Nederlands tijdschrift voor tandheelkunde最新文献

Botulinum neurotoxin type A (BoNT-A, popularly referred to as 'botox') is a muscle-relaxant that is injected into the mimic facial muscles to soften wrinkles in more than two percent of Dutch women annually. A similar number of women undergo filler injections with hyaluronic acid hydrogels, used to counteract the aging appearance of the skin, or to create desired facial contours. Complications are generally mild in nature and rare (certainly compared to surgical complication rates) and include nodules, bumps and a temporary heavy feeling of the eyebrows. Vascular complications related to filler injections (1:7000) can potentially lead to unilateral blindness or skin necrosis. In the Netherlands, the risk of blindness over the past six years is estimated to be 1 in every 1.4 million filler injections. Permanent skin damage due to gangrene has never been reported in the Netherlands. In conclusion, BoNT-A and hyaluronic acid filler injections are safe procedures in the hands of appropriately trained healthcare professionals.

Bruxism is a disabling condition in which unconscious contractions of the masticulatory muscles lead to teeth grinding and jaw clenching. Symptoms include toothache, temporomandibular dysfunction, headache and attrition. Treatment options range from conservative approaches to invasive interventions. Education, stress reduction, avoidance of stimulants, and relaxation techniques can help in mild cases. Wearing an occlusal splint can reduce attrition. Botulinum neurotoxin type A (BoNT-A) injections are a treatment option temporarily causing partial paralysis of the masticulatory muscles. BoNT-A is a treatment for reducing symptoms and improving the quality of life of patients with bruxism that has been proven safe and effective. The effects usually last several months. To achieve the best results and minimize side effects, BoNT-A injections should be applied by an experienced practitioner.

A recent survey indicates 49% of this journal's subscribers endorse the administration of cosmetic injectables by properly trained dentists. Given the surging demand for cosmetic treatments, it's essential to establish clear guidelines and conventions defining the roles of the various healthcare professionals in various situations. There is, however, considerable discussion still and from a legal standpoint, the role of dentists within cosmetic medicine remains ambiguous. Under the Dutch Individual Healthcare Professions Act (Wet BIG), dentists are authorized to administer cosmetic injectables exclusively for dental purposes. However, based on the content of current dental training, one might argue that dentists' authorization could be extended to include facial injectable treatments in the entire face, in future. Presently, it is prudent for general practice dentists to abstain from cosmetic procedures with cosmetic injectables without a specific (aesthetic) dental objective.

The use of dermal fillers for cosmetic procedures has increased rapidly both worldwide and in the Netherlands in recent years, which has led to an absolute increase in reported side effects and complications. Although most of these complications are mild, serious complications such as vascular occlusion can also occur. In this article, we describe a case of a 35-year-old woman who showed signs of reduced tissue perfusion and the early stage of skin necrosis following injection of hyaluronic acid fillers in the chin. This complication was successfully treated by ultrasound-guided injection of hyaluronidase, resulting in a full recovery without residual symptoms. To minimize the risk of serious complications treatment with hyaluronic acid fillers should be carried out by an experienced practitioner.

In addition to function, occlusion and airway volume, aesthetics play an important role in the planning and execution of orthognathic surgery. To improve the aesthetic outcome of orthognathic surgery, there are several procedures that can be combined with orthognathic surgery secondarily, or in the same operation. These include: lipofilling, dermal fillers, facial implants, liposuction, ear corrections, eyelid corrections, or a lip lift. Patients often appreciate it when the options for additional procedures are discussed. However, both undertreatment and overtreatment can lead to unfavorable outcomes. Proper care and thoroughness are of course required, as to not change the characteristic facial aspects of a patient too much.

Beauty, it seems, is a fascination inherent in human nature. Research shows that an attractive face plays a significant factor in human life, such as in the areas of appreciation and judgment.The growing demand for cosmetic treatments is amplified by social media and influencer marketing. However, there are possible negative effects, such as addiction and dissatisfaction with treatment outcome in people with Body Dysmorphic Disorder. It remains important to recognize that risks are inherent in medical procedures.

The caries prevalence in patients with cleft lip and/or palate is higher in both the deciduous and permanent dentition, compared to non-cleft patients. Inadequate oral hygiene is one of the main causes. Additional, individualized advice concerning diet and oral hygiene, such as the additional advice of the Ivoren Kruis (Dutch association of dental hygienists), is of great importance. During curative treatment, attention should be paid to any dental anxiety and possible reduced compliance.

A 51-year-old woman was referred to a periodontology practice for treatment of advanced generalized periodontitis stage IV, grade C. When the dental hygienist treated the distal surface of tooth 17 with the ultrasonic scaler, the patient indicated she heard a painful, high tone. The dental hygienist immediately stopped the treatment. At a subsequent attempt to treat the same distal surface, the patient heard a painful, high tone again. After two weeks, the high tone had not disappeared. The patient was referred to an ENT specialist. He confirmed the diagnosis: tinnitus in the right ear. Pharmacological treatment with prednisone did not produce a positive result. Ultrasonic treatment of periodontitis is generally considered safe. However, in exceptional cases, sudden deafness and/or tinnitus can occur. In the event of such complaints, it is recommended not to wait, but to refer the patient to an ENT specialist immediately.

In every dental practice, patients present with persistent physical symptoms. Such complaints can significantly complicate dental treatment, especially if they are not acknowledged, or if the patient feels they are not being taken seriously. For this reason, it is important to increase oral care providers' knowledge and expertise concerning persistent physical symptoms in a broader sense and in the head and neck area in particular, with the aim of improving the treatment alliance and to increase the effectiveness of dental treatment.

In this retrospective study, 2 intraoral scans with an interval of at least 1 year were superimposed in 25 oligodontic patients. The differences in vertical eruption (mm) were measured and the orthopantomograms were analyzed for the presence of ankylotic deciduous molars with no successor. The mean eruption of deciduous molars with and without successor was significantly lower than the mean eruption of permanent molars. The eruption of permanent molars was a predictive variable for the eruption of deciduous molars. The number of agenetic elements and the presence of a successor were strongly associated with the eruption of deciduous molars. Also, the mean eruption of deciduous molars with ankylosis was significantly lower than that of deciduous molars without ankylosis. This study showed a strong relationship between the diagnosis of ankylotic deciduous molars and the measurement of negative vertical eruption when monitored by intraoral scans.