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Yehia Z, Silbereisen A, Koletsi D, Arabzadehtousi M, Tsilingaridis G, Bostanci N. Efficacy of periodontal treatment modalities in Down syndrome patients: a systematic review and meta-analysis. Evid Based Dent 2024:10.1038/s41432-024-01055-x. [PMID: 39183214 DOI: 10.1038/s41432-024-01055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/01/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE The systematic review aimed to review the existing evidence, to identify and appraise the effectiveness of periodontal prevention and treatment modalities in individuals diagnosed with Down syndrome (DS) and to determine the estimates of the effects of implemented periodontal prevention and treatment strategies compared to chromosomally normal (CN) individuals. METHODOLOGY The systematic review was conducted and reported in conformity with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The study protocol was registered in the Open Science Framework. Electronic and manual searches, in accordance with PICO framework and delineated inclusion/exclusion criteria, were conducted in multiple databases. RESULTS The initial search identified 11,704 studies. After removing duplicates, 9,048 remained. Title and abstract screening narrowed these to 281 for full-text review. Ultimately, 16 studies met the inclusion criteria, with 4 eligible for quantitative data synthesis. Results of the meta-analysis indicated that professional tooth cleaning in combination with oral hygiene reinforcement was less effective in the reduction of PPD in patients with DS compared to those without DS (Mean difference (MD): 0.23; 95% Confidence Interval (CI): 0.14 to 0.32; p < 0.001). DISCUSSION These findings suggest that conventional periodontal treatment is less effective in managing periodontitis in patients with DS. Thus, tailored periodontal care strategies that address the specific needs of individuals with DS should be implemented to improve treatment outcomes for this population The presence of moderate to high risk of bias in the included studies underscores the need for rigorously designed research that minimizes bias through effective blinding, randomization, control of confounding factors, and inclusion of diverse treatment outcomes to further investigate these associations. CONCLUSION Based on the best available evidence, professional tooth cleaning combined with oral hygiene instructions appears to be less effective in reducing pocket depths in individuals with DS compared to those without DS. https://doi.org/10.17605/OSF.IO/UXTCG.
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Affiliation(s)
- Zakaria Yehia
- Division of Periodontology and Oral Health, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Orthodontics, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden
| | - Angelika Silbereisen
- Division of Periodontology and Oral Health, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Mahla Arabzadehtousi
- Division of Periodontology and Oral Health, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre of Pediatric Oral Health, Stockholm, Sweden
| | - Nagihan Bostanci
- Division of Periodontology and Oral Health, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
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2
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Mouchrek MMM, Franco MM, da Silva LA, Martins KAC, da Conceição SIO, de Azevedo Dos Santos APS, Rodrigues VP, Ribeiro CCC, Benatti BB. Cytokine levels in the gingival crevicular fluid and their association with periodontal status of down syndrome patients: a cross-sectional study. Clin Oral Investig 2024; 28:391. [PMID: 38907162 DOI: 10.1007/s00784-024-05789-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/13/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE To evaluate cytokine levels of interleukin (IL)-1β, IL-4, IL-6, IL-17a, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ in the gingival crevicular fluid (GCF) of periodontal sites in individuals with Down syndrome (DS) and analyze their relationship with clinical periodontal parameters. MATERIALS AND METHODS A cross-sectional study was conducted with 49 DS patients and 32 individuals without DS (non-DS group). Periodontal probing depth (PPD), clinical attachment level (CAL), bleeding on probing (BoP), and visible plaque index (VPI) were evaluated. The periodontal sites were classified as shallow, moderate, and deep. GCF was collected in all shallow sites and, when present, in moderate and deep sites for the analysis of cytokine levels. The cytokines, IL-1β, IL-4, IL-6, IL-17a, TNF-α, and IFN-γ, were quantified using the Luminex® automatic analyzer system. RESULTS The DS group presented greater severity of periodontitis compared to the non-DS group (P = 0.005). The DS group showed a significant direct correlation of IL-1β and an inverse correlation of IFN-γ and IL-14 with all periodontal variables. In the analysis stratified by periodontal pocket depth, we observed a higher level of IFN-γ, IL-17a, IL-1β, and IL-6 in the shallow sites, and IL-17a, IL-1β, and IL-6 in deep pockets of DS group individuals. Multivariate models showed that higher levels of IL-1β, IL-4, IL-6, and IL-17a were associated with Down syndrome even after adjusting for periodontal status, sex, and age. CONCLUSION The findings suggest that people with DS have greater periodontal impairment and higher levels of cytokines in GCF, even in sites having clinical periodontal parameters similar to those of individuals without DS. These data reiterate the concept of an altered and less effective immune response in the population with DS in the face of a periodontal microbial challenge. CLINICAL RELEVANCE Elevated periodontal inflammation burden can be observed with higher cytokine levels in the gingival crevicular fluid of people with Down syndrome, especially IL-1, IL-4, IL-6, and IL-17, regardless of the stage of periodontitis.
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Affiliation(s)
- Monique Maria Melo Mouchrek
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil
| | - Mayra Moura Franco
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil
| | - Leslie Alves da Silva
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil
| | - Kerry Alynne Campos Martins
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil
| | | | | | - Vandílson Pinheiro Rodrigues
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil
| | - Cecilia Cláudia Costa Ribeiro
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil
| | - Bruno Braga Benatti
- Dentistry Graduate Program, School of Dentistry, Federal University of Maranhão, Avenida dos Portugueses, 1966, São Luís, 65080-805, Brazil.
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3
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Salvi GE, Roccuzzo A, Imber JC, Stähli A, Klinge B, Lang NP. Clinical periodontal diagnosis. Periodontol 2000 2023. [PMID: 37452444 DOI: 10.1111/prd.12487] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/16/2023] [Accepted: 03/14/2023] [Indexed: 07/18/2023]
Abstract
Periodontal diseases include pathological conditions elicited by the presence of bacterial biofilms leading to a host response. In the diagnostic process, clinical signs such as bleeding on probing, development of periodontal pockets and gingival recessions, furcation involvement and presence of radiographic bone loss should be assessed prior to periodontal therapy, following active therapy, and during long-term supportive care. In addition, patient-reported outcomes such as increased tooth mobility, migration, and tilting should also be considered. More important to the patient, however, is the fact that assessment of signs of periodontal diseases must be followed by an appropriate treatment plan. Furthermore, it should be realized that clinical and radiographic periodontal diagnosis is based on signs which may not reflect the presence of active disease but rather represent the sequelae of a previous bacterial challenge. Hence, the aim of the present review is to provide a summary of clinical and radiographic diagnostic criteria required to classify patients with periodontal health or disease.
