Periodontal status of individuals with Down syndrome: sociodemographic, behavioural and family perception influence

Pressure pain threshold of the mastigatory muscles and reaction to touch in adults with down syndrome and neurotypicals: cross-sectional study

BACKGROUND

Down Syndrome (DS) is currently the most common chromosomal condition associated with intellectual disability in the global population and is characterized by a variety of additional clinical findings. Individuals with DS may exhibit altered perception and reaction to painful stimuli, which makes the diagnosis of pain in DS a challenge. This study aimed to evaluate the pressure pain threshold of the masticatory muscles and the reaction to social touch in individuals with DS compared to neurotypical individuals (NT).

METHODS

Patients with DS and NT individuals were included following predefined inclusion criteria. The assessment and comparison methods used between the groups were: 1) Algometry to quantify the pressure pain threshold of the masseter, temporal, and abductor pollicis brevis; 2) Social Touch Questionnaire (STQ) to assess social touch acceptance. Data obtained from the assessments were submitted to normality tests to determine if they followed a normal distribution. The Pressure Pain Threshold data were analyzed using the Mann-Whitney test, while the Social Touch data were analyzed using the student's t-test, both with a significance level of 5%.

RESULTS

A total of 32 patients were included in the study, sixteen with DS and sixteen NT individuals. The results showed that the pressure pain threshold of all analyzed muscles in the DS group was significantly higher (p < 0.001) than in the NT group. However, social touch acceptance was similar between the two groups (p = 0.270).

CONCLUSIONS

It was concluded that the pressure pain threshold is significantly higher in individuals with DS compared to NT, but social touch acceptance is similar between the groups.

The interaction between the nervous system and the stomatognathic system: from development to diseases

The crosstalk between the nerve and stomatognathic systems plays a more important role in organismal health than previously appreciated with the presence of emerging concept of the "brain-oral axis". A deeper understanding of the intricate interaction between the nervous system and the stomatognathic system is warranted, considering their significant developmental homology and anatomical proximity, and the more complex innervation of the jawbone compared to other skeletons. In this review, we provide an in-depth look at studies concerning neurodevelopment, craniofacial development, and congenital anomalies that occur when the two systems develop abnormally. It summarizes the cross-regulation between nerves and jawbones and the effects of various states of the jawbone on intrabony nerve distribution. Diseases closely related to both the nervous system and the stomatognathic system are divided into craniofacial diseases caused by neurological illnesses, and neurological diseases caused by an aberrant stomatognathic system. The two-way relationships between common diseases, such as periodontitis and neurodegenerative disorders, and depression and oral diseases were also discussed. This review provides valuable insights into novel strategies for neuro-skeletal tissue engineering and early prevention and treatment of orofacial and neurological diseases.

Identifying metabolic parameters related to severity and extent of periodontitis in down syndrome patients

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.

Sinus lift technique and dental implants for rehabilitation for a Down syndrome patient with tomographic 3-years follow-up

Down Syndrome or trisomy 21 (T21) is a genetic condition caused by the presence of an extra chromosome in pair 21 and is related to a high prevalence of agenesis of permanent teeth and periodontal alterations that may be associated to the loss of permanent teeth at early ages. With the increase in life expectancy of people with T21 in the last decades, it is necessary to expand the knowledge to offer possibilities of treatment with dental implants, aiming to serve this aging population.

AIMS

The aim of this article is to report a surgical procedure of sinus lift to enable the installation of dental implants in the posterior region of the maxilla.

METHODS AND RESULTS

A 50 year-old patient with T21 was rehabilitated with implants, simultaneously with sinus lift surgery, by the lateral window technique, using xenogenous bone graft and fibrin-rich plasma. After 1 year, the patient was rehabilitated with prosthetics on implants.

CONCLUSION

The feasibility of this technique in patients with Down syndrome could be observed, after 3 years of follow up, with favorable clinical results.

Impact of parental care on oral health of children with Intellectual Disabilities from zero to six years of age

Abstract Introduction the birth of a child with an intellectual disability requires the definition of the parents' roles in relation to the care of the child. Objective evaluate how much parental care practices, sociodemographic and behavioral characteristics and family knowledge can have an impact on the oral health of children with intellectual disabilities in the age group from zero to six years of age. Material and method the level of help given to the child in the practice of oral hygiene was evaluated according to the adapted functional independence scale. The Parental Beliefs and Care Practices Scale assessed primary care and stimulation offered to the child. The presence of dental plaque and the decay-missing-filled teeth (DMFT) index were analyzed. The significance level was 5%. Result the relative percentage of dental plaque was 11.4%. The DMFT was 2. The prevalence of teeth with indicated extraction is higher in children who receive full assistance for cleaning, when compared to those who receive maximum, moderate help or supervision. Higher levels of dental plaque and decayed teeth were found in children whose parents rated their dental health as poor, hygiene as deficient, and when they believed their children might feel discomfort due to their oral health. Low stimulation frequency resulted in a higher plaque index and number of decayed teeth. Conclusion the frequency of parental care stimulation influenced the percentage of plaque index and the number of decayed teeth in children with intellectual disabilities.

