E& "o&o$ %n"(c%"o oc($$e con epo!%c%)n "e& "%ene # #gene! +'!%co!B

7('/%co! o /ecn%co!. A "%+e$enc%# "e& "o&o$ po$ c#$%e! "e !eg(n"o

g$#"oB e& "o&o$ %n"(c%"o pe$!%!e #& e&%/%n#$ e& e!'/(&o.

Nec$o!%! p(&p#$

A7(' p(&p# # !%"o "e!$(%"# o#&/eneB po$ &o #no no #@ "o&o$B pe$o

! co/p&%c#c%one! !% !on "o&o$o!#! @ p(e"en !e$ "e!"e (n# /ono #$$%%!

#p%c#& #!# (n# pe$c(!%)nB !en!#c%)n "e #$g#/%eno @ /o6%&%"#"

#no$/#& "e p%e#. J o!eo/%e&%%! e! c(#n"o # &&eg#"o # /e"(

)!e#.

1.2.F.). C"si/iccin or e" %rdo de e'o"&cin

C#$%e! #c%6#! o #g("#!

A7(e& 7(e !%g(e (n c($!o $p%"o @ co/p$o/ee en poco %e/po

p(&p#B !e p$e!en# e!pec%#&/ene en n%:o! @ #"(&o! -)6ene!B e& p$oce!o



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39/76

pe$/#nene! $ec%n e$(pc%on#"o!. A(n7(e !e &e #$%0(@en "%6e$!o!

#gene! e%o&)g%co!B e! p$o0#0&e 7(e e& +#co$ p$%nc%p#& en e!o! c#!o!B

!e# e& #/0%ene +#/%&%#$ "%e#B 0%o! #&%/en%c%o!B p$#c%c# "e %g%ene

0(c#& @ g$#"o "e c(%"#"o "e &o! "%ene!B /! 7(e (n co/ponene

gen%coB #(n7(e no !e n%eg# !( p#$%c%p#c%)n. Co/o /e"%o "%#gno!%co

!e e/p&e# p$%nc%p#&/ene %n!pecc%)n 6%!(#&B ep&o$#c%)n c%& @

#n#/ne!%! "on"e e& p#c%ene p(e"e $e+e$%$ !%no/#o&og'# "o&o$o!#.

C#$%e! po$ $#"%#c%)n

E! "e!$(cc%)n "e %po c#$%o!o "e !(!#nc%# "e& "%ene #!oc%#"# con

e$o!o/'# @ p$o"(c%"# po$ $#@o! (!#"o! con +%ne! e$#p(%co!B

&e!%)n !e p#$ece # "e!/%ne$#&%#c%)n !( e/p%e# en on# ce$6%c#&

"e& "%ene.

C#$%e! $#"%c($

Inc&(%"o! e& ce/eno @ "en%n#B ! c#$%e! $#"%c($e! !on &e!%one!

p$og$e!%6#! 7(e c(0$en !(pe$+%c%e $#"%c($ en6(e po$ %n6#!%)n "e

pc# @ /%c$o+&o$#B p(e"e "%!%ng(%$!e "e #0$#!%)nB e$o!%)n @

$e#0!o$c%)n %"%op%c#B 7(e p(e"en #/0%n #+ec#$ !(pe$+%c%e $#"%c($.

C(#n"o ! !(pe$+%c%e! $#"%c($e! e!n ep(e!#! #& #/0%ene o$#&

co/o $e!("o "e $e$#cc%)n "e enc'# /#$g%n#&B ! $e#! "e

$eenc%)n "e pc# p(e"en #(/en#$ e!# een!%)nB p#$%c($/ene en

! g$#n"e! $e#! %ne$p$o%/#&e! @ # &o $go "e (n%)n ce/eno

e!/#&e.

C#$%e! "e o$%+%c%o! @ +%!($#!

[NOMBRE DEL AUTOR]-;


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Son co/(ne! en &o! n%:o! @ co/%en#n # #p#$ece$ #&$e"e"o$ "e &o! 1;

#:o! en ! p%e#! "en#&e! pe$/#nene!. Se c#$#ce$%#n po$

"e!#$$o&$!e 6e&o/ene.Po$ &o gene$#&B !e +o$/#n en ! co$$e"($#! "e

on# /#!%c#"o$# "e ! /(e! -(no # ! /e-%&!.

L# "e!/%ne$#&%#c%)n e/p%e# en #/0o! "o! con 6e$%ene "e& !($co

ce$c# "e& +on"o.En "%ene! e/po$#&e!B p(e"e encon$#$!e #+ec#c%)n "e

p(&p# con &e!%one! 7(e p$e!en#n c#6%"#"e! /(@ pe7(e:#! en e&

e!/#&e.

C#$%e! "e !(pe$+%c%e! &%!#!

E! c#$%e! "en#& 7(e !e o$%g%n# en ! !(pe$+%c%e! &%!#! "e &o! "%ene!

gene$#&/ene p$o%/#&e!B o en e& e$c%o g%ng%6#& "e ! !(pe$+%c%e! +#c%#&e!

@ &%ng(#&e!. Son #7(e&! "e /! &eno "e!#$$o&&o.18

C#$%e! !o$p$e!# "e& p$%/e$ /o$ pe$/#nene

L#! c#(!#! "e e!e %po "e c#$%e! !on 0#-# pe$/e#0%&%"#" "e& e!/#&e @

"en%n#B 0#-o poenc%#& "e "e+en!# "en%n#$%# e %g%ene 0(c#& %n#"ec(#"#.

L# &e!%)n e! 0en%gn#B c#!% !%e/p$e %n"o&o$# @ pene$#0&e. E& e!/#&e !e 6e

con!e$6#"o @ con c#$%e! "e !(co. L# "en%n# %ene #!peco g$%!

#/#$%&&enoB 0n"o @ e!pon-o!o.

Po&%c#$%e!

L# e6o&(c%)n "e e!# c#$%e! e! $p%"#. L# en+e$/e"#" e! /! co/?n en

c#!o "e +#&! en /#"($#c%)n "e& e!/#&eB "%!c#p#c%"#"B $e!p%$#c%)n

0(c#& o %nge!%)n +$ec(ene "e #&%/eno! con !#c#$o!#B !e p(e"e p#"ece$

po&%c#$%e! po$ +# "e %g%ene 0(c#&.

19 =AT, ?.MON) =2

[NOMBRE DEL AUTOR]6


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C#$%e! p$%/#$%#

C#$%e! "en#& en 7(e &e!%)n con!%(@e e& ##7(e %n%c%#& # !(pe$+%c%e

"e& "%ene.

C#$%e! !ec(n"#$%# o $ec%"%6#ne

A7(e& 7(e !e p$e!en# gene$#&/ene en e& 0o$"e "e (n# $e!#($#c%)nB

"e0%"o /(c#! 6ece! # (n# een!%)n %nco/p&e# o %n#"ec(#"#B !(

#!peco !e$ !%/%$ #& %po "e c#$%e! p$ee%!ene.

C#$%e! "e 0%0e$)n

L# c#$%e! en &o! n%:o! pe7(e:o! !e &/# c#$%e! "e 0%0e$)n. L# c#$%e!

oc($$e c(#n"o !e &e "#n #& 0e0 &'7(%"o! en"("o! @ !e &e "e-#n en

0oc# po$ $go! pe$%o"o!.