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Affiliation(s)
- Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Björn Klinge
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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4
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Dimopoulos K, Constantine A, Clift P, Condliffe R, Moledina S, Jansen K, Inuzuka R, Veldtman GR, Cua CL, Tay ELW, Opotowsky AR, Giannakoulas G, Alonso-Gonzalez R, Cordina R, Capone G, Namuyonga J, Scott CH, D’Alto M, Gamero FJ, Chicoine B, Gu H, Limsuwan A, Majekodunmi T, Budts W, Coghlan G, Broberg CS, Constantine A, Clift P, Condliffe R, Moledina S, Jansen K. Cardiovascular Complications of Down Syndrome: Scoping Review and Expert Consensus. Circulation 2023; 147:425-441. [PMID: 36716257 PMCID: PMC9977420 DOI: 10.1161/circulationaha.122.059706] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Cardiovascular disease is a leading cause of morbidity and mortality in individuals with Down syndrome. Congenital heart disease is the most common cardiovascular condition in this group, present in up to 50% of people with Down syndrome and contributing to poor outcomes. Additional factors contributing to cardiovascular outcomes include pulmonary hypertension; coexistent pulmonary, endocrine, and metabolic diseases; and risk factors for atherosclerotic disease. Moreover, disparities in the cardiovascular care of people with Down syndrome compared with the general population, which vary across different geographies and health care systems, further contribute to cardiovascular mortality; this issue is often overlooked by the wider medical community. This review focuses on the diagnosis, prevalence, and management of cardiovascular disease encountered in people with Down syndrome and summarizes available evidence in 10 key areas relating to Down syndrome and cardiac disease, from prenatal diagnosis to disparities in care in areas of differing resource availability. All specialists and nonspecialist clinicians providing care for people with Down syndrome should be aware of best clinical practice in all aspects of care of this distinct population.
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Affiliation(s)
- Konstantinos Dimopoulos
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom (K.D., A.C.).,National Heart and Lung Institute, Imperial College London, United Kingdom (K.D., A.C.)
| | - Andrew Constantine
- Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom (K.D., A.C.).,National Heart and Lung Institute, Imperial College London, United Kingdom (K.D., A.C.)
| | - Paul Clift
- Department of Cardiology, Queen Elizabeth Hospital Birmingham, United Kingdom (P.C.)
| | - Robin Condliffe
- Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom (R.C.)
| | - Shahin Moledina
- National Paediatric Pulmonary Hypertension Service UK, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom (S.M.).,Institute of Cardiovascular Science, University College London, United Kingdom (S.M.)
| | - Katrijn Jansen
- Adult Congenital and Paediatric Heart Unit, Freeman Hospital Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (K.J.).,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom (K.J.)
| | - Ryo Inuzuka
- Department of Pediatrics, The University of Tokyo Hospital, Japan (R.I.)
| | - Gruschen R. Veldtman
- Scottish Adult Congenital Cardiac Service, Golden Jubilee Hospital, Glasgow, Scotland, United Kingdom (G.R.V.)
| | - Clifford L. Cua
- The Heart Center, Nationwide Children’s Hospital, Columbus, OH (C.L.C.)
| | - Edgar Lik Wui Tay
- Department of Cardiology, National University Hospital Singapore (E.T.L.W.)
| | - Alexander R. Opotowsky
- The Heart Institute, Department of Pediatrics, Cincinnati Children’s Hospital, University of Cincinnati College of Medicine, OH (A.R.O.)
| | - George Giannakoulas
- Department of Cardiology, AHEPA University Hospital School of Medicine, Aristotle University of Thessaloniki, Greece (G.G.)
| | - Rafael Alonso-Gonzalez
- Division of Cardiology, Toronto General Hospital, University Health Network, Peter Munk Cardiovascular Center, University of Toronto, Canada (R.A.-G.).,Toronto Adult Congenital Heart Disease Program, Canada (R.A.-G.)
| | - Rachael Cordina
- Department of Cardiology, Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, New South Wales, Australia (R.C.)
| | - George Capone
- Down Syndrome Clinical and Research Center, Kennedy Krieger Institute, Baltimore, MD (G. Capone).,Johns Hopkins School of Medicine, Baltimore, MD (G. Capone)
| | - Judith Namuyonga
- Department of Paediatric Cardiology, Uganda Heart Institute, Kampala (J.N.).,Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda (J.N.)
| | | | - Michele D’Alto
- Department of Cardiology, University “L. Vanvitelli”–Monaldi Hospital, Naples, Italy (M.D.)
| | - Francisco J. Gamero
- Department of Cardiovascular Surgery, Benjamin Bloom Children’s Hospital, El Salvador (F.J.G.)
| | - Brian Chicoine
- Advocate Medical Group Adult Down Syndrome Center, Park Ridge, IL (B.C.)
| | - Hong Gu
- Department of Pediatric Cardiology, Beijing Anzhen Hospital, Capital Medical University, China (H.G.)
| | - Alisa Limsuwan
- Division of Pediatric Cardiology, Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (A.L.)
| | - Tosin Majekodunmi
- Department of Cardiology, Euracare Multi-specialist Hospital, Nigeria (T.M.)
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, and Department of Cardiovascular Science, Catholic University Leuven, Belgium (W.B.)
| | - Gerry Coghlan
- Department of Cardiology, Royal Free Hospital, London, United Kingdom (G. Coghlan)
| | - Craig S. Broberg
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland (C.S.B.)
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Nonoyama T, Nonoyama K, Shimazaki Y. Cross-sectional study of the factors associated with the number of teeth in middle-aged and older persons with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:793-804. [PMID: 35929423 PMCID: PMC9544665 DOI: 10.1111/jir.12967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND We investigated the number of teeth in middle-aged and older individuals with intellectual disability and evaluated the related factors. METHODS A questionnaire survey on oral health was administered to 604 persons over 40 years old with intellectual disabilities in Aichi Prefecture, Japan. The questionnaire designed for this study included items on diagnosis of disability, severity of intellectual disability and type of residence. As oral-health-related factors, the proxy-reported number of teeth, family dentist, regular dental check-ups, problems during dental treatment and tooth-brushing frequency were evaluated. A multinomial logistic regression analysis was performed using the proxy-reported number of teeth (≥20, 10-19 or 0-9) as the dependent variable, and the odds ratios (ORs) and 95% confidence intervals (CIs) of independent variables were calculated. In addition, linear regression analysis was performed using the proxy-reported number of teeth as the dependent variable. RESULTS In the multivariate multinomial logistic regression analysis, age, diagnosis of disability and type of residence were significantly associated with having 10-19 versus ≥20 teeth. Participants with autism spectrum disorder had a significantly lower OR for 10-19 teeth compared with those with intellectual disability [OR (95% CI): 0.49 (0.22-1.08)]. Age, diagnosis of disability, regular dental check-ups and tooth-brushing frequency were significantly associated with having 0-9 versus ≥20teeth. Participants with Down syndrome had a significantly higher OR for 0-9 teeth compared with those with intellectual disability [OR (95% CI): 3.17 (1.09-9.23)]. The ORs for 0-9 teeth of participants who did not attend regular dental check-ups and who brushed their teeth 1 time/day compared with ≥3 times/day were significantly high, and the OR (95% CI) was 2.37 (1.06-5.30) and 4.76 (1.09-20.77), respectively. [Corrections made on 22 August 2022, after first online publication: in the previous sentence, "who attend" has been changed to "who did not attend".] In the multivariate linear regression analysis, age, diagnosis of disability and regular dental check-ups were significantly associated with the proxy-reported number of teeth. The proxy-reported number of teeth was -0.42 less with each 1-year increase in age. With autism spectrum disorder, the proxy-reported number of teeth was 0.74 more compared with intellectual disability. In Down syndrome, the proxy-reported number of teeth was -0.93 less compared with intellectual disability. The proxy-reported number of teeth was -2.12 less for those who did not have regular dental check-ups. CONCLUSIONS The number of teeth in middle-aged and older individuals with intellectual disability was related to age and the type of disability. Regular dental visits may be effective at preventing tooth loss in middle-aged and older persons with intellectual disability.
