Special Care in Dentistry最新文献

Background: Oral verruciform xanthoma (OVX) is an uncommon benign epithelial lesion, typically observed in otherwise healthy individuals. It has occasionally been reported in association with chronic graft-versus-host disease (cGVHD) following hematopoietic stem cell transplantation (HSCT). To date, only 12 cases of OVX associated with cGVHD have been reported in the literature.

Case report: We present the first documented case of OVX in a 29-year-old male with Fanconi anemia (FA), occurring 19 years post-HSCT. The patient initially exhibited oral leukoplakia attributed to cGVHD, followed by the development of an OVX lesion on the posterolateral tongue. Clinically, the lesion appeared as a whitish plaque with a verrucous, irregular surface and well-demarcated borders. Histopathological examination revealed stratified squamous epithelium with papillary projections and keratin-filled clefts, along with numerous xanthoma cells confined to the connective tissue papillae.

Conclusion: This case contributes to the understanding of OVX in the context of FA and cGVHD, highlighting the critical importance of accurate diagnosis and individualized management of oral lesions in this high-risk population. Early recognition and intervention are essential to prevent progression and ensure optimal outcomes.

Aims: This scoping review aims to explore the application of digital dentistry in special care dentistry (SCD), focusing on the types of digital tools used, their clinical applications, reported outcomes, and challenges. The review seeks to synthesize current evidence to provide a foundation for advancing research and practice in this field.

Methods and results: Using the population, concept, and context (PCC) framework, this review included studies addressing digital dentistry applications for individuals requiring special care due to physical, cognitive, developmental, or medical conditions. A systematic search of PubMed, Embase, Scopus, and Web of Science identified 18 eligible studies, including case reports, cohort studies, and systematic reviews. Digital tools such as CAD/CAM systems, intraoral scanners, and 3D imaging technologies were highlighted for their effectiveness in improving diagnostic accuracy, treatment planning, and patient comfort. Key benefits included reduced patient discomfort and enhanced prosthetic precision, while barriers included high costs, limited training, and challenges with digital workflow integration.

Conclusion: Digital dentistry demonstrates significant potential to enhance care quality in SCD by addressing unique patient needs with improved efficiency and precision. However, financial, educational, and technological barriers limit widespread adoption. Future research should focus on long-term outcomes, cost-efficiency, and innovative solutions to promote equitable access and implementation.

Aims: To investigate and compare the experiences of specialists in pediatric and special care dentistry (SCD) using social stories as a management tool in the dental treatment of individuals on the autism spectrum METHODS: A 34-item online questionnaire was designed and distributed to specialists in Queensland. Univariate data were analyzed and graphed.

Results: A response rate of 62% was achieved. Results showed that 72% of participants agreed with the statement that "social stories are useful when treating patients with autism." More respondents reported using paper-based social stories (44%) than app-based (33%); however, 61% of participants responded they were more likely to use an app-based social story when given the choice. There was no statistically significant association between perception of social story usefulness and type of specialty (p = 0.627). As autism level of support increased, there was a decrease in perceived benefits of social stories (94% for ASD level 1 vs. 44% for ASD level 3).

Conclusion: This study showed that both Queensland specialists in pediatric dentistry and SCD find social stories to be a useful tool in the management of patients with autism. Further research would enable greater insights into the perception of social stories among dental specialists across Australia.

Background: Orphanage children often experience dental anxiety due to limited exposure and a lack of support. This research explores the therapeutic potential of music-based interventions like musical drama and music listening as alternatives to the traditional Tell-Show-Do (TSD) technique to alleviate anxiety.

Aim: To compare the effectiveness of musical drama and music listening over the TSD technique in reducing dental anxiety among 12-15-year-old orphanage children.

Methodology: A three-arm randomized controlled trial was conducted in orphanages in Pondicherry, India. A total of 80 children were randomly allocated into three groups: musical drama (n = 25), music listening through headphones (n = 29), and TSD technique (n = 26). Patients requiring full-mouth ultrasonic scaling in a single appointment, with a minimum of 20 permanent teeth, and who were willing to participate were included. Anxiety was measured before and after the intervention using the Modified Child Dental Anxiety Scale Faces Version (MCDASFv). IBM SPSS Statistics V21.0 and Microsoft Excel were used for statistical analysis. Descriptive statistics, paired t-tests, ANOVA, and post-hoc Bonferroni tests were employed to compare the effectiveness of the interventions, with a significance level set at p < 0.05.

Results: The mean anxiety score reductions were 15.32 ± 6.40 for Musical Drama, 15.06 ± 7.62 for Music Listening, and 4.00 ± 4.29 for TSD, all statistically significant (p < 0.001). One-way ANOVA comparing mean differences among the three groups showed a significant difference (p < 0.001). Post-hoc Bonferroni analysis revealed a significant difference between Musical Drama and TSD (p < 0.001), and between Music Listening and TSD (p < 0.001). However, no significant difference was observed between Musical Drama and Music Listening (p = 1.000). Both music-based interventions were more effective than TSD in reducing dental anxiety. This supports the potential of integrating music interventions in pediatric dental settings.

Conclusion: Musical interventions, particularly musical drama and music listening, significantly reduced dental anxiety in orphanage children compared to the TSD technique. The immersive and engaging nature of these interventions makes them effective alternatives for anxiety management in pediatric dentistry.

Clinical trials registry: India: CTRI/2022/11/046991.

Introduction: This case report examines the management of a 5-year-old male with Jacobsen Syndrome (JS) and Paris-Trousseau Syndrome (PTS), emphasizing the challenges of managing complex bleeding risks during dental surgery.

