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Véliz Méndez S, Baeza M, Krämer Strenger S. Impression technique modification and oral contracture release surgery for orthodontic treatment in a patient with severe microstomia due to recessive dystrophic epidermolysis bullosa. SPECIAL CARE IN DENTISTRY 2023; 43:689-695. [PMID: 36504454 DOI: 10.1111/scd.12808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 09/13/2023]
Abstract
INTRODUCTION Epidermolysis bullosa (EB) is a group of genetic disorders characterized by fragility of the skin and mucosal membranes. Dystrophic EB (DEB) is caused by mutations in the gene coding for type VII collagen. Among the most frequent oral manifestations in Recessive DEB (RDEB) are oral ulcers and blisters, absence of tongue papillae and palatal rugae, ankyloglossia, oral vestibule obliteration, and microstomia. The following report describes a modified impression technique used in a patient with severe RDEB and severe microstomia to obtain models for orthodontic treatment with aligners. CASE REPORT A 25-year-old female patient with severe RDEB was referred for orthodontic treatment. Severe microstomia (8 mm), hindered the use of conventional trays or intraoral scanners to design the aligners. Therefore, a contracture release surgery in combination with a modified impression technique was performed to obtain an optimal impression and subsequent aligners for orthodontic treatment. DISCUSSION This case presents an alternative strategy to provide orthodontic treatment with aligners in patients with severe microstomia due to severe RDEB. Reports of orthodontic treatment in people living with EB, especially in RDEB, are still rare, with few publications about fixed braces, early teeth extraction and removable devices, and none using aligners. Most of the impression techniques reported are aimed at oral rehabilitation. The multidisciplinary approach and impression technique reported should broaden the alternatives of orthodontic techniques provided to patients with EB and severe microstomia. CONCLUSIONS This article describes an oral contracture release surgery and modified impression technique for obtaining good quality impression for the design of orthodontic aligners in patients with severe microstomia due to severe RDEB.
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Affiliation(s)
- Sebastián Véliz Méndez
- Special Care Dentistry Unit, Faculty of Dentistry, University of Chile, Santiago, Chile
- Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago, Spain
| | - Mauricio Baeza
- Special Care Dentistry Unit, Faculty of Dentistry, University of Chile, Santiago, Chile
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Turkyilmaz A, Bulut AC, Hancerliogullari D. Endodontic management of a patient with dystrophic epidermolysis bullosa: A case report. AUST ENDOD J 2020; 47:97-104. [PMID: 33368821 DOI: 10.1111/aej.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 11/28/2022]
Abstract
Epidermolysis bullosa is a congenital genetic disease that causes blistering and erosion of the skin and mucosa. The main known forms include simple, junction, dystrophic and mixed subtypes. This case report presents the endodontic management and 1-year follow-up of a 27-year-old female patient with epidermolysis bullosa who was referred to the Faculty of Dentistry, Kırıkkale University, Turkey. An extraoral examination showed that the patient had multiple scars and blisters. The intraoral examination revealed ankyloglossia, microstomia, shallow buccal and vestibular sulci, enamel hypoplasia, gingival inflammation, mouth ulcers, symptomatic and asymptomatic deep caries, a tooth with an apical lesion and a tooth with pulpitis. The dental treatment was divided into four stages: (i) oral hygiene motivation and elimination of gingival bleeding, (ii) restorative and/or endodontic procedures, (iii) extractions and prosthetic treatments and (iv) recall appointments. A 1-year follow-up radiographic examination of the periapical status of the root canal treatments was clear.