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Affiliation(s)
- T. Nonoyama
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
| | - K. Nonoyama
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
- Nonoyama Dental OfficeTogoJapan
| | - Y. Shimazaki
- Department of Preventive Dentistry and Dental Public Health, School of DentistryAichi Gakuin UniversityNagoyaJapan
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6
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Mouchrek MMM, Franco MM, da Silva LA, Martins KAC, Conceição SIOD, Rodrigues VP, Benatti BB. Identifying metabolic parameters related to severity and extent of periodontitis in down syndrome patients. J Periodontal Res 2022; 57:904-913. [PMID: 35730357 DOI: 10.1111/jre.13028] [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: 09/01/2021] [Revised: 04/28/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Systemic metabolic status and periodontitis can be related in patients with Down syndrome (DS). The objective of this study was to identify metabolic indicators (anthropometric measurements, blood pressure, and serum markers) related to severity and extent of periodontitis in DS patients. METHODS A cross-sectional study was conducted with 49 patients with DS. Periodontal evaluation included the periodontal probing depth (PPD), clinical attachment level (CAL), gingival bleeding index (GBI), and visible plaque index (VPI). Periodontitis severity was classified by the stages system. The extent of periodontitis was assessed as the percentage of sites with CAL ≥3 mm, CAL ≥4 mm, PPD ≥4 mm, and PPD ≥5 mm. The metabolic condition of the participants was determined by analyzing anthropometric parameters, blood pressure, and serum markers. Data were analyzed using the Mann-Whitney test, Spearman's correlation coefficient, and multivariate regression analysis. RESULTS Periodontitis stage 3/4 was detected in 32.7% of patients, with high values of VPI (54.6 ± 35.8) and GBI (42.4 ± 33.3). The severity of periodontitis was related to higher mean corpuscular hemoglobin (β = .291, p = .028) and mean corpuscular volume values (β = .293, p = .046). Arm circumference measurements were inversely related to CAL ≥3 mm (β = -.408, p = .023), PPD ≥4 mm (β = -.475, p = .006), and PPD ≥5 mm (β = -.443, p = .010). CONCLUSIONS The findings suggest that the severity and extent of periodontitis may be related to some metabolic parameters in DS patients.
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Affiliation(s)
| | - Mayra Moura Franco
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Brazil
| | | | | | | | | | - Bruno Braga Benatti
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Brazil
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García-Mato E, Martínez-Lamas L, Álvarez-Fernández M, Varela-Aneiros I, Diniz-Freitas M, Limeres-Posse J, Diz-Dios P. Molecular Detection of Streptococcus downii sp. nov. from Dental Plaque Samples from Patients with Down Syndrome and Non-Syndromic Individuals. Microorganisms 2022; 10:microorganisms10061098. [PMID: 35744617 PMCID: PMC9227364 DOI: 10.3390/microorganisms10061098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023] Open
Abstract
A new bacterial species has recently been identified in the dental plaque of an adolescent with Down syndrome. The species is known as Streptococcus downii sp. nov. (abbreviated to S. downii), and it inhibits the growth of S. mutans and certain periodontal pathogens. The aim of this study was to determine the distribution of S. downii in the oral cavity of individuals with Down syndrome. Methods: A specific polymerase chain reaction for the operon of bacteriocin (class IIb lactobin A/cerein 7B family) was designed to detect S. downii in individuals with Down syndrome (n = 200) and in the general population (n = 100). We also compared the whole genome of S. downii and the regions related to its bacteriocins against 127 metagenomes of supragingival plaque of the “Human Microbiome Project”. Results: We detected the specific gene of the S. downii bacteriocin in an individual with Down syndrome (Cq, 34.52; GE/μL, 13.0) and in an individual of the non-syndromic control group (Cq, 34.78 Cq; GE/μL, 4.93). The prevalence of S. downii was ≤1% both in Down syndrome and in the general population, which did not allow for clinical-microbiological correlations to be established. This result was confirmed by detecting only one metagenome with an ANIm with approximately 95% homology and with 100% homology with ORFs that code class IIb lactobiocin A/cerein 7B bacteriocins among the 127 metagenomes of the “Human Microbiome Project” tested. Conclusions: The detection rate of S. downii in the supragingival dental plaque was very low, both in the Down syndrome individuals and in the non-syndromic controls. A clinical-microbiological correlation could therefore not be established.
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Affiliation(s)
- Eliane García-Mato
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (E.G.-M.); (I.V.-A.); (J.L.-P.)
| | - Lucía Martínez-Lamas
- Clinical Microbiology, Microbiology and Infectiology Group, Galicia Sur Health Research Institute, Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, 36312 Vigo, Spain; (L.M.-L.); (M.Á.-F.)
| | - Maximiliano Álvarez-Fernández
- Clinical Microbiology, Microbiology and Infectiology Group, Galicia Sur Health Research Institute, Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo, 36312 Vigo, Spain; (L.M.-L.); (M.Á.-F.)
| | - Iván Varela-Aneiros
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (E.G.-M.); (I.V.-A.); (J.L.-P.)
| | - Marcio Diniz-Freitas
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (E.G.-M.); (I.V.-A.); (J.L.-P.)
- Correspondence: (M.D.-F.); (P.D.-D.); Tel.: +34-881-812344 (P.D.-D.)
| | - Jacobo Limeres-Posse
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (E.G.-M.); (I.V.-A.); (J.L.-P.)
| | - Pedro Diz-Dios
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (USC), 15705 Santiago de Compostela, Spain; (E.G.-M.); (I.V.-A.); (J.L.-P.)
- Correspondence: (M.D.-F.); (P.D.-D.); Tel.: +34-881-812344 (P.D.-D.)
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8
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Kammer PV, Moro JS, Martins-Júnior PA, Cardoso M, Bolan M, Santana CM. The 100 most-cited papers in dentistry for individuals with neurodevelopmental disorders: Bibliometric profile of scientific research. SPECIAL CARE IN DENTISTRY 2021; 42:369-375. [PMID: 34856008 DOI: 10.1111/scd.12684] [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: 07/05/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 12/01/2022]
Abstract
AIM To conduct a bibliometric analysis of the top 100 most-cited papers in dentistry for individuals with neurodevelopmental disorders. METHODS AND RESULTS A search strategy was constructed and conducted at the Web of Science in the category of "Dentistry, Oral Surgery, and Medicine". The following information was extracted from each paper: title, authorship, year of publication, title of the journal, study subject, study design, age range of sample participants, type of disability, institution, country and continent, number of citations and citation density. Google Scholar and Scopus were used to crosscheck the number of citations of the most-cited papers. The VOSviewer software was used to generate bibliometric network maps. The papers received 4453 citations in Web of Science, ranging from 30 to 106 citations. Most papers were published by the USA (35%), had an observational design (78%) and the main subject was epidemiology (31%). Most studies focused on individuals with Down syndrome (34%) and Autism Spectrum Disorder (18%) and were published in the Journal of Periodontology (10%) and the Pediatric Dentistry Journal (7%). CONCLUSION Most of the studies included in this review were characterized as epidemiological studies. Future research should focus on behavior guidance, dental education, and access to dental services.
