Special Care in Dentistry最新文献

Neuropathic pain and its high impact on patient's quality of life, must be thoroughly assessed to be adequately managed. Unfortunately, there remains a lack of evidence for different treatment options that could improve the quality of life of those patients. Beyond first-choice therapies, complementary integrative therapies can emerge as a highly valuable option for controlling chronic pain. Thus, the aim of this study was to report a case of acupuncture utilized to manage chronic neuropathic pain associated with sensory loss following trauma after dental implant surgery. A 41-year-old female patient presented with a complaint of left-sided intraoral pain (visual analogic scale [VAS] = 9) in the posterior mandibula region over the last year following a dental implant surgery. On physical examination, the patient exhibited hypoesthesia in the region identified by qualitative somatosensory tests. The implant showed no clinical or tomographic alterations. The initial diagnosis was probable post-traumatic neuropathic pain (PTNP). As the patient opted against initiating central-acting medications, five sessions of acupuncture were performed. Following the proposed treatment, there was a significant reduction in the patient's pain report (VAS = 1) and a significant decrease in the sensory loss area. We can therefore conclude, that in this case, the use of acupuncture was effective in controlling pain and significantly reducing the sensory loss area caused by PTNP.

Background: Epidermolysis bullosa (EB) is a rare genetic condition characterized by skin and mucosal fragility. The clinical phenotype is highly variable. Severe types and subtypes, such as junctional EB (JEB), kindler EB (KEB), and recessive dystrophic EB (RDEB), are considered to present a high risk of oral health problems, including malocclusions. Despite this, the literature on orthodontic treatment in patients with EB is scarce and is limited to a few case reports.

Objective: To provide the users with information on the current best practices for orthodontic and dentofacial orthopedic diagnosis and treatment for patients with EB.

Methods: Current information regarding orthodontic treatment in patients with EB was identified based on a systematic literature review. A panel of experts was invited to provide additional information based on their experience through an open-ended form. Later, a Delphi study was performed over two rounds with a consensus threshold at 75%. Members of the medical team and patient representatives revised the final document.

Results: The panel (n = 12) agreed on a total of 15 recommendations, divided into three categories: general information on EB and orthodontics; orthodontic diagnosis and orthodontic treatment. A fourth category on perspectives was developed based on the feedback provided by non-dental members of the medical team (n = 4) and patients (n = 2).

Conclusions: Orthodontic treatment guidelines for patients living with EB are presented, including general aspects of EB, orthodontic diagnosis, and orthodontic treatment.

Introduction: The aim of this study is to report the case of nonclassical congenital adrenal hyperplasia (NCAH) observed in a female child, and to present the management of the surgical-orthodontic rehabilitation, through clinical and histological oral findings.

Method: A 13-year-old female was referred to our department for dental evaluation. The patient was affected by NCAH, confirmed by hormonal and genetic analysis from the age of 6 years, due to the appearance of premature pubic hair. At the time of the visit, she was in treatment with hydrocortisone, modulated on hormonal doses every 6 months. Clinical intraoral and extraoral examination, as well as radiographic and model analysis, were performed to obtain an accurate diagnosis. The impaction of the upper permanent canines required a surgical-orthodontic intervention for their exposure. Due to orthodontic traction impediment, after 3 months, a second surgery was required: the mucosal and fibrous tissues covering the impacted teeth were also removed and histologically examined, revealing hyperparakeratosis and inflammatory infiltrate.

Results: Two and a half years later, the appliance was removed. A correct occlusal relationship and a good aesthetic profile were achieved.

Conclusion: This clinical case, the first in the literature, showed that a microscopic alteration of the superficial and deep periodontium can be hypothesized in children with CAH, which could result in difficulty in tooth eruption associated with difficulties in orthodontic movement and, therefore, would require more careful management.

Background: Pediatric multisystem inflammatory syndrome (MIS-C) is a rare condition associated with COVID-19, with few reports on its oral manifestations.

Case report: A 13-year-old male pediatric patient with presented with fever, diarrhea, odynophagia, conjunctival hyperemia, rash, and bipalpebral edema. On physical examination, he exhibited diffuse ulcerated lesions with crusts on the vermilion border and labial mucosa, primarily affecting the labial commissures. Initially, immune-mediated diseases such as erythema multiforme or Stevens-Johnson syndrome were suspected, and treatment with topical corticosteroids and photobiomodulation was initiated. However, the lesions worsened, and polymerase chain reaction (PCR) testing of a sample from the lesion confirmed herpes simplex virus type 1. Given the diagnosis, corticosteroid therapy was discontinued, and decontamination using antimicrobial photodynamic therapy (methylene blue 0.01%, 5 min, 660 nm, 100 mW, 6 J/point, energy density of 199.98 J/cm²) was performed. However, oral lesions and overall systemic condition worsened, and the patient died.