Case description: This case report details the management of a 5-year-old male with JS and PTS. The patient presented with persistent bleeding around exfoliating primary mandibular central incisors and a platelet count of 28 000/mm³. Extractions were performed under general anesthesia due to the patient's inability to cooperate and complex medical history. Local and systemic hemostatic measures were required to obtain hemostasis. This emphasizes the importance of a multidisciplinary approach in managing complex bleeding risks.

Conclusion: A multidisciplinary approach is vital in managing bleeding in pediatric patients with JS and PTS. Limiting the use of sutures and the number of injections to prevent further bleeding, as well as emphasizing preventative care, are key in managing these patients.

Aims: The aim of this study was the comparison of PRISM (Pictorial Representation of Illness and Self-Measure) with an interview-based oral health education during a 4-week follow-up.

Methods and results: Patients under chronic hemodialysis (HD) were recruited and randomly assigned either to PRISM or a control group. At baseline, after the first intervention (T1), after 2 weeks (second intervention, T2) and after 4 weeks (third intervention, T3), three parameters were evaluated: gingival inflammation by papilla bleeding index (PBI), patient perspective (specific questionnaire), Oral health impact profile (OHIP-G5). Fifteen patients each group finished the follow-up. In PRISM group, neither after two (T2, p = 0.23) nor after 4 weeks (T3, p = 0.63), significant differences in PBI were found. In the Control, PBI values significantly increased between baseline and T3 (0.71 ± 0.52 vs. 0.95 ± 0.54, p = 0.02). Mainly non-significant changes in the specific questionnaire were observed. The sum score of OHIP-G5 did not differ between time points. Regarding the question whether the taste has worsened, a decrease was found in the control between T0 and T2 (p = 0.04). In the PRISM group, this decrease was apparent between T0 and T2 (p = 0.04) as well as between T0 and T3 (p = 0.04).

Conclusion: Oral health education in HD patients appears challenging and offers a need for novel patient-centered approaches.

Purpose: This retrospective cross-sectional study aims to elucidate the challenging oral and maxillofacial management associated with congenital insensitivity to pain with anhidrosis (CIPA), emphasizing the need for early intervention and specialized treatment approaches.

Methods: Conducted at the Soroka University Medical Center, this study spans from 2005 to 2024, examining a significant cohort within a high-prevalence Bedouin community. We analyzed clinical outcomes focusing on dental extractions, incidence of osteomyelitis (OM), and subsequent mandibular fractures.

Results: The study included 36 patients diagnosed with CIPA, highlighting a high incidence of early-onset dental extractions and OM leading to various complications, including pathological mandibular fractures. Specifically, 63.9% of the patients underwent tooth extractions, primarily due to self-mutilation and infection. The average age at first tooth extraction was remarkably young at 2.23 years. Pathological fractures were observed in several cases, emphasizing the progressive and destructive nature of the disorder's impact on oral structures.

Conclusion: Given the escalating nature of oral and maxillofacial manifestations in CIPA, there is a critical need for early dental intervention and the adoption of preventive strategies. This study advocates for a multidisciplinary approach to enhance long-term outcomes, integrating oral and maxillofacial surgeons, pediatricians, geneticists, and rehabilitation specialists in the care of these patients.

Introduction: Poor oral health (OH) can led to severe general health issues, including respiratory infections and malnutrition, impacting the quality of life. In Malaysia, high prevalence of oral diseases including dental caries among individuals with disabilities (IWDs) has been reported, indicating a possible gap in the current system. This study aimed to analyze caries experience using DMFT index of IWDs in community-based rehabilitation (CBR) centers across Selangor, Malaysia.

Methods: A CBR centers-based cross-sectional study was conducted on IWDs or CBR trainees in the period between August 2022 and December 2023. Recruitments of the study participants were done via census sampling method, involving all the trainees within the specific centers. Data collection was done using the World Health Organization oral health survey tool (WHO, 2013) and analyzed using SPSS 24.

Results: Two hundred and twenty-six students with the age range of 2-47 years old were included in the study. Clinical examination of CBR trainees revealed (1) the mean DMFT scores were low for primary dentition (2.02), moderate for both mixed (3.86), and permanent dentitions (4.17); (2) prevalence of caries among those with primary, mixed, and permanent dentitions as 44.44%, 74.4%, and 74.80%, respectively.

Conclusions: Trainees with primary dentition had a low prevalence of dental caries and mean DMFT score, while those with mixed and permanent dentition exhibited moderate levels. A statistically significant association was observed between the total DMFT scores for participants with primary dentition with both gender and disability types.

Aims: To assess the impact of tongue-tie (ankyloglossia) and lip-tie release on functional outcomes in pediatric patients with cerebral palsy (CP) and explore the role of oral restrictions in hindering therapy progress.

Methods: Four female patients with CP, aged 10 months, 3 years, 6 years, and 7 years, underwent tongue-tie release with concomitant lip-tie and/or buccal-tie release. Pre- and postprocedure assessments focused on parental reports of quality of life improvements.

Results: All four patients demonstrated significant functional improvements following the release procedures. Reported improvements included better speech clarity, more effective swallowing, improved breathing, increased postural balance, reduced fascial tension, alleviation of gastrointestinal symptoms, and improved sleep patterns. These changes were observed consistently across all patients, suggesting a positive correlation between the release of oral restrictions and functional gains in children with CP.

Conclusions: Undiagnosed oral restrictions may impair mobility and development in children with CP. Addressing these restrictions may improve speech, swallowing, and other critical functions. Proper assessment of oral restrictions in children with CP or other comorbidities is essential to optimize therapeutic outcomes and enhance quality of life. This case series highlights the importance of considering oral restrictions in children with special healthcare needs and the ongoing need for further research.