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Affiliation(s)
- Pedro Vitali Kammer
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Juliana Silva Moro
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Paulo Antônio Martins-Júnior
- Department of Child and Adolescent Oral Health, Federal University of Minas Gerais-Belo Horizonte, Minas Gerais, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Michele Bolan
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
| | - Carla Miranda Santana
- Department of Dentistry, Federal University of Santa Catarina-Florianópolis, Santa Catarina, Brazil
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9
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Sales PHDH, Barros AWP, de Lima FJC, Carvalho ADAT, Leão JC. Is Down syndrome a risk factor or contraindication for dental implants? A systematic review. J Prosthet Dent 2021; 129:531-537. [PMID: 34332773 DOI: 10.1016/j.prosdent.2021.06.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Whether oral rehabilitation with dental implants in patients with Down syndrome leads to an increased complication rate is unclear. PURPOSE The purpose of this systematic review was to determine the effectiveness of dental implants placed in patients with Down syndrome and whether the condition is a risk factor or contraindication for dental implant placement. MATERIAL AND METHODS Searches were conducted in 6 databases, including the non-peer-reviewed literature, up to February 2021 by 2 independent reviewers according to established inclusion and exclusion criteria to answer this question: Is Down syndrome a risk factor or contraindication for oral rehabilitation with dental implants? RESULTS A total of 655 studies were initially found in the databases. Five were included in this systematic review, all of which were observational studies. A total of 50 patients with 186 implants were evaluated, with a reported effectiveness of 79.1%. The risk of bias assessment determined that 3 of the 5 studies had a high risk of bias. CONCLUSIONS Treatment with dental implants in patients with Down syndrome is a suitable option, but more complications are to be expected than with patients without this condition. Controlled studies with better methodological design and less risk of bias should be developed to improve the scientific evidence for the treatment of these patients.
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Affiliation(s)
- Pedro Henrique da Hora Sales
- PhD student, Postgraduate Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.
| | - Ana Waleska Pessoa Barros
- MSc student, Postgraduate Program in Dentistry, Department of Prothesis and Oral and Maxillofacial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Fernando José Camello de Lima
- Adjunct Professor, Institute of Health and Biological Sciences, Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | | | - Jair Carneiro Leão
- Full Professor, Department of Clinical and Preventive Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
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Dental Treatment Needs and Related Risk Factors among School Children with Special Needs in Taiwan. J Pers Med 2021; 11:jpm11060452. [PMID: 34071021 PMCID: PMC8224663 DOI: 10.3390/jpm11060452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to assess dental treatment needs (TNs) and related risk factors of children with disabilities (CD). This cross-sectional study recruited 484 CD, 6 to 12 years of age, from 10 special education schools in Taiwan. Dental status and TNs were examined and evaluated by well-trained dentists and based on the criteria set by the World Health Organization (1997). The results indicated that 61.78% required restorative dental treatment due to their dental caries. On average, each participant had 2.72 teeth that required treatment, and 6.38 surfaces required restoration. One-quarter of the participants (24.79%) required 1- or 2-surface restoration, and one out of three (36.98%) had more complex TNs (including 3 or more surfaces to be filled, pulp care, extraction, and more specialized care). The significant risk factors associated with restorative TNs among CD were those whose parents had lower socioeconomic status, frequent sweets intake, insufficient tooth-brushing ability, and poor oral health. Most of the CD had extensive unmet TNs for their caries and required complex treatment to recover the function of their teeth. Encouraging parents/caregivers to take their children for dental treatment, promoting awareness of the importance of dental hygiene, giving assistance to brushing their teeth after eating, and controlling and/or modifying sweet diet habits are necessary to reduce CD’s dental caries, especially those with lower socioeconomic status parents/caregivers.
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11
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Access to Dental Care-A Survey from Dentists, People with Disabilities and Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041556. [PMID: 33562099 PMCID: PMC7915372 DOI: 10.3390/ijerph18041556] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/20/2022]
Abstract
The literature highlights differences in the dental conditions of people with disabilities compared with the general population. The aim of this study was to provide an overview of the dental health of people with disabilities in order to understand if their needs are met and to identify their most critical issues as per dentists. A paper and a Google Form platform were used in conducting a survey in Central Italy (the Abruzzo region), by performing an analysis on different points of view as reported by people with disabilities and dentists. The results showed that only 69.2% of dentists treat persons with disabilities. Of these, 73.5% treat less than 10 patients with physical disabilities per year. However, 54% of dentists do not treat people with cognitive impairment and a poor ability to collaborate during treatment. More than 80% of respondent dentists report that people with disabilities do not have good oral hygiene. On the other hand, 49.1% of people with disabilities (or their caregivers in cases where the patient was unable to answer) report that they rarely or never go to the dental office. Moreover, when they do go, it is mainly for emergencies. Despite this, respondents are well aware of their dental problems. However, they have difficulties in communicating their dental problems to their dentist. The 50% of dentists who treat people with cognitive impairment do not include them in follow-up, while only 20% of these patients reported being regularly recalled. This illustrates the importance of the implementation of follow-up. In addition, training courses could help clinicians to reduce this gap and create barrier-free dental offices.
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Valentini D, Di Camillo C, Mirante N, Vallogini G, Olivini N, Baban A, Buzzonetti L, Galeotti A, Raponi M, Villani A. Medical conditions of children and young people with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:199-209. [PMID: 33426738 DOI: 10.1111/jir.12804] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/29/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The life expectancy of people with Down syndrome (DS) has significantly increased in the last decades. We describe the congenital malformations and main comorbidities of a cohort of children and young people with DS and analyse their differences according to age and gender groups. METHODS This retrospective cross-sectional study was conducted at DS centre of Bambino Gesù Children's Hospital in Rome (Italy). The period for reviewing all electronic health records ran from July 2016 to September 2017. We collected data on clinical conditions and compared them with the general paediatric population. Moreover, we compared the main comorbidities, dental diseases and body mass index data between age groups. RESULTS Seven hundred sixty-three children and young people with DS included in this study were aged 7.45 ± 5.49 years. Gender distribution included 58.19% male patients. The majority of our population (71.04%) came from central regions of Italy. Respiratory diseases (19%), congenital heart defects (72.23%), malocclusions (58.62%), astigmatism (20.31%), farsightedness (16.51%), near-sightedness (12.19%) and autoimmune hypothyroidism (3.28%) were more frequent in our population compared with the typical paediatric population. Upper respiratory tract infections and underweight were significantly more frequent in the youngest children, whereas dental diseases, refractive errors, obesity and autoimmune hypothyroidism increased over age. CONCLUSIONS Children and young people with DS present a high prevalence of potentially treatable medical conditions making multidisciplinary teams a mandatory need for this population.