Conclusion: This case highlights the need for a differential diagnosis of oral lesions in MIS-C in order to carry out the most appropriate treatment.

Introduction: Molar incisor hypomineralization (MIH) is an enamel defect that has a systemic origin and affects at least one permanent first molar and incisors.

Aim: The present systematic review aims to answer the question: "Is there an association between maternal anemia during pregnancy and the occurrence of MIH in children and adolescents?"

Methods: Studies in children and teenagers affected with MIH compared to healthy children and teenagers, assessing anemia in the gestational period, with no data or language restrictions, were eligible. The search in eight databases was performed up to January 2024. Quality assessment was assessed using by Newcastle Ottawa Scale tool. The association between anemia during the gestational period and the MIH was assessed by odds ratio (OR) and its corresponding 95% confidence interval (CI) in the RevMan software. The certainty in the body of evidence was assessed for pooling of outcomes using the GRADE approach.

Results: One case-control and three cross-sectional studies were included. A positive association between anemia during the gestational period and MIH was measured (OR 1.84 [1.28; 2.65]) (biases were detected).

Conclusions: The results show with a very low certainty of evidence that anemia is associated with greater involvement of MIH in children and teenagers.

Introduction: Globally, around 3.5 billion people are affected by oral disease, with individuals with disabilities being more affected due to physical and cognitive limitations. They rely on their parents or caregivers to maintain their oral health.

Aim: To develop and validate educational videos for promoting oral health through a YouTube channel for the parents/caregivers of children with cerebral palsy (CP).

Methodology: The preparation of the script/storyboard was based on scientific articles addressing oral health promotion. The content was divided into eighteen videos, which were validated by a panel of experts.

Results: All the items in the script board content scored CVR greater than 0.80, and videos were considered valid. The Cohen's kappa for all the questions for the audiovisual content ranges between 0.86 and 1.00, showing strong agreement (κ > 0.80) among the content experts.

Conclusion: The developed educational videos demonstrated strong content validity scores, indicating their potential to significantly enhance oral health knowledge among parents and caregivers of children with CP.

Background: Visually impaired individuals face significant challenges in maintaining oral hygiene due to reliance on visual cues. Conventional oral health education (OHE) often fails to address their needs, leading to disparities in oral health outcomes. The aim of this study was to assess and compare the effectiveness of three customized oral health education strategies-Audio only (Group 1), Audio + Braille (Group 2), and Audio + Tactile Model (Group 3)-on oral health Knowledge, Attitude, Practice (KAP), and clinical oral hygiene status among institutionalized visually impaired individuals in Lucknow, India.

Methods: A prospective cluster randomized controlled trial was conducted across two institutions, enrolling 180 visually impaired individuals aged ≥ 7 years. Of these, 15 were excluded based on eligibility criteria. The remaining 165 participants were randomly allocated into three intervention groups (55 participants per group). During follow-up, 5 participants from each group were lost, resulting in a final analysis of 150 participants (n = 50 per group). Each group received structured OHE via a designated modality, reinforced at 30, 60, and 90 days. Pre- and post-intervention assessments included Knowledge, Attitude, and Practice (KAP) scores and clinical parameters-Debris Index (OHI-S) and Gingival Index (GI). Data were analyzed using repeated measures ANOVA, Tukey's HSD, paired t-tests, one-way ANOVA, Chi-square tests, and Pearson's correlation.

Results: All groups showed significant improvement post-intervention (p < 0.001), with the Audio + Braille group achieving the greatest gains in knowledge (26%-100%), attitude/practice (36.5%-68.4%), and clinical outcomes (Debris Index: 2.23 to 0.43; GI: 1.09 to 0.22). Repeated measures ANOVA and post hoc analysis confirmed Group 2's superiority across all parameters. Strong inverse correlations between behavior scores and clinical indices emerged over time (r > -0.85), highlighting the impact of behavior change on oral health.

Conclusion: Multisensory OHE strategies, especially Audio + Braille, were most effective in improving oral health knowledge and hygiene status. Integration of such sensory-adapted educational models into public health programs may enhance oral health equity among visually impaired populations.

Trial registration: CTRI/2024/10/093533.