Special Care in Dentistry最新文献

Objective: This systematic review aimed to verify if individuals with thalassemia present changes in radiomorphometric indices and fractal analysis that can be accessed using panoramic radiographs.

Material and methods: Observational studies that evaluated cortical and trabecular bone patterns in dental routine radiographs were selected from six bibliographic databases. Risk of bias was analyzed using the Joanna Briggs Institute Critical Appraisal Checklists. Quality of evidence was verified using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results: Two hundred three studies were initially retrieved from databases. Three cross-sectional studies, encompassing a total of 129 thalassemic patients, were deemed eligible after applying the inclusion criteria. Bone mineral density (BMD) evaluations were performed using panoramic radiographs and considered the following radiomorphometric indexes: mandibular cortical index (MCI), mandibular cortical width (MCW), panoramic mandibular index (PMI). Fractal dimension analysis (FDA) and simple visual estimation (SVE) were also employed. Overall, FDA and MCW from thalassemia individuals were lower than controls.

Conclusion: FDA and MCW are frequently altered in patients with thalassemia and may be employed as screening tools for reduced BMD. However, the certainty of evidence for this outcome was very low, mainly due to methodological flaws.

Aims: To assess and compare the effectiveness of pharmacological and cognitive-behavioral modalities-behavioral methods (BM), nitrous oxide inhalation sedation (NOIS), and premedication with Diazepam-for alleviating anxiety during dental treatment, using completed treatment sessions and adverse outcomes as indicators.

Methods and results: For 239 patients (515 dental records), 18-53 y/o, who underwent dental treatments under anxiety reduction measures, sessions under NOIS were categorized as "nitrous group" (456 sessions) versus premedication with Diazepam or behavioral strategies (control, 59 sessions). Outcomes were completed treatment sessions considering demographic and clinical parameters, and adverse outcomes during and between sessions. Adjusted logistic regression showed significantly higher odds of completing treatment sessions after NOIS (p = 0.014) as compared to controls. Univariate analyses demonstrated failure of anesthesia was higher in the control versus the nitrous group (p < 0.001). Adverse outcomes were more frequent in controls (p = 0.005). No significant effects of age, gender, and general health condition on completion rates of treatment plans were demonstrated. The complexity of the treatment plan had a significant effect on its completion (p = 0.03).

Conclusions: NOIS modality yielded significantly superior outcomes as compared to BM and premedication with Diazepam, with no significant effects of age or gender on the completion of treatment plans.

Renal tubular acidosis (RTA) is a group of disorders in which there is an alteration in acid-base homeostasis because of the impairment of nephrons to excrete hydrogen ions or reabsorb bicarbonate ions, resulting in chronic metabolic acidosis. RTA is an important cause of rickets, particularly 'resistant rickets'. Dental manifestations frequently reported in patients with RTA include enamel hypoplasia and amelogenesis imperfecta, affecting permanent dentition. To the best of our knowledge, the literature pertaining to the dental manifestations in RTA with secondary rickets is scarce. This case highlights oral manifestations in a 6-year-old girl with RTA, distal, four with haemolytic anaemia a rare form diagnosed on genetic testing, and refractory rickets having multiple missing teeth and enamel hypo-mineralisation. The radiograph revealed alveolar bone loss in both jaws with widened pulp chambers and root canals in primary teeth. Pre-eruptive enamel breakdown in multiple unerupted permanent teeth was also evident radiographically.

Aims: Dental anxiety (DA) is reported among the general population, including individuals with learning disabilities (LDs). In many studies, nonpharmacological interventions have been applied to significantly improve DA among patients. This study aimed to examine publication trends and patterns in both populations to identify the current research trends and literature gaps.

Methods: A descriptive analysis of bibliographic data and network visualization were conducted using Microsoft Excel and VosViewer, focusing on literature published in the Scopus database between 1994 and 2023 and using "title" as the search field.

Results: For the study period, the following were identified: 1429 authors, 5858 total citations, and an h-index of 36. From a total of 2058 publications discovered, 363 publications were included in the study. Of these, only 11 articles addressed nonpharmacological management for people with LDs. In terms of the research country, the United Kingdom was the leading contributor, with 56 publications. Ad de Jongh was the most productive author, with 13 publications and 447 citations. The most highly cited paper was Lehrner et al. (2005), with 312 citations.

Conclusion: This study determined the number of publications related to nonpharmacological management of DA over three decades. The number of studies involving people with LDs was lower than that involving the general population, suggesting future research should occur in this area.

Purpose: To access and synthesize the existing literature about the effects of compassionate care on oral health outcomes.

Methods: A scoping review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify articles from six electronic databases: MEDLINE via the PubMed interface, Embase, Age-Line, Scopus, CINAHL, and Cochrane.

