Special Care in Dentistry最新文献

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by obesity, hypotonia, intellectual disability, and behavioral disturbances that complicate dental management. Parafunctional habits such as bruxism often lead to severe tooth wear, while cooperation and anesthesia represent additional challenges. A 34-year-old woman with genetically confirmed PWS presented with generalized dental wear, poor oral hygiene, and multiple carious lesions. Preventive and splint therapies were initially proposed but not feasible. Two years later, she returned with pain due to pulp exposure. Because of limited cooperation and comorbidities, dental treatment under general anesthesia was planned in two sessions, including molar extractions and multiple root canal treatments. Complete acrylic dentures with metal reinforcement were fabricated, restoring vertical dimension, improving esthetics, and serving as protective splints. Caregivers were instructed on hygiene, and annual follow-up was established. After six years, bone atrophy and further wear were noted, but the patient continued using relined prostheses without sedation. This case demonstrates that a resolutive, interdisciplinary approach can successfully manage complex dental problems in PWS. General anesthesia minimized the number of interventions while ensuring comprehensive care. Reinforced acrylic dentures provided a functional, aesthetic, and cost-effective solution, despite the progressive nature of dental wear and bone loss.

Objectives: Hypomineralized Second Primary Molars (HSPM) are qualitative enamel defects that typically involve one to four second primary molars. Although widely investigated, their etiology remains unclear. This review synthesizes current evidence on potential etiological factors.

Materials and methods: The design of this systematic review complied with the 2020 PRISMA guidelines. The research was conducted using five databases. Study quality and bias were assessed using the Newcastle-Ottawa Scale.

Results: Nine articles met the inclusion criteria, underscoring the limited evidence base. Prenatal factors were most frequently associated with HSPM, particularly epigenetic markers in blood (DNA hypermethylation and hypomethylation, p < 0.05), maternal smoking (p = 0.001), and maternal illness (p < 0.001). Though effect sizes varied, and methodological heterogeneity limited comparability. Perinatal factors such as preterm birth (p = 0.024) and delivery complications (p = 0.032) were also reported, but evidence was less robust and often confounded by small sample sizes. Postnatal factors, including recurrent childhood illnesses (asthma, otitis media, episodes of fever, and eczema) were significantly linked to HSPM, yet causality remains uncertain given the dependence on retrospective designs and parent-reported data.

Conclusions: Current evidence suggests that HSPM is likely multifactorial with contributions from prenatal, perinatal, and postnatal exposures. However, the overall level of evidence is moderate, constrained by small study numbers, variable quality, low response rate, and the retrospective nature of the studies. Stronger conclusions will require large-scale, prospective studies with standardized diagnostic criteria and rigorous control of bias.

Aim and background: Addressing oral hygiene in children with autism remains a critical concern for dental professionals and caregivers. These challenges make routine toothbrushing difficult and increase the risk of oral health problems. Recognizing the urgent need for practical solutions, this investigation was undertaken to evaluate three structured toothbrushing teaching interventions and their effectiveness among autistic children.

Materials and methods: This study evaluated the effectiveness of three instructional methods-visual posters, video demonstrations, and caregiver modeling to improve oral hygiene in autistic children aged 7-15 years. Sixty participants were randomly divided into three groups. Toothbrushing skills, cooperation (Frankl Scale), and oral hygiene (OHI-S) were assessed over 3 months.

Results: All groups showed significant improvement. Parent Modeling (15.55 ± 1.23) was highly superior to both Video and Poster groups (p < 0.001). A statistically significant difference (p = 0.024) was also found favoring the Video (12.80 ± 1.20) over the Poster (10.75 ± 2.49) group.

Conclusion: Caregiver modeling was the most effective method for teaching toothbrushing to children with ASD, promoting better outcomes in both oral hygiene and behavioural cooperation.

Trial registration: CTRI/2025/03/083547.

Introduction: Transgender individuals are disproportionately affected by temporomandibular disorders (TMDs), often compounded by psychosocial stressors and limited access to affirming healthcare. Conventional TMD treatments may fall short in addressing the emotional and behavioral components of chronic orofacial pain, underscoring the need for integrative interventions. This study aimed to explore the implementation and perceived impact of a Mindfulness-Based Orofacial Pain Education Program as a complementary approach for transgender individuals with TMD.

Methods: A qualitative design was employed, using weekly instructor reports and a post-intervention focus group with transgender participants (ages 24-39), each diagnosed with TMD according to the DC/TMD criteria. Over eight weeks, participants attended weekly 60-min sessions incorporating mindfulness practices, pain education, and self-management strategies. Data sources included 8 weekly instructor audio reports (n = 32 recordings) and one focus group interview (duration: 68 min). All transcriptions were analyzed using Thematic Network Analysis supported by NVivo software (QSR International).

Results: The Analysis identified a global theme of increased self-awareness and engagement in pain management. Three organizing themes emerged: (1) social support as a catalyst for adherence; (2) mindfulness as a strategy for emotional and sensory regulation; and (3) environmental and motivational barriers to sustained practice. Participants reported qualitative improvements in emotional regulation, sleep quality, and pain perception. Challenges included distraction due to the shared clinic setting and difficulties maintaining routine mindfulness practice, especially among participants reporting lower initial motivation.

