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Mélou C, Sixou JL, Sinquin C, Chauvel-Lebret D. Temporomandibular disorders in children and adolescents: A review. Arch Pediatr 2023:S0929-693X(23)00053-2. [PMID: 37147156 DOI: 10.1016/j.arcped.2023.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/21/2023] [Accepted: 03/25/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Temporomandibular disorders (TMD) are generally observed in individuals between the ages of 20 and 40 years. TMD have also been described in children and adolescents but are still not widely detected and treated in routine practice. Through a literature review, this work aims to improve the diagnosis and management of TMD in children and adolescents by dentists. METHODS This literature review was performed by a computerized search of the database PubMed for published articles on TMD in children and adolescents. Articles evaluating the prevalence, etiologies and risk factors, diagnosis, signs, and symptoms as well as the comorbidities of TMD, published between 2001 and 2022, were included in this review. RESULTS A total of 51 articles were included. Most of studies reported a prevalence of over 20%, with a higher prevalence in females. The two most common diagnoses were myofascial pain and disk displacement with reduction. Headaches were often associated with the condition. The management of TMD in children and adolescents has been poorly studied. CONCLUSION TMD frequently affect children and adolescents. Therefore, for prevention purposes, an examination of the masticatory system should be included in the dental check-up. Early diagnosis is essential in order to limit effects on their growth, development, and quality of life. TMD management is not currently validated for children and adolescents. Noninvasive and reversible care should be preferred.
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Affiliation(s)
- C Mélou
- Université de Rennes, UFR Odontologie F-35043 Rennes, France - CHU Rennes, Pôle d'Odontologie, F-35033 Rennes, France
| | - J L Sixou
- Université de Rennes, UFR Odontologie F-35043 Rennes, France - CHU Rennes, Pôle d'Odontologie, F-35033 Rennes, France
| | - C Sinquin
- 20 avenue des ibis 44500 la baule, France
| | - D Chauvel-Lebret
- Université de Rennes, UFR Odontologie F-35043 Rennes, France - CHU Rennes, Pôle d'Odontologie, F-35033 Rennes, France.
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Pouliquen A, Boyer E, Sixou JL, Fong SB, Marie-Cousin A, Meuric V. Oral sedation in dentistry: evaluation of professional practice of oral hydroxyzine in the University Hospital of Rennes, France. Eur Arch Paediatr Dent 2021; 22:801-811. [PMID: 33840073 DOI: 10.1007/s40368-021-00620-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/29/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Management of a child's anxiety early in their treatment is essential in dentistry. Sedative medications are used to overcome increased anxiety from previous appointments and to promote the cooperation of children during treatment. Hydroxyzine is currently prescribed to young patients as part of the first level of conscious sedation. The main objective was to evaluate the professional practice of oral hydroxyzine, when prescribed for children presenting anxiety during dental treatment procedure performed by students and senior practitioners. METHODS A retrospective study of dental records and questionnaires was conducted at the Dental Care Centre of the University Hospital of Rennes, France. Parameters related to the prescription of hydroxyzine in children were evaluated as potential predictors of the dental session success, with adjustments on potential confounders. RESULTS The therapeutic outcome was very encouraging with 78.3% of success during dental sessions under sedation with oral hydroxyzine. Anxiety levels before the dental procedure and the medication compliance of the child were the main predictors of success. On the other hand, lower age (< 6 years old) and longer treatments (such as pulpotomy) worsened the outcome. CONCLUSIONS Careful analysis of the literature and results of this work showed the safety of hydroxyzine within the maximum dose authorized without adverse effects, compared to other molecules described and commonly used in dentistry. No adverse effects during dental procedure were noted. This allows for minimal sedation with efficiency for the great majority of pediatric treatment. This solution should be the first step in sedation to help practicing clinicians.
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Affiliation(s)
- A Pouliquen
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France
| | - E Boyer
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France. .,INSERM, INRAE, Univ Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France.