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Affiliation(s)
- D Valentini
- Pediatric Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - C Di Camillo
- Pediatric Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - N Mirante
- Pediatric Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - G Vallogini
- Unit of Dentistry, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - N Olivini
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart - ERN GUARD-Heart HCP, Pediatric Cardiology and Arrhythmia/Syncope Units, Bambino Gesù Children Hospital-IRCCS, Rome, Italy
| | - A Baban
- European Reference Network for Rare, Low Prevalence and Complex Diseases of the Heart - ERN GUARD-Heart HCP, Pediatric Cardiology and Arrhythmia/Syncope Units, Bambino Gesù Children Hospital-IRCCS, Rome, Italy
| | - L Buzzonetti
- Department of Ophthalmology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - A Galeotti
- Unit of Dentistry, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - M Raponi
- Medical Directorate, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - A Villani
- Pediatric Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
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Nuernberg MAA, Ivanaga CA, Haas AN, Aranega AM, Casarin RCV, Caminaga RMS, Garcia VG, Theodoro LH. Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:1181-1192. [PMID: 31062454 DOI: 10.1111/jir.12629] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/09/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aim of the present study was to assess the periodontal condition of individuals with Down syndrome and the association with sociodemographic and behavioural characteristics and family perception of oral health. METHODS This cross-sectional observational study was performed at a referral centre for dental assistance to disabled persons in Araçatuba, Brazil. Parents of the individuals were interviewed, and the visible plaque index, bleeding on probing, probing pocket depth and clinical attachment level were recorded by one periodontist in six sites per tooth of all teeth. The individual was the unit of analysis. The significance level was set at 5%. RESULTS Sixty-four subjects (23.8 ± 8.3 years old) were included. Eighteen (28.1%) were diagnosed with gingivitis and 46 (71.9%) with periodontitis. In the multiple logistic regression final model, age and self-reported oral hygiene practices were associated with the occurrence of periodontitis. The chance of having periodontitis was 4.7 times higher among individuals older than 20 years and approximately 4 times higher in patients whose oral hygiene was performed by themselves and their parents, compared with those who performed oral hygiene alone. Sex, follow-up time in the centre, education, degree of participants' dependence, flossing and family history of periodontal disease were not associated with the occurrence of periodontitis. Higher levels of plaque and bleeding were observed for participants with parents reporting bad gingival health (76.2% and 46.9%) and deficient oral hygiene (79.5% and 47.3%). The perception of parents regarding gingival bleeding was correlated with higher bleeding detected clinically (P = 0.01; 50.1%). CONCLUSIONS The prevalence of periodontitis in individuals with Down syndrome is high and increases with age, even in the face of the parents' perception about their children's oral condition.
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Affiliation(s)
- M A A Nuernberg
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - C A Ivanaga
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - A N Haas
- Department of Periodontology, Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - A M Aranega
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
| | - R C V Casarin
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, Brazil
| | - R M S Caminaga
- Department of Morphology, Araraquara Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - V G Garcia
- Post Graduate Program, Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, Brazil
| | - L H Theodoro
- Department of Surgery and Integrated Clinic, Division of Periodontology, School of Dentistry, São Paulo State University (UNESP), Araçatuba, Brazil
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Oral health status among visually impaired schoolchildren in Northeast China. BMC Oral Health 2019; 19:63. [PMID: 31029116 PMCID: PMC6487059 DOI: 10.1186/s12903-019-0752-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/02/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Visual impairment is an important disability affecting a substantial proportion of people globally. The aim of this study was to assess the oral health status of visually impaired schoolchildren in northeast China, and to investigate the influencing factors. METHODS The study was performed in 2015, according to the criteria and methods used in the Third National Oral Health Epidemiological Survey in China. One hundred and three visually impaired schoolchildren from the only special school for the blind in northeast China were included in the study. Oral examinations were performed to assess the caries of deciduous and permanent teeth, periodontal disease, malocclusion. A questionnaire-based survey was conducted to investigate oral health-related behaviors, knowledge and attitude about oral care. RESULTS The overall prevalence of caries was 78.64%, and mean number of caries was 2.43 ± 2.75. The prevalence of caries in deciduous and permanent teeth was 65.22 and 71.84%, respectively. The rates of gingival bleeding and dental calculus were 44.66 and 67.96%, respectively. Malocclusion was observed in 49.51% of the children with visual impairment. The prevalence of caries was significantly higher in girls than boys (P < 0.05). The logistic regression analysis identified the knowledge level of parents and the toothache experience as risk factors for oral health, while the daily use of fluoride toothpaste could reduce the caries incidence. CONCLUSIONS This group of visually impaired schoolchildren exhibited a high prevalence of dental caries, poor periodontal health, and severe malocclusion. Oral health status is relatively poor among visually impaired schoolchildren in northeast China. Factors that significantly affected the prevalence of dental caries included education level of the mother, experience of toothache, and use of fluoride toothpaste.
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Nicolau B, Castonguay G, Madathil S, Vuong T, Almeida TDD. Periodontal Diseases and Traumatic Dental Injuries in the Pediatric Population. Pediatr Clin North Am 2018; 65:1051-1061. [PMID: 30213348 DOI: 10.1016/j.pcl.2018.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article provides an overview of periodontal diseases and traumatic dental injuries (TDIs) in children and adolescents, which are serious public health problems worldwide. Periodontal diseases, including gingivitis and periodontitis, commonly affect the oral soft tissues and teeth and often co-occur with other chronic diseases. TDIs are prevalent from an early age and carry high treatment costs. Behavioral and environmental factors contribute to both TDIs and periodontal diseases, but their etiology varies according to population characteristics and case definition. Both conditions may lead to pain, function impairment, esthetic problems, and psychosocial effects, with major consequences on quality of life.
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Affiliation(s)
- Belinda Nicolau
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada.
| | - Geneviève Castonguay
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Sreenath Madathil
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Thien Vuong
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada
| | - Tahyna Duda Deps Almeida
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1, Canada; Faculty of Dentistry, Federal University of Minas Gerais, Av. Presidente Antônio Carlos, 6627 Pampulha, Belo Horizonte, Minas Gerais, Brazil
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Scalioni FAR, Carrada CF, Martins CC, Ribeiro RA, Paiva SM. Periodontal disease in patients with Down syndrome: A systematic review. J Am Dent Assoc 2018; 149:628-639.e11. [PMID: 29779565 DOI: 10.1016/j.adaj.2018.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/20/2018] [Accepted: 03/08/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND The authors systematically reviewed the scientific evidence of an association between periodontal disease and Down syndrome (DS). TYPES OF STUDIES REVIEWED In this systematic review, the authors included observational studies in which the investigators assessed the prevalence, incidence, or experience of periodontal disease in patients with DS compared with that in healthy patients. The authors used the Population, Exposure, Comparison, Outcome structure. The population was patients of any age, the exposure was the presence of DS, the comparison was the absence of DS, and the outcome was the presence of periodontal disease. The authors conducted an electronic search in 5 databases through March 2017. Two independent reviewers assessed the risk of bias by using the Fowkes and Fulton scale. The authors performed a meta-analysis to compare periodontal disease among patients with DS and those without DS. The authors calculated a summary effect measure-standard mean difference-when evaluating the means of the oral hygiene index. The authors assessed the strength of evidence from the selected studies by using a modified Grading of Recommendations Assessment, Development and Evaluation system. RESULTS The authors included 23 case-control studies in the systematic review and submitted 3 to meta-analysis. In the qualitative analysis, results from most studies showed that the prevalence of some periodontal parameters was higher among patients with DS than among those without DS. Evaluations of the Fowkes and Fulton scale point to many methodological problems in the studies evaluated. Results of the meta-analysis revealed no differences between groups with regard to the oral hygiene index (standard mean difference, 0.05; 95% confidence interval, -0.55 to 0.65; I2 = 0.0%). CONCLUSIONS AND PRACTICAL IMPLICATIONS Further research is required, in particular well-designed studies that avoid the deficiencies identified in the studies in this review.