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Affiliation(s)
- Ali Turkyilmaz
- Department of Endodontics, Faculty of Dentistry, University of Kirikkale, Kirikkale, Turkey
| | - Ali Can Bulut
- Department of Prosthodontics, Faculty of Dentistry, University of Kirikkale, Kirikkale, Turkey
| | - Dilek Hancerliogullari
- Department of Endodontics, Faculty of Dentistry, University of Kirikkale, Kirikkale, Turkey
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Conservative dental management of a patient with Epidermolysis bullosa. A case report. PEDIATRIC DENTAL JOURNAL 2020. [DOI: 10.1016/j.pdj.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Krämer S, Lucas J, Gamboa F, Peñarrocha Diago M, Peñarrocha Oltra D, Guzmán‐Letelier M, Paul S, Molina G, Sepúlveda L, Araya I, Soto R, Arriagada C, Lucky AW, Mellerio JE, Cornwall R, Alsayer F, Schilke R, Antal MA, Castrillón F, Paredes C, Serrano MC, Clark V. Clinical practice guidelines: Oral health care for children and adults living with epidermolysis bullosa. SPECIAL CARE IN DENTISTRY 2020; 40 Suppl 1:3-81. [PMID: 33202040 PMCID: PMC7756753 DOI: 10.1111/scd.12511] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Inherited epidermolysis bullosa (EB) is a genetic disorder characterized by skin fragility and unique oral features. AIMS To provide (a) a complete review of the oral manifestations in those living with each type of inherited EB, (b) the current best practices for managing oral health care of people living with EB, (c) the current best practices on dental implant-based oral rehabilitation for patients with recessive dystrophic EB (RDEB), and (d) the current best practice for managing local anesthesia, principles of sedation, and general anesthesia for children and adults with EB undergoing dental treatment. METHODS Systematic literature search, panel discussion including clinical experts and patient representatives from different centers around the world, external review, and guideline piloting. RESULTS This article has been divided into five chapters: (i) general information on EB for the oral health care professional, (ii) systematic literature review on the oral manifestations of EB, (iii) oral health care and dental treatment for children and adults living with EB-clinical practice guidelines, (iv) dental implants in patients with RDEB-clinical practice guidelines, and (v) sedation and anesthesia for adults and children with EB undergoing dental treatment-clinical practice guidelines. Each chapter provides recommendations on the management of the different clinical procedures within dental practice, highlighting the importance of patient-clinician partnership, impact on quality of life, and the importance of follow-up appointments. Guidance on the use on nonadhesive wound care products and emollients to reduce friction during patient care is provided. CONCLUSIONS Oral soft and hard tissue manifestations of inherited EB have unique patterns of involvement associated with each subtype of the condition. Understanding each subtype individually will help the professionals plan long-term treatment approaches.
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Affiliation(s)
- Susanne Krämer
- Facultad de OdontologíaUniversidad de ChileSantiagoChile
| | - James Lucas
- Dental DepartmentRoyal Children's HospitalMelbourneAustralia
| | | | | | | | - Marcelo Guzmán‐Letelier
- Hospital Base ValdiviaValdiviaChile
- Facultad de OdontologiaUniversidad San SebastiánValdiviaChile
| | | | - Gustavo Molina
- Universidad Nacional de CórdobaArgentina
- Universidad Católica de CórdobaArgentina
| | | | - Ignacio Araya
- Facultad de OdontologíaUniversidad de ChileSantiagoChile
- Hospital Santiago OrienteMaxillofacial Surgery UnitChile
| | - Rubén Soto
- Facultad de OdontologíaUniversidad de ChileSantiagoChile
| | | | - Anne W Lucky
- Cincinnati Children's Epidermolysis Bullosa CenterCincinnati Children's HospitalCincinnatiOhioUSA
- The University of Cincinnati College of MedicineCincinnatiOhioUSA
| | - Jemima E Mellerio
- St John's Institute of DermatologyGuy's and St Thomas’ NHS Foundation TrustLondonUK
| | - Roger Cornwall
- Cincinnati Children's Epidermolysis Bullosa CenterCincinnati Children's HospitalCincinnatiOhioUSA
| | - Fatimah Alsayer
- Royal National ENT and Eastman Dental HospitalsUniversity College London HospitalsLondonUK
| | - Reinhard Schilke
- Hannover Medical SchoolDepartment of Conservative DentistryPeriodontology and Preventive DentistryHannoverGermany
| | | | | | - Camila Paredes
- Facultad de OdontologíaUniversidad de ChileSantiagoChile
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Singh S, Ray A, Gupta N, Sethi N. Anaesthetic management of a rare case of paediatric epidermolysis bullosa. Indian J Anaesth 2019; 63:73-74. [PMID: 30745623 PMCID: PMC6341888 DOI: 10.4103/ija.ija_595_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shalendra Singh
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Arijit Ray
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Nipun Gupta
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Navdeep Sethi
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
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Kudva P, Jain R. Periodontal manifestation of epidermolysis bullosa: Looking through the lens. J Indian Soc Periodontol 2016; 20:72-4. [PMID: 27041842 PMCID: PMC4795140 DOI: 10.4103/0972-124x.164760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Epidermolysis bullosa (EB) is a genetic disease associated with fragility and bullous lesions of the skin and mucous membranes. There are various patterns of inheritance and histopathology. The disease is associated with systemic and oral manifestations. Treatment of this disease is multidisciplinary and remains only palliative till today. The present case report describes periodontal manifestations of EB and the treatment plan for the same.