P(e"e "e!$(%$ &o! "%ene! @ oc($$e /#@o$/ene en &o! "%ene! #ne$%o$e!

!(pe$%o$e!B pe$o p(e"e #+ec#$ o$o! "%ene!. E! c#$#ce$'!%co en

pe7(e:o! 7(e "(e$/en con e& c(pee /o-#"o con e&e/eno!

#(c#$#"o! o "e #7(e&&o! 7(e o/#n 0%0e$)n en c(n#.

E& e&e/eno #(c#$o 0$%n"# (n 0(en /e"%o "e c(&%6o p#$# &o!

/%c$oo$g#n%!/o! #c%")geno. E& +&(-o !#&%6#& "%!/%n(@e "($#ne e& !(e:o @

!e %"en%+%c# e& "e!pe-e "e &'7(%"o "e c#6%"#" 0(c#&.

C#$#ce$'!%c#! p$op%#! "e c#$%e! "e 0%0e$)n

o T%ene (n# e6o&(c%)n /(@ $p%"#

o Son %n6o&(c$#"o! /(co! "%ene!

o En c#!o! g$#6e! #+ec# #/0%n # &o! %nc%!%6o! %n+e$%o$e!

1.2.1. S#nto-s de " cries



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Lo! p$%nc%p#&e! !'no/#! "e (n# c#$%e! "en#& p(e"en !e$F

Do&o$B %n+/#c%)n en &o! "%ene!B !o0$e o"o "e!p(! "e co/e$ #(c#$e! @

"e o/#$ 0e0%"#! o #&%/eno! +$'o! o c#&%ene!.

O$%+%c%o! o c#6%"#"e! 6%!%0&e! en &o! "%ene!

M#& #&%eno o /#& !#0o$ en 0oc#

Pe$"%"# "e& "%ene

L# /#@o$'# "e ! c#$%e! !on "e!c(0%e$#! en !(! +#!e! p$e&%/%n#$e! "($#ne

&o! con$o&e! "e $(%n#. L# !(pe$+%c%e "en#& p(e"e e!#$ !(#6e #& p(n#$! con

(n %n!$(/eno p(n%#g("o. E& "o&o$ p(e"e no p$e!en#$!e #!# ! e#p#!

#6#n#"#! "e c#$%e! "en#&. L#! $#"%og$#+'#! "en#&e! p(e"en /o!$#$

#&g(n#! c#$%e! #ne! "e 7(e !e#n 6%!%0&e! p#$# e& o-o.

1.2.11. Co-"icciones de " cries

D%6e$!o! p$o0&e/#! p(e"en !($g%$ c(#n"o ! c#$%e! no !on $##"#! # %e/po.

E& p$%/e$o e! 7(e p(e"en #&c#n#$ p$o+(n"%"#". C(#n"o e!o oc($$e e&

p$o+e!%on#& !(e&e (%&%#$ (n $e&&eno p$o6%!o$%o p#$# 7(e e& "%ene c%c#$%ce @

&(ego #p&%c#$ p#!# pe$/#nene.

E& !eg(n"o p$o0&e/# e! c(#n"o #@ (n# %n+ecc%)nB 7(e "e no #en"e$!e #

%e/po p(e"e &&eg#$ # $#' "e p%e# "en#& gene$#n"o (n #0!ce!oB e! "ec%$

#c(/(c%)n "e p(! 7(e p(e"e een"e$!e o p$o6oc#$ (n# %n+/#c%)n "e

enc'#.

E& e$ce$ %ncon6en%ene !e p$o"(ce c(#n"o po$ p$o+(n"%"#" 7(e #

#&c#n#"o c#$%e! e& "#:o en p(&p# e! %$$e6e$!%0&e. En e!o! c#!o! !e



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p$oce"e # !#c#$ p(&p# po$ e& con"(co "e $#'B cn%c# 7(e !e conoce con

e& no/0$e "e en"o"onc%#. O$# !o&(c%)n e! $e%$#$ e& "%ene. En oc#!%one!B (n#

/(e !o/e%"# # en"o"onc%# !e c(0$e con (n# co$on# 7(e p$oege.1,

1.2.12. M?todos di%nsticos r deter-inr " cries dent"

1.2.12.1. M?todo 'is&".

L# %n!pecc%)n c&'n%c# "epen"e "e e6#&(#c%)n "e &o! c#/0%o! "e

$#n!&(c%"e "e& e!/#&eB e! "ec%$ pe$"%"# "e 0$%&&o e& #!peco op#co.

T#/0%n po"e/o! e6#&(#$ ! p%g/en#c%one!B &oc#&%#c%)n @

p$e!enc%# o no "e e-%"o 0n"o o &o! c#/0%o! en e($# "e& e!/#&e

$e!(ne "e& g$#"o "e "e!/%ne$#&%#c%)n.

1.2.12.2. M?todo t,cti"

E& ep&o$#"o$ !e con!%"e$) co/o (n# e$$#/%en# p#$# e& "%#gn)!%co "e

c#$%e!B # &( "e &o! conoc%/%eno! #c(#&e! en $ec%)n # &e!%)n

%n%c%#&B (n# pe7(e:# +(e$# e-e$c%"# con e!e %n!$(/eno "e p(n# #g("#

po"$'# p$o6oc#$ (n "#:o en e& e-%"o "e ! on#! !(pe$+%c%#&e!B co/o

con!ec(enc%# !e con6%e$e (n# /#nc# 0nc# en (n# &e!%)n c#6%#"#B e&

ep&o$#"o$ "e (n# p(n# #g("#B no "e0e !e$ (!#"o po$ e& "%#gn)!%co "e&e!%one! %n%c%#&e! "e !(pe$+%c%e! &%#! @ "e p(no! @ +%!($#!.

En !( &(g#$ po"e/o! (%&%#$ (n ep&o$#"o$ "e p(n# $e"on"# o (n#

!on"# pe$%o"on#&B #ne! "e %n%c%#$ e& e#/en c&'n%co @ &(egoB !%n $e#&%#$

n%ng?n %po "e &e!%)n po"e/o! cec#$ e($# "e !(pe$+%c%e !%n

pene$#$.

1: : ($$&IJJ$ooensal")!o#J2


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1.2.12.*. M?todo rdio%r,/ico

L#! $#"%og$#+'#! co$on#&e! !on (n co/p&e/eno p#$# e& "%#gn)!%co "e

c#$%e! %ne$p$o%/#& @ pe$/%en p$og$e!%)n "e &e!%)n. C(#n"o

%!o&)g%c#/ene &e!%)n "e c#$%e! %n6o&(c$# !o&o /%#" "e& e!pe!o$

"e& e!/#&eB (!(#&/ene no !e p(e"e "eec#$ &e!%)n con $#"%og$#+'#

co$on#&B "e0%"o # 7(e p$o+(n"%"#" "e &e!%)n "e!"e e& p(no "e 6%!#

%!o&)g%co e! /! #6#n#"# 7(e #p#$%enc%# "e $#"%og$#+'#.

No !e $eco/%en"# $#"%og$#+'# co$on#& p#$# e& "%#gn)!%co "e !