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Abstract
Down syndrome is a common disorder with many oral conditions and systemic manifestations. Dentists need to take a holistic approach including behavioral, oral, and systemic issues. This review of the literature focuses on oral anomalies, systemic interaction, management, and recommendations.
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Affiliation(s)
- Azizah Bin Mubayrik
- Department Oral Medicine & Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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Najeeb S, Khurshid Z, Siddiqui F, Zohaib S, Zafar MS. Outcomes of Dental Implant Therapy in Patients With Down Syndrome: A Systematic Review. J Evid Based Dent Pract 2017; 17:317-323. [PMID: 29197433 DOI: 10.1016/j.jebdp.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Patients with Down syndrome (DS) require an earlier and more frequent tooth replacement than rest of the population. The objective of this systematic review is to critically analyze and summarize studies to ascertain the outcomes and survival of dental implants placed in jaws of DS patients. METHODS Using the key words "dental implants," "Down syndrome," and "prosthodontics," an electronic search was conducted via PubMed/MEDLINE, ISI Web of Science, Google Scholar, Embase, and Central Register of Controlled Trials (CENTRAL) databases by 2 authors, S.N. and Z.K., independently. Retrieved studies were screened against the predefined exclusion and inclusion criteria. To estimate the risk of bias, quality assessment of included studies was carried using the 'Case Reports (CARE) guidelines'. RESULTS Primary search resulted in 156 studies. Eight studies met the inclusion criteria and reporting a total of 81 dental implants placed in 36 DS patients. The type of implant loading ranged from immediate to a delay of 1 year after placement of the implant. Implant diameter ranged from 3.3 to 4.5 mm, and height ranged from 8.5 to 18 mm. The follow-up ranged from 1 to 6 years. Of 81 implants placed, 21 implants (26%) were reported as failed. CONCLUSIONS Patients with DS have a higher risk of implant failure. However, the reason for the failure is not very well understood. Although case reports and case series suggest that implant survival is diminished in DS patients, large-scale randomized controlled trials are required to determine the exact mechanism associated with risks of implant failure.
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Affiliation(s)
| | - Zohaib Khurshid
- Department of Prosthodontics and Implantology, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Fahad Siddiqui
- Department of Pediatric Dentistry, Rutgers University, New Brunswick, NJ, USA
| | - Sana Zohaib
- School of Biomedical Engineering, King Faisal University, Al-Hofuf, Saudi Arabia
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan.
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Ferreira R, Michel RC, Greghi SLA, de Resende MLR, Sant’Ana ACP, Damante CA, Zangrando MSR. Prevention and Periodontal Treatment in Down Syndrome Patients: A Systematic Review. PLoS One 2016; 11:e0158339. [PMID: 27355338 PMCID: PMC4927059 DOI: 10.1371/journal.pone.0158339] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/14/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this systematic literature review was to evaluate which type of periodontal preventive and therapeutic approaches presents superior outcomes in patients with Down syndrome (DS). Studies reporting different methods of periodontal care from DS patients were considered eligible. Included clinical studies should indicate at least two periodontal parameters in different periods of assessment. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Electronic search according to the PICO search, with both Key-words and MESH terms were conducted in MEDLINE, EMBASE and CENTRAL databases until March 2016. Manual search was conducted in four journals, namely Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and Special Care in Dentistry and their electronic databases were searched. Electronic and manual search resulted in 763 papers, and of them 744 were excluded after title/abstract assessment. The full text of 19 potentially eligible publications was screened and 9 studies met inclusion criteria. The results demonstrated the importance to introduce youngest DS patients in preventive programs, as well as participation of parents, caregivers or institutional attendants in supervising/performing oral hygiene. In studies with higher frequency of attendance, all age groups presented superior preventive and therapeutic results, irrespective of the therapeutic approach used (surgical/nonsurgical/periodontal care program). The important factors for reducing periodontal parameters were the frequency of the appointments and association with chlorhexidine/plaque disclosing agents as adjuvant treatment. This systematic review demonstrated that early introduction in periodontal care, participation of parents/caregivers/institutional attendants, frequency of attendance and association with chemical adjuvants (independently of the periodontal treatment adopted) seems to improve periodontal outcomes in preventive and periodontal treatment of DS patients. Registration number (Prospero): CRD42016038433.
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Affiliation(s)
- Rafael Ferreira
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Raphaella Coelho Michel
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Sebastião Luiz Aguiar Greghi
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Maria Lúcia Rubo de Resende
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | | | - Carla Andreotti Damante
- Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Comparative study of oral health among trisomy 21 children living in Riyadh, Saudi Arabia: Part 2, gingival condition. Saudi Dent J 2015; 27:224-7. [PMID: 26644759 PMCID: PMC4642193 DOI: 10.1016/j.sdentj.2015.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Trisomy 21 (T21) is a congenital disorder characterized by triplication of Chromosome 21 components. Patients with T21 have an increased risk of acquiring periodontal disease due to their inability to maintain good oral hygiene. Consequently, it is important to determine an approach for disease prevention in this population. AIM The purpose of the study was to assess the periodontal health, through the prevalence of gingivitis and plaque, among children with T21 living in Riyadh, Saudi Arabia. SUBJECTS AND METHOD This study included 93 children with T21 and 99 age- and gender-matched children without T21 between the ages of 7 and 15 years. Parents were informed about the study and provided informed consent. Trained examiners using standardized tools assessed the prevalence rates of gingivitis and plaque in all children. RESULTS Gingivitis prevalence was elevated among T21 children (46.9%) compared to controls (34%) in all arch sextants except the mandibular middle (P < 0.01). Comparing the two groups, the prevalence of plaque was higher in the maxillary right sextant of the T21 group and the mandibular middle sextant of the control group (P < 0.05). CONCLUSION T21 children have significantly elevated plaque levels, resulting in greater prevalence of gingivitis, compared to healthy children. Preventive measure, such as oral health awareness programs, should be delivered early to parents and continued at school to encourage and motivate children.