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Affiliation(s)
- Praveen Kudva
- Department of Periodontics and Implantology, Jaipur Dental College, Jaipur, Rajasthan, India
| | - Rajsi Jain
- Department of Periodontics and Implantology, Jaipur Dental College, Jaipur, Rajasthan, India
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Mello BZF, Neto NL, Kobayashi TY, Mello MBA, Ambrosio ECP, Yaedú RYF, Machado MAAM, Oliveira TM. General anesthesia for dental care management of a patient with epidermolysis bullosa: 24-month follow-up. SPECIAL CARE IN DENTISTRY 2016; 36:237-40. [PMID: 26936632 DOI: 10.1111/scd.12170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Epidermolysis bullosa comprises a group of uncommon skin-related diseases, characterized by the formation of blisters on mucocutaneous regions occurring spontaneously, following a trauma, exposure to heat, or as a result of minimal mechanical trauma. The dental treatment of the patient with epidermolysis bullosa raises many questions and discussions, due to the difficulty of carrying out the procedures. This report aimed to detail the clinical considerations of the treatment under general anesthesia of a patient with epidermolysis bullosa. The extraction of all deciduous teeth under general anesthesia was recommended based on the clinical and radiographic examinations. At 24-month follow-up, the patient had great improvement in oral hygiene without new caries lesions. The patient has been followed-up at every month for caries lesion prevention and permanent tooth development. The treatment under general anesthesia provided the ideal safe conditions and was beneficial for the patient.
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Affiliation(s)
- Bianca Zeponi Fernandes Mello
- PhD Student, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Natalino Lourenço Neto
- Postdoctoral Student, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Tatiana Yuriko Kobayashi
- Postdoctoral Student, Department of Pediatric Dentistry, Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marina Barbosa Almeida Mello
- MSc Student, Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Eloá Cristina Passucci Ambrosio
- MSc Student, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Renato Yassutaka Faria Yaedú
- Professor, Department of Stomatology, Bauru School of Dentistry and Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
| | - Maria Aparecida Andrade Moreira Machado
- Full Professor, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Thais Marchini Oliveira
- Associate Professor, Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry and Hospital of Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil
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Chahed J, Mekki M, Ksia A, Kechiche N, Hidouri S, Youssef TM, Sahnoun L, Krichene I, Belghith M, Nouri A. Management of digestive lesions associated to congenital epidermolysis bullosa. Afr J Paediatr Surg 2015; 12:221-6. [PMID: 26712284 PMCID: PMC4955475 DOI: 10.4103/0189-6725.172544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Congenital epidermolysis bullosa (CEB) is a rare genodermatosis. The digestive system is very frequently associated with skin manifestations. Pyloric atresia (PA) and oesophageal stenosis (OS) are considered the most serious digestive lesions to occur.The aim of this work is to study the management and the outcome of digestive lesions associated to CEB in four children and to compare our results to the literature. PATIENTS AND METHODS A retrospective study of four observations: Two cases of PA and two cases of OS associated to CEB managed in the Paediatric Surgery Department of Fattouma Bourguiba Teaching Hospital in Monastir, Tunisia. RESULTS Four patients, two of them are 11 and 8 years old, diagnosed as having a dystrophic epidermolysis bullosa since the neonatal period. They were admitted for the investigation of progressive dysphagia. Oesophageal stenosis was confirmed by an upper contrast study. Pneumatic dilation was the advocated therapeutic method for both patients with a favourable outcome. The two other patients are newborns, diagnosed to have a CEB because of association of PA with bullous skin lesions with erosive scars. Both patients had a complete diaphragm excision with pyloroplasty. They died at the age of 4 and 3 months of severe diarrhoea resistant to medical treatment. CONCLUSION Digestive lesions associated to CEB represent an aggravating factor of a serious disease. OS complicating CEB is severe with difficult management. Pneumatic dilatation is the gold standard treatment method. However, the mortality rate in PA with CEB is high. Prenatal diagnosis of PA is possible, and it can help avoiding lethal forms.