&e!%one! %n%c%#&e! 7(e %n6o&(c$#n /eno! "e /%#" "e& e!pe!o$ "e&

e!/#&eB pe$o !% e! 0(en# #&e$n#%6# p#$# "ee$/%n#$ p$og$e!%)n e!

&e!%)n "e!p(! "e (n# e$#p%# "e $e/%ne$#&%#c%)n en (n# e#p# "e

$ee6#&(#c%)n.1;

E! %/po$#ne "e!#c#$B 7(e c&'n%c#/ene po"$'#/o! "%#gno!%c#$

!(pe$+%c%e! %ne$p$o%/#&e! &%0$e! "e c#$%e!B /%en$#! 7(e

%!o&)g%c#/ene &e!%)n @# p(e"e e!#$ p$e!ene en n(/e$o!#!

!(pe$+%c%e! %ne$p$o%/#&e!. Po$ &o #no e& e#/en $#"%og$+%co no e! (n

/o"o #"ec(#"o p#$# %"en%+%c#$ ! &e!%one! "e c#$%e! %n%c%#&e! #no en

!(pe$+%c%e! p$o%/#&e! co/o en c#$#! oc&(!#&e!B no o0!#ne e! (n

/o"o "e "%#gn)!%co co/p&e/en#$%o 7(e pe$/%e "eec#$ c#$%e!

%ne$p$o%/#& "e &e!%one! /! #6#n#"#! #!' co/o e6#&(#$ p$og$e!%)n

"e (n# &e!%)n "e!p(! "e (n $##/%eno "e $e/%ne$#&%#c%)n.

1.2.12.). M?todo de trns"&-incin

o@ en "'# !e (%&%# $#n!&(/%n#c%)n po$ +%0$# )p%c#B e!e e! (n

/o"o p$c%co p#$# e& "%#gn)!%co "e c#$%e!B &( 6%!%0&e e! en6%#"#

po$ (n# +%0$# )p%c# #& "%eneB &( !e p$op#g# "e!"e +%0$# # $#6! "e&



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e-%"o "en#$%o #!# !(pe$+%c%e op(e!#. E& $e!("o "e ! %/gene!

o0en%"#! "e "%!$%0(c%)n "e &( !e (%&%# p#$# e& "%#gn)!%co.

Se #n "e!#$$o&"o e7(%po! 7(e pe$/%en c#p#$ ! %/gene!B co/o en

e& c#!o "e $#n!&(/%n#c%)n po$ +%0$# )p%c# "e %/#gen "%g%#&%#"#B

"on"e %&(/%n#c%)n @ ! %/gene! !on con$o"#! @ $ep$o"(c%0&e!.

1.2.12.!. M?todo de "&; /"&orescente

E& p$%nc%p%o co/?n p#$# e!e /o"o e! +&(o$e!cenc%# "e& e!/#&e @

"en%n#.

Lo! "%ene! #& e&%/%n#$!e con &( 6%o&e# e/%en &( 6e$"e #/#$%&&en# @

c(#n"o e%!e c#$%e!B +&(o$e!cenc%# !e p%e$"e. Se #n "e!#$$o&"o

cn%c#! "e +oog$#+'# (&$#6%o&e# c#p#ce! "e e6#&(#$ +o$/#c%)n "e

&e!%one! c#$%o!#! %n6%$o.

Po"e/o! conc&(%$ 7(e e!e /o"o !e 0#!# en c#p#c%"#" "e

!(pe$+%c%e "en#$%# "e #0!o$0e$ @ $e+&e-#$ $#"%#c%)n (&$#6%o&e# @ no en

! "%+e$enc%#! en +&(o$e!cenc%# o p$"%"# "e /%!/#.

1.2.12.(. M?todo de cond&ctnci e"?ctric

E!e /o"o !e 0#!# en 7(e e& e!/#&e e! (n po0$e con"(co$ e&c$%co.

E& #/#:o "e &o! po$o! e! /(@ pe7(e:o en e& o$"en "e 1 # * // pe$o #&

p$o"(c%$!e "e!/%ne$#&%#c%)n "e& e!/#&e "($#ne e& p$oce!o c#$%o!o !eo$%g%n# (n %nc$e/eno "e& #/#:o "e &o! /%!/o!.

Po$ e!# $#)n e& e!/#&e c#$%#"o %ene (n# # con"(c#nc%# e&c$%c#

co/p#$#"# con e e!/#&e !#no. L# con"(c#nc%# "e "en%n# e! /(co

/#@o$ 7(e "e& e!/#&e !#no "e0%"o # !(! #&o! conen%"o! "e #g(#.

1.2.1*. Medids de re'encin de " cries



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En #c(#&%"#" ! &e!%one! c#$%o!#! !on con!%"e$#"#! co/o

/#n%+e!#c%one! c&'n%c#! "e %n+ecc%)n 0#ce$%#n# 7(e p$og$e!#n #!# (n

p(no %$$e6e$!%0&e. E& /e-o$#/%eno "e p$e6enc%)n @ "e& $##/%eno

e$#p(%co !e &og$#$ /e"%#neF e& Con$o& "e c#$%e! "en#& c$)n%c#

P$o/oc%)n p#$# 7(e "en%c%)n pe$/#nec# %n#c#B @ "e& Con$o& "e

0#ce$%# %n6o&(c$#"# en e& p$oce!o c#$%o!o.

L# p$e6enc%)n "e pe$"%"# "e e!$(c($# "e& "%ene $e"(ce epo!%c%)n

"e #gene! #ne!!%co!B $e"(ce e& "o&o$ @ !( %ncon6en%enc%# # $go po

p$e!e$6# e!%c#B +%!%o&og'# @ +on#c%)n "e& %n"%6%"(oB @ $e"(ce e& g#!o

econ)/%co "e& $##/%eno.

Un co$$eco "%#gn)!%co e! 0#!e p#$# e& $##/%eno "e o"#! !

en+e$/e"#"e!.

P#$# c#$%e! "en#&B e& "%#gn)!%co po$ &o gene$#& !%gn%+%c# o0!e$6#c%)n "e

!%gno! c&'n%co! co/o p$e!enc%# "e c#6%"#"e!. S%n e/0#$goB e& co$$eco

"%#gn)!%co "e0e$ een"e$!e # %"en%+%c#$ @ e6#&(#$ +#co$e! co/o #gene!

e%o&)g%co! "e en+e$/e"#" !% e!o! no !on %"en%+%c#"o! @ c(%"#"o!B !e$n

(n $%e!go p#$# $ec($$enc%# "e p#o&og'#. L# %n+o$/#c%)n nece!#$%# p#$#

(n "%#gn)!%co #"ec(#"o "e c#$%e! "en#&B "e #c(e$"o # en%"#" p#o&)g%c#B

!e 0#!e en $e! /o"e&o!F 1 %!o$%# gene$#& en en$e6%!#B @ en !

o0!e$6#c%one! "e& p#c%eneB 2 e& e#/en c&'n%co @ $#"%og$+%coB @ 3 e& (!o "e

p$(e0#! "e c#$%e! p#$# "ee$/%n#$ "e /#ne$# +%"e"%gn# &o! +#co$e! "e $%e!go.