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Grewal N, Sethi T, Grewal S. Widening horizons through alternative and augmentative communication systems for managing children with special health care needs in a pediatric dental setup. SPECIAL CARE IN DENTISTRY 2014; 35:114-9. [DOI: 10.1111/scd.12099] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Navneet Grewal
- Professor and Head, Department of Pedodontics and Preventive Dentistry; Government Dental College; Amritsar Punjab India
| | - Tanvi Sethi
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry; Government Dental College; Amritsar Punjab India
| | - Sukrit Grewal
- Research Assistant, Department of Pedodontics and Preventive Dentistry; Government Dental College; Amritsar Punjab India
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Al-Sufyani GA, Al-Maweri SA, Al-Ghashm AA, Al-Soneidar WA. Oral hygiene and gingival health status of children with Down syndrome in Yemen: A cross-sectional study. J Int Soc Prev Community Dent 2014; 4:82-6. [PMID: 25254190 PMCID: PMC4170549 DOI: 10.4103/2231-0762.139429] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose: The objective of the present study was to assess the oral hygiene and gingival health status among Yemeni children with Down syndrome. Materials and Methods: The study sample comprised 101 children with Down syndrome attending special needs schools in Sana’a, Yemen. The calculus index (CI), plaque index (PI), and the gingival index (GI) were used to assess oral hygiene and gingival health status. Results: All subjects had gingivitis; the mean CI, PI, and GI scores were 0.58 ± 0.61, 1.45 ± 0.57, and 1.54 ± 0.64, respectively, with no significant difference found across gender. Stepwise linear regression analysis revealed that the best predictors in the descending order for CI were age and mother's education, and the best predictors for PI were IQ level, age, and father's education. Having severe mental retardation, older age, less educated parents were the most important predictors for poor gingival health status. Conclusions: These findings show that children with Down syndrome have poor oral hygiene and high levels of periodontal diseases. Hence, appropriate oral health education should be tailored to the needs of these children with the support of their teachers and parents.
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Affiliation(s)
| | - Sadeq Ali Al-Maweri
- Department of Oral Medicine and Periodontology, School of Dentistry, Sana'a University, Yemen
| | | | - Walid A Al-Soneidar
- Department of Oral Medicine and Periodontology, School of Dentistry, Sana'a University, Yemen
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Cavalcante LB, Tanaka MH, Pires JR, Henrique Apponi L, Aparecida Giro EM, Roberto Valentini S, Palomari Spolidório DM, Capela MV, Rossa C, Scarel-Caminaga RM. Expression of the Interleukin-10 Signaling Pathway Genes in Individuals With Down Syndrome and Periodontitis. J Periodontol 2012; 83:926-35. [DOI: 10.1902/jop.2011.110056] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Al Habashneh R, Al-Jundi S, Khader Y, Nofel N. Oral health status and reasons for not attending dental care among 12- to 16-year-old children with Down syndrome in special needs centres in Jordan. Int J Dent Hyg 2012; 10:259-64. [DOI: 10.1111/j.1601-5037.2012.00545.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Khocht A, Heaney K, Janal M, Turner B. Association of interleukin-1 polymorphisms with periodontitis in Down syndrome. J Oral Sci 2011; 53:193-202. [PMID: 21712624 DOI: 10.2334/josnusd.53.193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study examined the association of IL1 genetic polymorphisms (IL-1A +4845, IL-1B +3954 & IL-1RN +2018) with periodontal disease status of Down syndrome (DS) individuals. Fifty-four DS patients (18-56 yr, 48.15% male, 77.78% Caucasians) were recruited from the Georgia Regional Hospital (GRH) health care system. Two comparable groups (71 mentally retarded patients and 87 control subjects) were also recruited. All subjects were nonsmokers. Periodontal evaluations (plaque index, gingival index, bleeding-on probing and clinical attachment levels (AL)), personal and professional dental care habits were recorded. Blood was collected by a venipuncture. The IL-1A +4845, IL-1B +3954 & IL-1RN +2018 loci were genotyped by the TaqMan assay. No statistically significant differences were noted in the distribution of IL-1 gene polymorphisms between the three groups. The IL-1 variant genotypes varied by race; for both IL-1A and IL-1RN, the variant gene was significantly more prevalent among whites than non-whites (ps > 0.1). ANCOVA, which also adjusted for age, showed a 3-way interaction among dental visits, gene variation and Down status [(F(1, 179) = 3.96, P = 0.048 in White subjects and F(1, 241) = 2.96, P = 0.087 in all subjects). Post-hoc t-tests confirmed lower levels of AL in IL-1RN-variant Down subjects receiving more frequent dental visits (P < 0.05). ANCOVA, which also adjusted for age, showed an interaction between IL-1A/B gene variation and Down status (F(1, 174) = 3.04, P = 0.083 in White subjects and F(1, 235) = 3.72, P = 0.055 in all subjects). Post-hoc t-tests confirmed lower levels of AL in IL-1A/B-variant Down subjects (P < 0.05). The distribution of variant IL-1 genes in DS subjects was not different from the general population. However the association between the carriage of the IL-1 rare alleles and periodontitis differed between the Down and non-Down subjects. The carriage of the IL-1 rare alleles in the Down subjects tended to confer a protective effect against loss of periodontal attachment.
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Affiliation(s)
- Ahmed Khocht
- Department of Periodontology, School of Dentistry, Temple University, Philadelphia, PA 19140, USA.
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Anders PL, Davis EL. Oral health of patients with intellectual disabilities: a systematic review. SPECIAL CARE IN DENTISTRY 2010; 30:110-7. [PMID: 20500706 DOI: 10.1111/j.1754-4505.2010.00136.x] [Citation(s) in RCA: 232] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A systematic review of original studies was conducted to determine if differences in oral health exist between adults who have intellectual disabilities (ID) and the general population. Electronic searching identified 27 studies that met the inclusion criteria. These studies were assessed for strength of evidence. People with ID have poorer oral hygiene and higher prevalence and greater severity of periodontal disease. Caries rates in people with ID are the same as or lower than the general population. However, the rates of untreated caries are consistently higher in people with ID. Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. Evidence supports the need to develop strategies to increase patient acceptance for routine care, additional training for dentists to provide this care, and the development of more effective preventive strategies to minimize the need for this care.
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Affiliation(s)
- Patrick L Anders
- Department of Oral Diagnostic Sciences, State University of New York at Buffalo School of Dental Medicine Buffalo, New York, USA.
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Meurs D, Rutten M, De Jongh A. ARTICLE: Does information about patients who are intellectually disabled translate into better cooperation during dental visits? SPECIAL CARE IN DENTISTRY 2010; 30:200-5. [DOI: 10.1111/j.1754-4505.2010.00152.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vieira TR, Péret ADCA, Péret Filho LA. Alterações periodontais associadas às doenças sistêmicas em crianças e adolescentes. REVISTA PAULISTA DE PEDIATRIA 2010. [DOI: 10.1590/s0103-05822010000200017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVO: O objetivo deste estuo foi revisar na literatura a inter-relação entre condições sistêmicas e a ocorrência de doenças periodontais em crianças e adolescentes, destacando-se as manifestações periodontais frequentemente encontradas. FONTES DE DADOS: Artigos indexados nas bases de dados Medline, Lilacs e Bibliografia Brasileira em Odontologia, nos últimos 20 anos, além de referências clássicas. As palavraschave utilizadas foram: "doença periodontal", "periodontite", "doenças sistêmicas", "criança" e "adolescente". SÍNTESE DOS DADOS: Doenças sistêmicas como hipofosfatasia, histiocitose X, síndrome de Down, síndrome de Papillon-Lefèvre, síndrome de Ehlers-Danlos, síndrome de Chédiak-Higashi, leucemias, Aids e as deficiências quantitativas e qualitativas dos neutrófilos estão associadas ao aparecimento de alterações periodontais graves em crianças e adolescentes. Os estudos demonstraram a ocorrência de alteração periodontal na forma de periodontite em crianças e adolescentes com doenças sistêmicas, podendo levar à perda precoce de dentes. CONCLUSÕES: A ocorrência de alterações periodontais é observada em crianças e adolescentes com alterações sistêmicas, que manifestam desde inflamação gengival até formas mais destrutivas, como periodontites e perda precoce dos dentes.