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Affiliation(s)
- Jamila Chahed
- Department of Paediatric Surgery, School of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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Sharma S, Bedi S. Dystrophic epidermolysis bullosa associated with non-syndromic hypodontia. Indian Dermatol Online J 2013; 4:296-9. [PMID: 24350009 PMCID: PMC3853894 DOI: 10.4103/2229-5178.120644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Epidermolysis bullosa (EB) is a genetic disease associated with fragility and bullous lesions of the skin and mucous membranes. There are various patterns of inheritance and histopathology. The disease is associated with systemic and oral manifestations, among which may be dental decay necessitating oral rehabilitation. The aim of this article is to present the course of the condition in a child with dystrophic EB and also to report an association between EB, hypodontia, and supernumerary teeth which has not been reported earlier in literature.
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Affiliation(s)
- Sonali Sharma
- Department of Oral Medicine and Radiology, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Sumit Bedi
- Department of Pedodontics and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
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Ksia A, Mosbahi S, Ben Brahim M, Sahnoun L, Laamiri R, Maazoun K, Krichene I, Mekki M, Belguith M, Nouri A. [Esophageal strictures in children with epidermolysis bullosa]. Arch Pediatr 2012; 19:1325-9. [PMID: 23116982 DOI: 10.1016/j.arcped.2012.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/28/2012] [Accepted: 09/23/2012] [Indexed: 11/16/2022]
Abstract
UNLABELLED Esophageal stricture is a rare but often severe complication of recessive dystrophic epidermolysis bullosa in children. The purpose of the study was to review this digestive complication with emphasis on diagnostic modalities and therapeutic management. PATIENTS AND METHODS This was a retrospective study of two pediatric cases of esophageal stenosis that occurred during generalized recessive dystrophic epidermolysis bullosa of the Hallopeau-Siemens type. RESULTS The 2 patients were aged 8 years 8 months and 11 years 5 months, respectively. Dysphagia was of early onset, before the age of 10 years in both cases. Esophageal opacification led to the diagnosis of esophageal stenosis located in the upper 1/3 of the esophagus in 1 case and at the junction between the middle and the lower 1/3 of the esophagus in the other case. None of the 2 patients received medical treatment, and pneumatic dilation was the treatment method that was advocated. Esophageal endoscopy showed the stenosis and helped guide the positioning of the balloon catheter. These patients underwent 2 and 3 sessions of dilation, respectively, at intervals of 2 months and 1 year. Balloon dilation has allowed the patients to have a more comfortable life with decreased dysphagia and a substantial improvement in nutritional status. However, this improvement was transient (1 patient had symptomatic recurrence of stenosis after 3 years), which shows that monitoring of the patients and the resumption of dilatation sessions may be necessary. CONCLUSION Esophageal strictures in dystrophic epidermolysis bullosa of the Hallopeau-Simens type are severe and difficult to support. Pneumatic dilatation is the treatment of choice for the fragile esophagus. It gives satisfactory results and can be repeated without significant risk.
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Affiliation(s)
- A Ksia
- Service de chirurgie pédiatrique, hôpital Fattouma Bourguiba, 5000 Monastir, Tunisie.
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Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain C. [Immunological diseases of buccal localisation]. Med Clin (Barc) 2012; 140:88-92. [PMID: 22989674 DOI: 10.1016/j.medcli.2012.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 06/04/2012] [Accepted: 06/14/2012] [Indexed: 11/16/2022]
Affiliation(s)
- Antonio Bascones-Martínez
- Departamento de Medicina y Cirugía Bucofacial, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, España.