L#! cn%c#! "e p$e6enc%)n e!n -(!%+%c#"#! en +o$/# c%en'+%c# "e #c(e$"o

#& p#$)n #c(#& "e e!# en+e$/e"#". E!# +%&o!o+'# %ene e& poenc%#& "e

p$o"(c%$ (n# !e$%e "e /e"%"#! /! e+ec%6#! p#$# p$e6enc%)n en o"o! &o!

p#c%ene! "e #& /#ne$#B 7(e co/0%n#c%)n "e ! "%+e$ene! cn%c#! "e



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p$e6enc%)n p(e"en $e"(c%$ en !( o#&%"#" e& $%e!go "e c#$%e!B pe$o !% !(

/#ne-o no e! #"ec(#"oB no !e$n 0en+%c#! p#$# po0c%)n.

P#$# %g(e%$e"o @ co&. p$e6enc%)n "e c#$%e! "en#& p(e"e !e$ e-ec(#"#

po$ 6#$%o! /o"o!B en$e &o! c(#&e! po"e/o! c%#$F e/p'$%coB e%o&)g%co @ e&

"e $%e!go.

1.2.1*.1. Hi%iene &codent"

L# %g%ene 0(c#& e! (no "e &o! e&e/eno! p$%nc%p#&e! "e& c(%"#"o

pe$!on#&. E& "e!eo "e &(c%$ (n# !on$%!# con "%ene! &%/p%o!B !#no! @

0nco! # "#"o &(g#$ # 7(e en e& /e$c#"o e%!#n "en'+$%co! "e /(co!

%po! @ c#$#ce$'!%c#!. Se p(e"en encon$#$ en (n# g$#n 6#$%e"#" "e

!#0o$e!B co&o$e! @ en6#!e! en ge& o c$e/# con co/p(e!o! con$#

c#$%e!B e& !#$$oB pc# "eno0#ce$%#n# o p#$# con$#$$e!#$

!en!%0%&%"#" "e &o! "%ene!B en$e /(c#! o$#! p$op%e"#"e! #n(nc%#"#!

7(eB po$ c%e$oB no o"o! c(/p&en c#0#&/ene. M! #&& "e %&(!%)n

co!/%c#B &o c%e$o e! 7(e e& (!o "e p#!# "en#&B /! (n 0(en

cep%&"oB p(e"e #@("#$ # p$e6en%$ p$o0&e/#! co/o e& /#& #&%eno o

c#$%e! "en#&.

Con6%ene $eco$"#$ 7(e c#$%e! e! e& $e!("o "e o"o (n p$oce!o 7(e

en gene$#& "# %n%c%o con #p#$%c%)n "e pc# 0#ce$%#n#B +o$/#"# po$

!#&%6# @ $e!o! #&%/en%c%o! 7(e !e #"%e$en # &o! "%ene!. Po$ o$o "oBen oc#!%one! pc# 0#ce$%#n# p(e"e "#$ #&%/en%c%o! en !%%o!

%n#cce!%0&e! #& cep%&&o "en#&B +o$/#n (n# +(ene %n+ecc%o!# 7(e %$$%#

enc'#B c#(!#n"o 7(e $e$oce"# @ epong# p#$e "e& "%ene 7(e

no$/#&/ene e! c(0%e$# @ e! /! !(!cep%0&e #& "e!g#!e. S% no !e

$## # %e/poB e& p$o0&e/# p(e"e e6o&(c%on#$ #!# %n+ec#$ e& "%ene @

&o! e-%"o! 7(e &o !o!%enen.



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L# !#&(" "en#& "epen"e p$ec%!#/ene "e e6%#$ e!e %po "e p$o0&e/#! @

p#$# e&&o e! nece!#$%o e& c(%"#"o !%!e/%co "e "en#"($#.

1.2.1). NI4ELES DE PRE4ENCION

E!o! co/p$en"en &o !%g(%eneF

1.2.1).1. Pro-ocin de " s"&d

A. E"(c#c%)n #ce$c# "e %g%ene 0(c#&F e! %/po$#ne p$opo$c%on#$ e!#

e"(c#c%)n en ! e!c(e!B con!(&o$%o!B c&'n%c#! @ og#$e!. Lo! 0%o!

"e0en +o$/#$!e "e!"e e/p$#n# e"#"B !o0$e o"o e& cep%&"o "e &o!

"%ene! @ 6%!# pe$%)"%c# #& o"on)&ogo.

=. A&%/en#c%)n #"ec(#"#F e! %n"%!pen!#0&e con e& #po$e co$$eco "e

6%#/%n# DB e& c#&c%o @ e& +o!+o$o.

C. D%e# pne#"#

D. E/ene! pe$%)"%co! !e&ec%6o!F e!o! "e0en e+ec(#$!e en e!co$e!

@ /(-e$e! e/0#$##"#!B 7(e con!%(@en g$(po! #/ene !(!cep%0&e!.

1.2.1).2. Proteccin esec#/ic

A. =(en# %g%ene 0(c#&

=. &(o$%#c%)n "e &o! #0#!ec%/%eno! p?0&%co! "e #g(#B !#& ( o$o!

#&%/eno!

C. Ap&%c#c%)n )p%c# "e +&(o$($o

D. Ec&(%$ #&%/eno! #/ene c#$%ogn%co! "e "%e#B !o0$e o"o en$e

Co/%"#!

Cep%&"o "e o! "%ene! "e!p(! "e %nge$%$ #&%/eno!



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. T$##/%eno "e &e!%one! %n!%p%ene!

G. T$##/%eno "e #$e! #/ene !(!cep%0&e!B pe$o no co/p&%c#"#!B con

!e&"o$e!.

. O"ono&og'# p$e6en%6#

1.2.1!. Di%nstico trt-iento oort&no

A. E#/en pe$%)"%co "e 0oc#. Lo! $#@o! #@("#n # "ee$/%n#c%)n

e/p$#n# "e c#$%e!.

=. E& $##/%eno %n/e"%#o e! /(@ %/po$#neB p#$# p$e6en%$ &e!%one!

!ec(n"#$%#!

C. Aenc%)n # &o! "e+eco! "e "e!#$$o&&o

D. E/ene! o0&%g#o$%o! # &o! e!co$e!

L%/%#c%)n "e %nc#p#c%"#"B p#$# e6%#$ "#:o! %$$e6e$!%0&e! e! con6en%eneF

A. T#p#$ p(&p#

=. T$##$ $#' @ e& c#n#&

C. Re!#($#$

D. E$#e$ e& "%ene en c#!o nece!#$%o

E. P$oecc%)n con$# +o$/#c%)n "e #0!ce!o!

1.2.1!.1. Rei"itcin

E& $ee/p#/%eno "e ! e!$(c($#! pe$"%"#! p(e"e #ce$!e /e"%#ne

p(ene! @ "en#"($#! po!%#! p#$# $e!#($#$ #$/on'# @ +(nc%)n "e

"en#"($#.

1.2.1!.2. Cei""do

[NOMBRE DEL AUTOR]6;


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E& cep%&"o "en#& e! (n 0%o co%"%#no en %g%ene "e (n# pe$!on#.

E! (n# #c%6%"#" nece!#$%# p#$# e&%/%n#c%)n "e pc# "en#&

$ec%on#"# #no con c#$%e! "en#& co/o con ! en+e$/e"#"e!

pe$%o"on#&e! g%ng%6%%! @ conoc%"# p%o$$e#. Ap#$e "e& cep%&"o

"en#& e%!en #/0%n o$o! /o"o! 7(e #@("#n # e&%/%n#$ pc#

0#ce$%#n# #&e! co/o !e"# "en#&B &o! cep%&&o! %ne$ p$o%/#&e! o !