Conclusions: The Mindfulness-Based Orofacial Pain Education Program was perceived as a feasible and beneficial adjunct to standard TMD care, promoting self-efficacy, emotional resilience, and pain self-management in a socially vulnerable population. Despite the small sample, consistent thematic convergence and participant engagement suggest promising applicability.

Introduction: Many studies reported on the existence of a relationship between tooth loss and hearing loss. However, only few studied the new relationship between dental implants and hearing loss.

Aims: To report the effect of a single implant-retained removable complete overdenture in the mandibular jaw on hearing loss of completely edentulous first-time denture wearers with sensorineural hearing loss.

Methods: This study is a case series that reports on the hearing thresholds of four completely edentulous patients at the ages between 55 and 62 years, which were tested before the insertion of a removable complete denture (RCD) and after loading the implant, through pure tone audiometry (PTA) for air and bone conduction in the Audiology Department at Almouwasat Hospital, from 2022 to 2024.

Results: Improvements of 5-10 dB in bone conduction thresholds were observed in some of the frequencies. A transition from minimal hearing loss to normal hearing was noted in the right ear of the second patient.

Conclusion: This experiment supports the new insight into the enhancement in hearing after loading the implant-retained removable complete overdentures, which suggests that placing dental implants improves hearing ability.

Clinical trial registration: Cases in this case series are part of a clinical trial approved by ClinicalTrials.gov Protocol Registration and Results System (PRS) with the approval number NCT05744830.

Objectives: Tooth eruption may serve as a potential indicator of systemic health and a potent developmental milestone in children. This study evaluated the impact of perinatal and neonatal risk factors on the chronology of primary tooth eruption among high-risk infants admitted to the neonatal intensive care unit (NICU).

Methods and results: A cross-sectional study was conducted on 232 high-risk infants. Maternal and neonatal data were extracted from validated medical records. Oral examinations were performed to record the timing of erupted primary teeth. Delayed eruption scoring was based on deviations from established mean eruption ages ( ± 2 SD). Logistic regression was used to assess associations between risk factors and delayed tooth eruption (DTE). The mean age of first primary tooth eruption was 6.9 ± 2.6 months. The overall prevalence of delayed primary tooth eruption was 9.1%. Emergence of the first primary tooth was observed earlier in preterm infants ( < 37 weeks) (p = 0.001). Infants born to mothers with PIH (pregnancy-induced hypertension) had earlier first deciduous tooth eruption compared to those without PIH (p = 0.009).

Conclusion: The study advocates for early risk assessment and early dental referrals. Furthermore, the study identified associations between gestational age, maternal PIH, and timing of tooth eruption, underscoring the importance of early oral assessment in high-risk infants.

Aims: The present qualitative study aims to explore the needs of families with children with disabilities, regarding their orthodontic care in a dedicated university orthodontic clinic.

Methods: Thirteen parents of children with disabilities, followed in a University orthodontic clinic dedicated to individuals with disabilities, were selected to participate in the present study. A grounded-theory approach was used to conduct informal in-depth interviews, which were digitally recorded and transcribed verbatim. Interview transcriptions were analyzed to develop a theoretical proposition grounded in real-world observations.

Results: A core category was identified, namely the aspiration of parents of children with disabilites to afford a positive experience for their child. In association with the core category, six other categories emerged: location, accessibility, and a welcoming environment; convenience and availability; an empathetic team; good communication; appropriate and modern equipment; and quality of treatment outcome.

Conclusions: The families of children with disabilities seek personalized and high-quality orthodontic care in a favorable environment with a welcoming, empathetic, and communicative team. Gaining a clearer understanding of what families value in clinics and teams that provide orthodontic care for children with disabilties can help inform meaningful and positive improvements to these dedicated services.

Aim: To assess the effectiveness of prophylactic antibiotics in preventing infective endocarditis (IE) after dental procedures in pediatric patients with congenital heart disease.

Methods: Six electronic databases and grey literature were searched for randomized controlled trials (RCTs), case-control studies, and cohort studies in pediatric patients who received antibiotic prophylaxis (AP) before any dental procedure compared to pediatric patients undergoing the same procedures without AP to prevent IE and/or bacteremia. The Newcastle-Ottawa scale was used to evaluate the internal validity of the included studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to assess the certainty of evidence.

Results: 1774 studies were screened after duplicate removal. Three case-control studies met the inclusion criteria and were included. One study evaluated IE as an outcome, whereas the other two studies evaluated bacteremia after dental procedures. Meta-analysis could not be conducted for IE, whereas pooling results were attempted for two studies evaluating bacteremia as an outcome. The odds of IE after a dental procedure within the last 6 months with AP were higher than without AP (Odds ratio: 3.44, 95% CI: 0.93, 12.65, p = 0.06) in the only study. However, AP was effectively able to reduce bacteremia after dental procedures in two studies that evaluated bacteremia (Pooled odds ratio: 0.24, 95% CI: 0.14, 0.42, p < 0.05).

Conclusions: The GRADE evidence was very low to conclude that prophylactic antibiotics might have a role in preventing IE or bacteremia in children with congenital cardiac diseases due to insufficient studies.