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Krämer SM, Serrano MC, Zillmann G, Gálvez P, Araya I, Yanine N, Carrasco-Labra A, Oliva P, Brignardello-Petersen R, Villanueva J. Oral health care for patients with epidermolysis bullosa--best clinical practice guidelines. Int J Paediatr Dent 2012; 22 Suppl 1:1-35. [PMID: 22937908 DOI: 10.1111/j.1365-263x.2012.01247.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To provide the users with information on the current best practices for managing the oral health care of people living with EB. METHODS A systematic literature search, in which the main topic is dental care in patients with Epidermolysis Bullosa, was performed. Consulted sources, ranging from 1970 to 2010, included MEDLINE, EMBASE, CINAHL, The Cochrane Library, DARE, and the Cochrane controlled trials register (CENTRAL). In order to formulate the recommendations of the selected studies the SIGN system was used. The first draft was analysed and discussed by clinical experts, methodologists and patients representatives on a two days consensus meeting. The resulting document went through an external review process by a panel of experts, other health care professionals, patient representatives and lay reviewers. The final document was piloted in three different centres in United Kingdom, Czech Republic and Argentina. RESULTS The guideline is composed of 93 recommendations divided into 3 main areas: 1) Oral Care--access issues, early referral, preventative strategies, management of microstomia, prescriptions and review appointments 2) Dental treatment: general treatment modifications, radiographs, restorations, endodontics, oral rehabilitation, periodontal treatment, oral surgery and orthodontics, and 3) Anaesthetic management of dental treatment. CONCLUSIONS A preventive protocol is today's dental management approach of choice.
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Affiliation(s)
- Susanne M Krämer
- Department of Paediatric Dentistry, Facultad de Odontología, Universidad de Chile, Santiago, Chile.
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Abstract
BACKGROUND Epidermolysis bullosa (EB) is a skin disease characterized by epithelial fragility that leads to blistering and erosion of the skin and mucosae. The authors conducted a literature review to provide an update on oral manifestations and dental care of patients with EB. Literature Search. The authors reviewed the dental literature on EB in relation to clinical findings and provision of dental care. They searched textbooks and three databases: MEDLINE, Cochrane Library and Embase. The authors did not impose any date or publication status restrictions. They searched all databases up to August 2010. RESULTS The literature review revealed that four major groups and 32 subtypes of EB can be distinguished on the basis of the ultrastructural characteristics of skin cleavage, genetic mode of transmission and clinical phenotype. Oral manifestations differ in frequency and severity according to the disease subtype, but the most common are bullae, which leave painful ulcers on rupture, followed by scarring and tissue contraction. Although good oral health status is essential to maintaining oral function, dental treatment can induce new lesions and be hindered by the sequelae of existing lesions. CLINICAL IMPLICATIONS Dental treatment in patients with EB requires a multidisciplinary approach. Dental procedures must be minimally traumatic, and the effectiveness of treatment is determined mainly by the patient's general health, cooperation in the dental office and at home, oral hygiene and diet.
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Torres CP, Gomes-Silva JM, Mellara TS, Carvalho LP, Borsatto MC. Dental care management in a child with recessive dystrophic epidermolysis bullosa. Braz Dent J 2011; 22:511-6. [PMID: 22189648 DOI: 10.1590/s0103-64402011000600012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 10/01/2011] [Indexed: 11/22/2022] Open
Abstract
Epidermolysis bullosa (EB) is a heterogeneous group of rare genetic disorders characterized by marked fragility of the skin and mucous membranes in which vesiculobullous lesions occur in response to trauma, heat or no apparent cause. The recessive form of EB presents the greatest oral alterations including repeated blistering and scar formation leading to limited oral opening, ankyloglossia, tongue denudation, microstomia, vestibule obliteration and predisposition to oral carcinoma. Routine dental care may cause bullae formation on the lips and oral mucosa. Together with the ingestion of soft and frequently carbohydrate food, these anomalies lead to a high caries risk. This paper documents a case of a child diagnosed with recessive dystrophic epidermolysis bullosa (RDEB); describes the phases and difficulties of dental treatment and the measures that dentists and health care providers should adopt in order to provide a safe and effective dental treatment as well as earlier prevention to these patients.
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Affiliation(s)
- Carolina Paes Torres
- Department of Pediatric Clinic, Preventive and Community Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Krämer SM. Oral Care and Dental Management for Patients with Epidermolysis Bullosa. Dermatol Clin 2010; 28:303-9, x. [DOI: 10.1016/j.det.2010.02.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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