&%/p%e#! p$o+e!%on#&e!B pe$o en e!e #$'c(&o 6#/o! # cen$#$no!

p$%nc%p#&/ene en ! cn%c#! "e cep%&"o "en#&. A!' p(e!B #0$e/o!

"e ! c#$#ce$'!%c#! @ %po! "e cep%&&o!B #!' co/o "e ! "%!%n#!

cn%c#! "e cep%&"oB %n"%c#n"o c(& "e o"#! $e!( /! e+%c# #no

p#$# #"(&o! co/o p#$# n%:o!.13

C#$#ce$'!%c#! "e &o! cep%&&o! "e "%ene!

L#! ce$"#! "e &o! cep%&&o! "en#&e! p(e"en !e$ n#($#&e! pe&o! "e ce$"o

o "e -#0#&' o !%n%c#! n@&on. En #c(#&%"#" $eco/en"#c%)n e!

(%&%#$ cep%&&o! "e ce$"#! !%n%c#! @ con (n g$#"o "e "($e# /e"%o o

0n"o.

Ac(#&/ene #@ (n# g$#n "%6e$!%"#" "e cep%&&o! @ "e0e/o! (%&%#$

!%e/p$e e& 7(e /! !e #"#pe # n(e!$#! nece!%"#"e!F

Cep%&&o con6enc%on#&F con 3 o 4 %$#! "e ce$"#!B e! e& 7(e (!#/o!

no$/#&/ene.

Cep%&&o pe$%o"on#&F #/0%n &/#"o !(&c($ o c$e6%c($B %ene "o! %$#!

"e ce$"#!. Se (%&%# en c#!o! "e %n+/#c%)n g%ng%6#& @ !($co!

pe$%o"on#&e! p$o+(n"o!. T#/0%n e! $eco/en"#0&e en n%:o! con

o$o"onc%# +%-#.

[NOMBRE DEL AUTOR]7


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Cep%&&o e&c$%coF %ene 3 %po! "e /o6%/%eno o$%on#&B #&e$n#"oB 6e$%c#&

#$7(e#"o o 6%0$#o$%o. P(e"en !e$ e!pec%#&/ene ?%&e! en pe$!on#!

"%!/%n(%"#! +'!%c#! o /en#&e!B "e0%"o # !%/p&%c%"#" "e ope$#c%)n

po$ e& p#c%ene o po$ 7(%en &e #@("e.

Cep%&&o! %ne$p$o%/#&e!F !on (n pen#co p#$# &o! e!p#c%o! %ne$"en#&e!.

E& %e/po "e 6%"# p$o/e"%o "e (n cep%&&o "en#& e! "e $e! /e!e!. S%n

e/0#$go e!o e! /(@ 6#$%#0&eB "e /#ne$# 7(e "e0e$e/o! c#/0%#$ e&

cep%&&o c(#n"o 6e#/o! 7(e ! ce$"#! e/p%e#n # "o0$!e #c%# &o!

"o!B @# 7(e e!o po"$'# "#:#$ ! enc'#!B #"e/! "e 7(e c(#n"o

oc($$e e!o e& cep%&&o p%e$"e !( +(nc%)n "e &%/p%e#.13

1.2.1!.*. 5rec&enci de cei""do

L# pc# 0#ce$%#n# 6(e&6e # e!#0&ece$!e !o0$e !(pe$+%c%e "en#& en

/eno! "e 24 o$#! $#! !( e&%/%n#c%)nB po$ &o 7(e &o! "%ene! "e0en

cep%&$!e #& /eno! (n# 6e #& "'#. Lo %"e#& e! 7(e !e $e#&%ce e& cep%&"o

"e!p(! "e c#"# co/%"#B #(n7(e !e $eco/%en"# 7(e e& cep%&"o /!

/%n(c%o!o !e $e#&%ce po$ noce #ne! "e %$ # c#/#. En &o! n%:o! #@

7(e %n!%!%$ /(co en %g%eneB @# 7(e e! e& pe$%o"o "($#ne e& c(#& !e

+o$/# "en%c%)nB #"e/! #@ 7(e "#$ /(c# %/po$#nc%# en e&

cep%&"o en &o! n%:o! po$#"o$e! "e #p#$#o&og'# o$o")nc%c#.19

1.2.1(. T?cnics de cei""do

1.2.1(.1. T?cnic de Bss8

1; ;($$&IJJ)sal"alia)!o#J?al"aliaJe+Ksal"aliaJvivirKsanoJo!J(igieneJo!

J!e&illao)($#



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E& cep%&&o !e co&oc# # 45 $e!peco "e& e-e /#@o$ "e& "%eneB ! ce$"#! !e

p$e!%on#n &%ge$#/ene !o0$e enc'# @ en on# %ne$p$o%/#& on#

7(e e! en$e /e"%o "e &o! "%ene!.

E& cep%&&o !e /(e6e en +o$/# o$%on#& "e %7(%e$"# # "e$ec#B en

on# "e &o! "%ene! #ne$%o$e!B o "e #$! #c%# "ene en on# "e &o!

/o$e!B "($#ne 1; # 15 !eg(n"o! 1; 6ece! en e& /%!/o &(g#$B p#$#

"e!o$g#n%#$ pc# 0#ce$%#n#. E!o !e $ep%e en ! c#$#! %ne$n#! "e

o"o! &o! "%ene! po!e$%o$e!.

E& /#ngo "e0e /#nene$!e p#$#&e&o @ o$%on#& #& #$co "en#$%o. P#$#

! c#$#! %ne$n#! "e %nc%!%6o! @ c#n%no! !(pe$%o$e! e %n+e$%o$e!B e& cep%&&o

!e !o!%ene 6e$%c#&/eneB @ ! ce$"#! "e& /%!/o !e %n!e$#n en e&

e!p#c%o en$e "e &o! "%ene!. En e!e c#!o &o! /o6%/%eno! 6%0$#o$%o! !e

#cen "e #$$%0# #c%# #0#-oB en e& /#%$ !(pe$%o$B @ "e #0#-o #c%#

#$$%0# en e& /#%$ %n+e$%o$.

P#$# ! c#$#! oc&(!#&e! p#$e "e &o! "%ene! po!e$%o$e! con 7(e !e

/#!%c#n &o! #&%/eno!B !e $eco/%en"#n /o6%/%eno! "e 0#$$%"o co$o!

en !en%"o #ne$opo!e$%o$. E!# cn%c# !e $eco/%en"# en p#c%ene! con

%n+/#c%)n g%ng%6#& @ !($co! pe$%o"on#&e! p$o+(n"o!.

1.2.1(.2. T?cnic Hori;ont"8

L#! ce$"#! "e& cep%&&o !e co&oc#n # 9; con $e!peco #& e-e /#@o$ "e&

"%ene @ e& cep%&&o !e /(e6e "e #$! #c%# "ene co/o en e& 0#$$%"o.

E!# cn%c# !e $eco/%en"# p#$# n%:o! pe7(e:o! o con "%+%c("e!