Identification of Neuropeptides as Potential Crosstalks Linking Down Syndrome and Periodontitis Revealed by Transcriptomic Analyses

Background

This bioinformatics study was aimed to investigate the relationship between periodontitis (PD) and Down Syndrome (DS) regarding potential crosstalk genes, related neuropeptides, and biological processes.

Methods

Data for PD (GSE23586, GSE10334 and GSE16134) and DS (GSE35665) were downloaded from NCBI Gene Expression Omnibus (GEO). Following normalization and merging of PD data, differential expression analysis was performed (p value < 0.05 and ∣log FC | ≥0.5). The common deregulated genes between PD and DS were considered as crosstalk genes. The significantly differentially expressed genes were used to construct the coexpression network and to further identify coexpression gene modules. To acquire the significant modules, the significant expression level of genes in the module was used to analyze the enrichment of genes in each module. Neuropeptides were assessed from NeuroPedia database. Neuropeptide genes and crosstalk genes were merged and mapped into PPI network, and the correlation coefficient (Spearman) was determined for the crosstalk genes.

Results

138 crosstalk genes were predicted. According to the functional enrichment analysis, these genes significantly regulated different biological processes and pathways. In enrichment analysis, the significant module of DS was pink module, and turquoise module was significant in PD. Four common crosstalk genes were acquired, i.e., CD19, FCRL5, FCRLA, and HLA-DOB. In the complex network, INS and IGF2 interacted with CASP3 and TP53, which commonly regulated the MAPK signaling pathway. Moreover, the results showed that TP53 interacted with IGF2 and INS inducing the dysregulation of PI3K-Akt signaling pathway. UBL was positively correlated with crosstalk genes in both diseases. LEP was revealed to be both a neuropeptide and crosstalk gene and was positively correlated with other crosstalk genes.

Conclusion

Different crosstalk genes, related neuropeptides, and biological pathways and processes were revealed between PD and DS, which can serve as a theoretical basis for future research.

Is Down syndrome a risk factor or contraindication for dental implants? A systematic review

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.

Opportunities, barriers, and recommendations in down syndrome research

BACKGROUND

Recent advances in medical care have increased life expectancy and improved the quality of life for people with Down syndrome (DS). These advances are the result of both pre-clinical and clinical research but much about DS is still poorly understood. In 2020, the NIH announced their plan to update their DS research plan and requested input from the scientific and advocacy community.

OBJECTIVE

The National Down Syndrome Society (NDSS) and the LuMind IDSC Foundation worked together with scientific and medical experts to develop recommendations for the NIH research plan.

METHODS

NDSS and LuMind IDSC assembled over 50 experts across multiple disciplines and organized them in eleven working groups focused on specific issues for people with DS.

RESULTS

This review article summarizes the research gaps and recommendations that have the potential to improve the health and quality of life for people with DS within the next decade.

CONCLUSIONS

This review highlights many of the scientific gaps that exist in DS research. Based on these gaps, a multidisciplinary group of DS experts has made recommendations to advance DS research. This paper may also aid policymakers and the DS community to build a comprehensive national DS research strategy.

Evaluation of the craniofacial and oral characteristics of individuals with Down syndrome: A review of the literature

The aim of this investigation was to describe the craniofacial and oral characteristics of children and/or adolescents with and without Down syndrome (DS). A bibliographic search of the Medline database (via PubMed), Scopus and SCIELO was performed using the keywords "craniofacial characteristics", "dental characteristics" and "Down syndrome". Systematic reviews, observational cross-sectional and longitudinal studies were included. On the contrary, case reports, letters to the editor, editorials and opinion articles were excluded. 251 articles were recovered, and only 30 fulfilled the selection criteria. DS patients were characterized by reduced dimensions of the maxillary bone, mandible, and skull base, compared to normal patients. Likewise, some of these abnormalities influenced more frequent presentation of a class III malocclusion in these patients. On the other hand, this population group showed a higher prevalence of periodontal diseases, less risk of dental caries, and the presence of alterations in the tongue, lips, dental development and palate morphology. The quality of life of these individuals is affected by difficulties in swallowing, talking, eating or breathing through the nose. In conclusion, the craniofacial and oral characteristics of DS patients present various alterations compared to healthy patients, and these alterations have a negative impact on their quality of life.