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Khocht A, Janal M, Turner B. Periodontal health in Down syndrome: Contributions of mental disability, personal, and professional dental care. SPECIAL CARE IN DENTISTRY 2010; 30:118-23. [DOI: 10.1111/j.1754-4505.2010.00134.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Haveman M, Heller T, Lee L, Maaskant M, Shooshtari S, Strydom A. Major Health Risks in Aging Persons With Intellectual Disabilities: An Overview of Recent Studies. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2010. [DOI: 10.1111/j.1741-1130.2010.00248.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Etiologic factors of early-onset periodontal disease in Down syndrome. JAPANESE DENTAL SCIENCE REVIEW 2008. [DOI: 10.1016/j.jdsr.2008.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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de Jongh A, van Houtem C, van der Schoof M, Resida G, Broers D. Oral health status, treatment needs, and obstacles to dental care among noninstitutionalized children with severe mental disabilities in The Netherlands. SPECIAL CARE IN DENTISTRY 2008; 28:111-5. [DOI: 10.1111/j.1754-4505.2008.00022.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cheng RHW, Leung WK, Corbet EF, King NM. Oral health status of adults with Down syndrome in Hong Kong. SPECIAL CARE IN DENTISTRY 2007; 27:134-8. [DOI: 10.1111/j.1754-4505.2007.tb00335.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Salako NO, Rotimi V, Philip L, Haidar HA, Hamdan HM. The prevalence and antibiotic sensitivity of oral Viridans streptococci in healthy children and children with disabilities in Kuwait. SPECIAL CARE IN DENTISTRY 2007; 27:67-72. [PMID: 17539223 DOI: 10.1111/j.1754-4505.2007.tb00331.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to compare the antibiotic susceptibility profiles of Viridans streptococci (VS) isolated from the oral cavity of healthy children and children with disabilities in Kuwait. Plaque samples were collected from the tooth and tongue surfaces of 102 healthy children and 102 children who were intellectually disabled and institutionalized. The resistance to seven antibiotics (amoxicillin, cephalothin, clindamycin, erythromycin, penicillin G, tetracycline, and vancomycin) was tested. A total of 330 (44.5%) VS were isolated from the children who were healthy and 411 (55.5%) from children with disabilities. The most common isolates were S. salivarius (27.3%) in healthy children; S. sanguis (22.6%) was predominant among children who were disabled. S. mutans was found in 12.1% of the healthy children and in 16.5% of the children who were disabled. The combined percentage of resistant strains (healthy and disabled) was found to be highest with amoxicillin (43%) and lowest with vancomycin (12%). S. sanguis, S. mitis and S. oralis were more resistant in healthy children (45%, 56%, and 55% respectively) than in children with disabilities (40%, 47% and 47% respectively). S. mutans was the least resistant species to all antibiotics in both groups of children. About 56% of all streptococci isolated from both groups were resistant to at least one of the antibiotics tested. The data showed that there was a difference in the level of resistance of oral VS isolated from healthy children and children with disabilities to some antibiotics commonly used in dentistry.
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Affiliation(s)
- Nathanael O Salako
- Department of Developmental and Preventive Sciences, Faculty of Dentistry Kuwait University.
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Owens PL, Kerker BD, Zigler E, Horwitz SM. Vision and oral health needs of individuals with intellectual disability. ACTA ACUST UNITED AC 2006; 12:28-40. [PMID: 16435325 DOI: 10.1002/mrdd.20096] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Over the past 20 years, there has been an increased emphasis on health promotion, including prevention activities related to vision and oral health, for the general population, but not for individuals with intellectual disability (ID). This review explores what is known about the prevalence of vision problems and oral health conditions among individuals with ID, presents a rationale for the increased prevalence of these conditions in the context of service utilization, and examines the limitations of the available research. Available data reveal a wide range of prevalence estimates for vision problems and oral health conditions, but all suggest that these conditions are more prevalent among individuals with ID compared with the general population, and disparities exist in the receipt of preventive and early treatment for these conditions for individuals with ID. Recommendations for health improvement in these areas include better health planning and monitoring through standardized population-based data collection and reporting and increased emphasis on health promotion activities and early treatment in the healthcare system.
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Affiliation(s)
- Pamela L Owens
- Agency for Healthcare Research and Quality, Rockville, MD 20850, USA.
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Morinushi T, Lopatin DE, Nakao R, Kinjyo S. A Comparison of the Gingival Health of Children with Down Syndrome to Healthy Children Residing in an Institution. SPECIAL CARE IN DENTISTRY 2006; 26:13-9. [PMID: 16703929 DOI: 10.1111/j.1754-4505.2006.tb01504.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The purpose of this study was to compare the onset and severity of gingivitis in children with Down syndrome, when compared to a healthy control group of children. The subjects included 41 children with Down syndrome ages two to 14 years (mean age: 7.6 years) and 112 age-matched healthy controls. We assessed the gingival health of all subjects using the gingival inflammation (M-PMA) index and periodontal probing depth (PD). Children were divided into three age categories: <5 years (AI), 5 to <10 years (AII), and 10 to <17 years (AIII). Supragingival plaque was measured using the Oral Hygiene Index (OHI) and the subjects were screened with the BANA test (Perioscan-Oral-B). Measurement of the M-PMA index in the healthy children showed an age-related increase (F = 10.369, p < 0.001), and the M-PMA index at the younger age group <5 year (AI) was significantly lower than that for the other two age groups All or AIII (p < 0.005, p < 0.001). In contrast, the M-PMA index values at AI and AIII in the subjects with Down syndrome were significantly higher than those for healthy children (p < 0.001, p < 0.001). Both groups had an age-related increase in PD (F = 3.388, p < 0.05 & F = 10.806, p < 0.001), and PD at AIII was significantly higher than that at AI in both groups (p < 0.01, p < 0.001). The children with Down syndrome showed an age-related increase in the BANA test score (F = 3.452, p < 0.05), and the BANA test score at AIII was significantly higher than that at AI (p < 0.02). The BANA test score in the healthy children was not age-related but was significantly higher than that in the children with Down syndrome (p < 0.02, p < 0.05).
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Affiliation(s)
- Takanobu Morinushi
- Dept. of Pediatric Dentistry, Kagoshima University Dental School, Kagoshima, Japan.
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