/o$%ce!.15

1.2.1(.*. T?cnic de Sti""-n Modi/icd8



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L#! ce$"#! !e co&oc#n # 45 $e!peco "e $#' "e &o! "%ene! !o0$e

on# "e enc'#B en (n# po!%c%)n !%/%$ #& /o"o $o#o$%oB

"e!c#n!#n"o p#$c%#&/ene en enc'#. E& cep%&&o !e !%?# en +o$/#

o$%on#& con (n /o6%/%eno g$#"(#& #c%# on# oc&(!#& e! "ec%$ e&

0o$"e "e &o! "%ene! #ne$%o$e! o on# "e /#!%c#c%)n "e &o!

po!e$%o$e!.E! "ec%$ 7(e !e #ce (n 0#$$%"o "e!"e enc'# #c%# e&

"%ene.

De e!# /#ne$# !e &%/p%# on# %ne$p$o%/#& @ !e /#!#-e# e& e-%"o

g%ng%6#&. 15

1.2.1(.). T?cnic de Crters8

E& cep%&&o !e co&oc# # 45 $e!peco "e& e-e /#@o$ "e& "%ene @ ! ce$"#!

"e& cep%&&o !e "%$%gen #c%# !(pe$+%c%e /#!%c#o$%# "e &o! "%ene!. L#!

ce$"#! !e +(e$#n p#$# 7(e pene$en en e& e!p#c%o 7(e e! en$e &o!

"%ene! con (n &%ge$o /o6%/%eno $o#o$%o "e!"e on# "e /#!%c#c%)n

#c%# enc'#.

Lo! "o! "e ! ce$"#! con#c#n con e& /#$gen "e enc'# p$o"(c%en"o

(n /#!#-e 7(e !e $ep%e en c#"# "%ene. L#! !(pe$+%c%e! /#!%c#o$%#! !e

&%/p%#n con (n /o6%/%eno $o#o$%o &%ge$oB +o$n"o! #c%# &o! !($co! @

+%!($#!. En c#$# %ne$n# "e &o! "%ene! #ne$%o$e! e& cep%&&o !e co&oc#

6e$%c#&/ene @ $#0#-#n !o&o ! ce$"#! "e p(n#.

E!# cn%c# e! e+%c# c(#n"o #@ #pn#/%eno "e ! p#p%!

%ne$"en#$%#! c(#n"o on# "e enc'# 7(e !e enc(en$# en$e "%ene @

"%ene e! /! pn#B "e-#n"o (n e!p#c%o en$e e&&o!B @# 7(e pe$/%e

pene$#c%)n "e ! ce$"#!.



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KCon (n en$en#/%eno #"ec(#"oB c(#&7(%e$ cn%c# p(e"e $e!($

e+%c#.

1.2.1(.!. T?cnics reco-endds en nios8

#@ (n# en"enc%# # en!e:#$ e& /o"o $o#o$%o po$7(e +(e e& /!

"%+(n"%"o #ne! "e #p#$%c%)n "e& cep%&&o /(&%pen#co. S#$>e@

$eco/%en"# 7(e &o! p#"$e! cep%&&en &o! "%ene! "e& n%:o #!# 7(e e!e

"e/(e!$e #0%&%"#" p#$# #ce$&o !o&o en$e 9 @ 1; #:o!.

D($#c%)n "e& cep%&"oF T$e! /%n(o! e! p$o0#0&e/ene e& %e/po /'n%/o

nece!#$%o p#$# c(0$%$ o"#! ! on#! 7(e nece!%#n !e$ &%/p%#"#! con

c#n%"#" "e /o6%/%eno! #"ec(#"o!.2;

1.2.1. Cei""do de " "en%&

E& cep%&"o "e &eng(# e! e& /! %/po$#neB @# 7(e e! /#&o no cep%&$!e

&eng(#B &eng(# !e cep%& p#$# no c#(!#$ en+e$/e"#"e!B $o($#B /#nc#!

ec. E& cep%&"o "e &eng(# e! "e !%g(%ene +o$/#F

De #$$%0# # #0#-oB "e!"e #$! #!# "on"e &&eg(e! #!# "on"e e$/%n#B

#!# &og$#$ 15 6ece! /%/o.

1.2.1$. Pst dent"

Den$o "e (n# /%!/# /#$c# e! po!%0&e encon$#$ %po! /(@ "%6e$!o! "e

p#!#! "en#&e! 7(e p(e"en "%+e$%$ "e /#ne$# !(!#nc%#& "epen"%en"o "e !(!

co/ponene!. Se p(e"en %"en%+%c#$ en ! e%7(e#! &o! %ng$e"%ene!

p$e!ene! en e& p$o"(coB p#$# &o c(#& &e /enc%on#/o! #&g(n#! "e !(!

p$op%e"#"e!F

2< < ($$&IJJor$oon!iasal")!o#)arJ2


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Agene! &%/p%#"o$e!. Gene$#&/ene o"o! &o! p$o"(co! %nc&(@en co/p(e!o!

"ee$gene! 7(e pene$#n @ #+&o-#n &o! "ep)!%o! "e !(pe$+%c%e "e& "%eneB

+#6o$ec%en"o !( e&%/%n#c%)n e& /! co/?n e! e& ($%& !(&+#o "e !o"%o.

Agene! 7(e p$e6%enen c#$%e!. L# o"ono&og'# p$e6en%6# con!%"e$#

e!enc%#& (%&%#c%)n "e& +&?o$ "e0%"o # 7(e # "e/o!$#"o p$oege$ con$#

c#$%e!B #"e/! "e $e/%ne$#&%#$ ! &e!%one! (n# 6e 7(e "%co /#& #

#p#$ec%"o.

L# /#@o$'# "e ! p#!#! "en#&e! &o %nc&(@en. D#"o 7(e e& +&?o$ "e0e !e$

#"/%n%!$#"o en c#n%"#"e! &%/%#"#! p#$# e6%#$ e+eco! neg#%6o!B co/o

+&(o$o!%! "en#& no$/# #c(#& e%ge 7(e concen$#c%)n "e Re6%!# "e&

Con!(/%"o$ No. 311B Ene$o 2;;3 +&?o$ en (n# p#!# "en#& no ece"# "e& ;.2

po$ c%eno. #@ e!("%o! 7(e !(g%e$en &%/%#$ e& conen%"o "e +&?o$ en

p$o"(co! p#$# n%:o! /eno$e! "e !e%! #:o! # (n /%/o "e ;.;5 po$ c%enoB

o 0%enB !e:#n 7(e ! p#!#! con /#@o$ conen%"o "e +&?o$ "e0en e/p&e#$!e

en c#n%"#"e! pe7(e:#! "e& #/#:o "e (n# go# @ 0#-o !(pe$6%!%)n "e (n

#"(&o.

Agene! 7(e p$e6%enen e& !#$$o. Lo! /! co/?n/ene e/p&e#"o! !on &o!

p%$o+o!+#o!B 7(e %ne$+%e$en 7('/%c#/ene con$# +o$/#c%)n "e& !#$$o @#

7(e 0&o7(e#n &o! !%%o! $ecepo$e! "e ! !#&e!B $e!pon!#0&e! "e e!e p$oce!o.