Results: Among 30 studies reporting on compassion in dental treatment, only two reported on the effects of compassionate care on oral health outcomes. One study is cross-sectional and evaluated oral health outcomes in children, while the other is a cohort study evaluating oral health outcomes in older adults. Each study used different tools to assess oral health outcomes. However, both studies used the Jefferson Scale of Physician Empathy (JSPE) to assess empathy among dental students, dentists, or dental hygienists.

Conclusion: The retrieved studies used different methodologies and had discrepant results. More clinical studies investigating the effects of compassionate care on the outcomes of dental treatment are necessary.

Objective: Over 1.1 million people in the Netherlands have a mild intellectual disability (MID). This population also exhibits a higher prevalence of poor oral health. The present study aims to investigate the oral health status and oral health-related beliefs of young adults with MID and co-occurring challenges like mental health issues.

Material and methods: A questionnaire was administered to 76 individuals in residential care facilities of the Salvation Army in Amsterdam, accompanied by intraoral examinations. The study group comprised young adults (ages 18-29; mean 21.7 ± 2.5 years). Data were compared with a reference group of Dutch young adults of low socioeconomic position.

Results: No significant difference was found between the participants (4.8 ± 4.3) and the reference group (4.6; t(73) = 0.45, p > 0.05) mean DMFS scores. The average Locus of Control score (M = 23.6; scale 10-50) indicated no relationship between oral health beliefs and actual oral health status. Adjusting for whether participants had their own dentist, a weak negative correlation was observed between DMFS score and LOC (n = 30, r = -0.25, p = 0.04). The restorative care index was significantly lower in participants (33%) compared to the reference group (76%; Z = -5.72, p < 0.001).

Conclusion: These findings highlight the critical need for enhanced professional oral healthcare for young adults with MID, given their compromised oral hygiene and treatment backlog. A flexible, tailored approach is essential to meet the treatment needs of this population.

Aims: People with disabilities (PWD) often face more significant oral healthcare needs than the general population. This study, conducted in response to the urgent and pressing need for improved dental care for PWD, aims to assess the infrastructural and work process flow of dental centers in Delhi that provide specialized dental care for PWD.

Methods and results: A descriptive cross-sectional study was conducted across primary, secondary, and tertiary healthcare centers in Delhi, evaluating their infrastructure adaptations and work processes in delivering oral healthcare to PWD. The findings, which highlight the disparities in adaptations and work processes among different healthcare centers, are crucial for understanding the current state of oral healthcare for PWD in Delhi. The study reveals that while secondary and tertiary healthcare centers exhibit better adaptations for PWD than primary centers, challenges persist with insufficient accessibility and smooth functioning of the work process.

Conclusion: This study underscores the need for dentists to be equipped with the competence to address the unique needs of PWD. It also highlights the significant potential for improvement in oral healthcare for PWD, as dentists should become more aware of the importance of designing clinics that are accessible for PWD.

Introduction: As of 2020, about 21% of adults in the United States have a diagnosable mental health disorder, excluding substance use and developmental disorders. Depression, predicted by the WHO to be the leading cause of disease burden by 2030, is linked to various systemic conditions and has been associated with poor oral health. Both behavioral factors, like poor dental hygiene and irregular visits, and biological mechanisms, such as changes in salivary immunity, contribute to this connection, which impacts overall well-being and quality of life. This systematic review aims include: (1) Does tooth loss affect depression? (2) Does oral pain, such as that experienced during chewing and speaking, impact depression? (3) Does oral functionality, including chewing and speaking, influence depression? (4) Does overall oral health affect depression?

Methods: We conducted a systematic search of PubMed, EBSCO host, Medline, and Google Scholar databases from January 2000 to June 2024 using relevant keywords. Studies examining the impact of oral health parameters (tooth loss, oral pain, oral functionality, overall oral health) on depression were included. Articles were included if (1) full text manuscripts in English were available, (2) the study described the association of oral health and depression, and (3) the independent value was an oral related factor and the dependent value was depression. The following were excluded from our analysis: (1) any articles where oral factors were not the independent value, (2) systematic reviews, (3) case reports, and (4) duplicate studies among our databases. Thirty-one studies met the inclusion criteria.

Results: Tooth loss, oral pain, and impaired oral functionality were consistently associated with increased depressive symptoms across the included studies. Greater tooth loss was linked to higher odds of both onset and progression of depression. Oral pain exacerbated depressive symptoms, while difficulties in chewing or speaking were associated with elevated risks of depression.

Conclusion: There is a bidirectional relationship between oral health and depression, highlighting the urgent need for comprehensive public health initiatives. Integrating oral health assessments into routine medical care, and developing targeted interventions are crucial steps to mitigate the impact of poor oral health on mental health outcomes.