Agene! #n%pc# 0#ce$%#n#. L# pc# "eno0#ce$%#n# e! (n# pe&'c(%nco&o$# @ peg#-o!# 7(e !e +o$/# con!#ne/ene !o0$e &o! "%ene! @ e!

c#(!# p$%nc%p#& "e en+e$/e"#"e! "e ! enc'#!B 7(e p(e"en oc#!%on#$ %nc&(!o

p$"%"# "e &o! "%ene!. Po$ e&&o e! "e !(/# %/po$#nc%# $e/oc%)n

con!#ne "e e!# pe&'c(.

En$e &o! #gene! 7('/%co! co/e$c%#&e! #n%pc# e! e& $%c&o!nB

#n%0#ce$%#no e+ec%6o con$# (n# g$#n 6#$%e"#" "e 0#ce$%#!.



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Agene! "e!en!%0%&%#ne!. L# %pe$!en!%0%&%"#" p(e"e p$e!en#$!e en !%%o!

?n%co! o /?&%p&e!. Se $ec%on# con p$o0&e/#! co/o #&g(n# +$#c($# "en#&B

n(e6#! c#$%e!B $ec($$enc%#! "e ! /%!/#! o /%g$#c%)n "e enc'#B 7(e "e-#

#& "e!c(0%e$o on#! !en!%0&e!.

P#$# $##$ %pe$!en!%0%&%"#" &o! "en'+$%co! p(e"en %nc&(%$ n%$#o "e po#!%oB

c%$#o "e !o"%o @o c&o$($o "e e!$onc%o. P#$# e& (!o p$o&ong#"o "e e!o!

p$o"(co! e! #con!e-#0&e !(pe$6%!%)n "e (n "en%!#.

Agene! p(&%"o$e! o 0n7(e#"o$e!. Lo! p(&%"o$e! !e (%&%#n p#$# e&%/%n#$

/#nc#!B !%en"o &o! /! +$ec(ene/ene (!#"o! !'&%ceB )%"o "e #&(/%n%oB

c#$0on#o "e c#&c%o @ +o!+#o! "e c#&c%oB en$e o$o!. %&e! p#$# "en#"($#!

/(@ p%g/en#"#! @ no "e0en e/p&e#$!e c(#n"o #@ on#! !en!%0&e!

ep(e!#!. E& 0%c#$0on#o "e !o"%o #/0%n p(e"e #c(#$ co/o (n #0$#!%6o

&e6e !% !e &e (%&%# en !(+%c%ene concen$#c%)n.

O$o! %ng$e"%ene!. Se %nc&(@en #gene! !#0o$%#ne! co/o /en#B

%e$0#0(en# @ o$o! e"(&co$#ne! #$%+%c%#&e! #/0%n e%!en #gene!

(/ec#ne! 7(e p$e6%enen p$"%"# "e #g(# en p#!# @ #gene! 7(e &e

"#n c(e$po #& p$o"(coB e6%#n"o !ep#$#c%)n "e !(! co/ponene!.

1.2.1F. C"ore+idin

E!# e! (n# "e &o! #gene! 7('/%co! /! e+%c#ce! p#$# co/0#%$ pc#

"eno0#ce$%#n#. S( 6en#-#B en $ec%)n con o$o! #n%!p%co!B con!%!e en

+%-#$!e # /(co!# o$#& "e0%"o # !( +(e$e c#$g# po!%%6# @ &%0e$#$!e poco #

poco en e& $#n!c($!o "e ! !%g(%ene! , # 12 o$#! e!# p$op%e"#" !e &/#

!(!#n%6%"#".



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58/76

E& %&o "e0e !e$ co$$%"o "e!p(! "e !e$ p#!#"o po$ (n e!p#c%o

%ne$p$o%/#& p#$# &%/p%#$ con (n n(e6o %&o c#"# e!p#c%o n(e6o.21

CAPITULO II8

CASO CLINICO

21 @.NN, ?yney B) =1;:7> oon$ologa &ei4$ri!a, Ei$orial Pana#eri!ana)

B"enos Aires &)&) 81-



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II. CASO CLINICO

2.1 Histori C"#nic

[NOMBRE DEL AUTOR]7;


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61/76


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64/76



65/76

2.2 Di%nostico Pres&nti'o

De !#&(" gene$#&F

En #p#$ene 0(en e!#"o gene$#&B &(c%"# o$%en#"# en %e/poB e!p#c%o @ pe$!on#.

De !#&(" e!o/#o&)g%coF

1. Te-%"o! 0n"o!F

P$e!enc%# "e +%!( "e p%e# 8.5.

2. Te-%"o! "($o!F

P$e!enc%# "e c#$%e! en e!/#&e "e p%e#! 5.1B 5.1 @ *.1.

P$e!enc%# "e c#$%e! en "en%n# en p%e#! 5.5B 5.4B *.4B *.5B 8.3 @ ,.4.

P(&p%%! %$$e6e$!%0&e en p%e#! ,.5 @ 8.5.

3. Oc&(!%)nFE!c#&)n "e$eco /e!%#&.E!c#&)n %7(%e$"o /e!%#&.

4. Con"(c#FPo!%%6#.5. R%e!go @o #c%6%"#" "e c#$%e!FR%e!go #&o con #c%6%"#" "e c#$%e!.

2.* E+,-enes Co-"e-entrios

2.*.1 An,"isis ie; or ie;

PIEJ

A

DESCRIPCION PIEJ

A

DESCRIPCION



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2.*.* An,"isis de rdio%r/#s eriic"es


FOTOGRAFIA ARCADA

INFERIOR

@or#a e ar!oI Para+*li!o) Ta#aoI Meiano) Ti&oI Alineao) PisoI Meiano)

FOTOGRAFIA DE

FRENTE EN MAXIMA

INTERCUSPIDACION

Over+i$eI 1 ## Over%e$I 2)7 Linea #eiaI

FOTOGRAFIA LATERAL

DERECHA

RMDI Mesial RDI Mesial

FOTOGRAFIA LATERAL

IZQUIERDA

RM.I Mesial R.I Mesial Al$era!ionesI

Presen!ia e 3s$"la a


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R#"%og$#+'# pe$%#p%c#& "e p#. ,.5

Ine$p$e#c%)n $#"%og$+%c#F

L# po$c%)n co$on#$%# !e o0!e$6# "e 0o$"e! %$$eg($e! con %/#gen $#"%o&?c%"#

co$$e!pon"%ene # &e!%)n c#$%o!# 7(e co/p$o/ee c(e$no p(&p#$ "%!#&.

L# po$c%)n $#"%c($ en e& e$c%o !(pe$%o$ @ /e"%o !e o0!e$6# "e 0o$"e!

$eg($e!B e& e$c%o #p%c#& !e o0!e$6# $e#0!o$c%)n )!e# po$ p$e!enc%# "e p%e#

4.5 en "e!#$$o&&o.

C$e!#! #&6eo$e! pn#! po$ "e!g#!e +%!%o&)g%coB &%g#/eno #&6eo$ "e

g$o!o$ (n%+o$/eB (e!o #&6eo$ e!pon-o!o (n%+o$/e.

R#"%og$#+'# pe$%#p%c#& "e p#. 8.5

Ine$p$e#c%)n $#"%og$+%c#F

L# po$c%)n co$on#$%# !e o0!e$6# "e 0o$"e! %$$eg($e! con p$e!enc%# "e

%/#gen $#"%o&?c%"# co$$e!pon"%ene # &e!%)n c#$%o!# 7(e co/p$o/ee

c/#$# p(&p#$.



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CAPITULO III8

DISCUSION0

CONCLUSIONES RECOMENDACIONES

[NOMBRE DEL AUTOR]9


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III. DISCUSION0 CONCLUSIONES RECOMENDACIONES

*.1 Disc&sin

L# c#$%e! "en#& #+ec# # (n g$#n po$cen#-e "e po0c%)nB /! "e& 5; "e

po0c%)n n%:o! /eno$e! "e 5 #:o! "e e"#"B ?n%c# po!%0%&%"#" "e po"e$ /#nene$

!#&(" 0(c#& e! p$e6en%$ en+e$/e"#" "e /#ne$# p$ecoB e& /#@o$ 0ene+%c%o "e

e!oB e! ene$ opo$(n%"#" "e %ne$cep#$ o /o"%+%c#$ p#$one! "e con"(c# 7(e

p(e"e $e!($ "#:%no!B e! po$ e!o 7(e !% "e0e$'# # &o! n%:o! "e ; # 5 #:o! "e e"#"

co/o (n g$(po p$%o$%#$%oB @# 7(e &o! c(%"#"o! 7(e !e o0eng#n "($#ne e!# e#p#B

p(e"en /o"%+%c#$ !#&(" 0(co"en#& "e &o! n%:o! en e& +(($o.

E!("%o! 7(e p$o+(n"%cen en e!e e/# po"$'#n "ee$/%n#$ (n p#$)n 0#!e @ #!' po"e$

c$e#$ p$og$#/#! "e p$o/oc%)n "e !#&(" 0(co"en#& "on"e !e %nc&(@# o$%en#c%)n # &o!

p#"$e! "e +#/%&%# @ #enc%)n 0(c#& p$%/#$%# p#$# &o! n%:o!.

E! nece!#$%# %/p&e/en#c%)n "e po&'%c#! "e !#&(" enc#/%n#"#! # $e"(c%$ o e&%/%n#$

e& p$o0&e/# p#$# /e-o$#$ !#&(" o$#& "e po0c%)n %n+#n%& en e& e!#"o. T#/0%n !e

"e0e c$e#$ p$og$#/#! "e p$o/oc%)n p#$# !#&(" o$#& #p&%c#"o! "e +o$/# p$e6en%6#

"($#ne e& e/0#$#o @ en &o! p$%/e$o! /e!e! "e 6%"# p(e"en $e"(c%$ %nc%"enc%# "e

c#$%e! "en#& en &o! n%:o!.



72/76

*.2 Conc"&sin

De #c(e$"o # &o o0!e$6#"o en e& p$e!ene c#!o c&'n%co @ # &o! $e!("o! 7(e !e

o0(6%e$on "($#ne $e#&%#c%)n e! 7(e conc&(@o &o !%g(%eneF

L# p$e6#&enc%# "e c#$%e! en n%:# 7(e #!%!%e$on # C&'n%c# O"ono&)g%c#

"e #c(" "e O"ono&og'# "e Un%6e$!%"#" o! C#$&o! M#$%eg(% "e

Mo7(eg(#B e! # @# 7(e "e (n o#& "e 2; p%e#! "en#$%#! "ec%"(#!

p$e!ene! en c#6%"#" 0(c#&B e%!e (n# p$e6#&enc%# "e c#$%e! "e& ,8B

e! "ec%$ p%e#! "en#&e! p$e!en#n p#o&og'# c#$%o!# @ !o&o %enen

#(!enc%# "e /%!/#. De+%n%%6#/ene coo$#c%)n "e &o! p#"$e! e! %n"%!pen!#0&e p#$# e&

%o "e& $##/%eno o"ono&)g%coB @# 7(e "e no !e$ e&&o! !en!%0%&%#"o!

p$e6%#/ene no (0%e$#n enen"%"o %/po$#nc%# "e "en%c%)n "ec%"(#. L(ego "e e$/%n#"o e& p$oce!o "e $e#0%&%#c%)n o$#& en p#c%ene! n%:o! e!

nece!#$%o en!e:#n# "e (n# co$$eco cep%&"o "en#& #!' co/o (n#

"%e# no c#$%ogn%c#B p#$# c$e#$ (n #0%o 7(e pe$/%# /#nene$ !( !#&("

0(c#&



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*.* Reco-endciones

Conc%en%#$ # po0c%)n 7(e &o! 0%o! "e %g%ene 0(c#& "e& !e$

(/#no !on "e g$#n %n+&(enc%# en !#&(" o en+e$/e"#" "e c#"# (no. Eo$#$ &o! %n6e!%g#"o$e! # 7(e !e !%g#n $e#&%#n"o e!("%o! @# 7(e !on

(n 0(en /o"o p#$# !#0e$ p$e6#&enc%# "e c#$%e! en po0c%)n %n+#n%& A &o! n%:o! !e &e! "e0e %nc(&c#$ e& 0%o "e &%/p%e#B no !o&o po$ &o!

p#"$e! !% no po$ e& o"on)&ogo o en !(! cen$o! "e !#&(" /! ce$c#no!B

en%en"o en c(en# 7(e no !o&o e& (!o "e& cep%&&o "en#& !% no #/0%n e&

(!o "e o$o! /o"o! #(%&%#$e! "e %g%ene 0(c#&. Ac("%$ #& o"on)&ogo #& /eno! "o! 6ece! #& #:o.



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75/76

11. Mc Don#&" R#&pB #6e$@ "#6%"e 199;. O"ono&og'# pe"%$%c# "e& #"o&e!cene.

E"%o$%#& /e"%c# p#n#/e$%c#n# M#$ce&o . "e #&6#$ 21450(eno! #%$e!B =ogo

c#$#c#!M#"$%"Y!#o P#(&oB ,31 p.p.

12. pFHHH.H%>%pe"%#.o$g.

13.pFHHH.(#no+.!e/"#c#$%e!"en#&./

14. R(% Re@n#&"o "e %g(e%$e!o #&e$B Anon%o ee&&eB M@#>% ISSAO. O"ono&og'#

p#$# & 0e0e

15. e$n#n"o E!co0#$ M(:o. O"ono&og'# Pe"%$%c# p.p. 1;,118

1*. =ARRANCOS MONEJB Ope$#o$%# Den#&B Te$ce$# e"%c%)nB e"%o$%#& /"%c#

p#n#/e$%c#n#.

18. ATWB SIMON. 2;;2 O"ono&og'# p$e6en%6# en #cc%)n 3 e"%c%)n. E"%o$%#&

M"%c# P#n#/e$%c#n# Me%coB D..

1,. pFo"oen!#&(".co/2;1;;9!co/p&%c#c%one!"e!c#$%e!

19. pFHHH.!#&("#&%#.co/S#&("#&%#He0Y!#&("#&%#6%6%$Y!#no"oc%g%ene"occe

p%&"o./

2;. pFo$o"onc%#!#&(".co/.#$2;;8;5ecn%c#!"ecep%&"o

21. INNB S@"ne@ =. 19,5 o"ono&og'# pe"%$%c#B E"%o$%#& P#n#/e$%c#n#. =(eno!

A%$e! p.p. *13



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