| | - J-L Sixou
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France
| | - S B Fong
- University of Rennes 1, Rennes, France
| | - A Marie-Cousin
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France
| | - V Meuric
- Paediatric Dentistry Department, Univ Rennes 1, CHU de Rennes, Rennes, France.,INSERM, INRAE, Univ Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, Rennes, France
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Cabasse C, Marie-Cousin A, Huet A, Sixou JL. Computer-assisted intraosseous anaesthesia for molar and incisor hypomineralisation teeth. A preliminary study. Odontostomatol Trop 2015; 38:5-9. [PMID: 26058304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Anesthetizing MIH (Molar and Incisor Hypomineralisation) teeth is one of the major challenges in paediatric dentistry. Computer-assisted IO injection (CAIO) of 4% articaine with 1:200,000 epinephrine (Alphacaine, Septodont) has been shown to be an efficient way to anesthetize teeth in children. The aim of this study was to assess the efficacy of this method with MIH teeth. This preliminary study was performed using the Quick Sleeper system (Dental Hi Tec, Cholet, France) that allows computer-controlled rotation of the needle to penetrate the bone and computer-controlled injection of the anaesthetic solution. Patients (39) of the department of Paediatric Dentistry were included allowing 46 sessions (including 32 mandibular first permanent molars) to be assessed. CAIO showed efficacy in 93.5% (43/46) of cases. Failures (3) were due to impossibility to reach the spongy bone (1) and to achieve anaesthesia (2). This prospective study confirms that CAIO anaesthesia is a promising method to anesthetize teeth with MIH that could therefore be routinely used by trained practitioners.
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Gendronneau M, Kérourédan O, Taque S, Sixou JL, Bonnaure-Mallet M. Dental abnormalities and preventive oral care in Schimke immuno-osseous dysplasia. Eur Arch Paediatr Dent 2013; 15:217-21. [PMID: 24327104 DOI: 10.1007/s40368-013-0099-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 11/27/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Schimke immuno-osseous dysplasia (SIOD) is a rare, severe, autosomal recessive disorder that results in spondyloepiphyseal dysplasia, renal dysfunction, immunodeficiency, facial dysmorphism and growth failure. Little is known about oral features associated with SIOD. Some of the dental anomalies encountered are specific to SIOD and have only been reported in individuals with SIOD. CASE REPORT This paper describes the clinical and radiographic dental manifestations of SIOD in two Caucasian brothers. Both lived to be about 10 years old. After a variety of symptoms were reported, a diagnosis of SIOD was finally made when the brothers were, respectively, 5 and 8 years old. At that time, dental anomalies, such as dyschromia, bulbous crowns, short and thin roots, had not been taken into account to establish the diagnosis. However, knowledge of the dental features characteristic of this disease could have helped make the diagnosis. Although both were caries- and periodontal disease-free, special attention was focused on prevention, including dietary counselling, plaque control, oral hygiene instructions and the use of fluoridated toothpaste. FOLLOW-UP The two patients were followed every 6 months, for over 2 years (until their death), by both a private dentist and a university hospital dentist, which helped them maintain good oral health. Oral hygiene was assessed at each appointment and fissure sealants were placed by the private practitioner on their first permanent molars. CONCLUSION This report describes dental anomalies specific to SIOD that could facilitate diagnosis. Clinicians and dentists should work in collaboration to diagnose and treat children with SIOD. These patients require regular and specific dental management because of their fragile health and their characteristic dental anomalies. Ideally, preventive visits should be scheduled every 6 months in addition to curative visits as needed.
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Affiliation(s)
- M Gendronneau
- Université Européenne de Bretagne, Université de Rennes 1 and Centre Hospitalier Universitaire de Rennes, Rennes, France
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Corbet E, Akinwade J, Duggal R, Gebreegziabher G, Hirvikangas H, Hysi D, Katrova L, Karaharju-Suvanto T, McGrath C, Ono K, Radnai M, Schwarz E, Scott J, Sixou JL, Soboleva U, Uoshima K, Yaneva-Ribagina K, Fox C. Staff recruitment, development and global mobility. Eur J Dent Educ 2008; 12 Suppl 1:149-160. [PMID: 18289277 DOI: 10.1111/j.1600-0579.2007.00496.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
This paper considers issues that relate to staff recruitment, staff development and global mobility of dental academics. Published literature, which has a North American bias, is reviewed. Recommendations, which may be applicable world-wide, are made to address evident and pertinent areas of concern in terms of the availability of quality dental teaching staff in dental teaching institutions so as to sustain the global dental academic enterprise at appropriately high levels of achievement.
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Affiliation(s)
- E Corbet
- The University of Hong Kong, Hong Kong, China.
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Sixou JL, Aubry-Leuliette A, De Medeiros-Battista O, Lejeune S, Jolivet-Gougeon A, Solhi-Pinsard H, Gandemer V, Barbosa-Rogier M, Bonnaure-Mallet M. Capnocytophaga in the dental plaque of immunocompromised children with cancer. Int J Paediatr Dent 2006; 16:75-80. [PMID: 16430520 DOI: 10.1111/j.1365-263x.2006.00697.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES (i) To compare the prevalence and levels of Capnocytophaga, a known systemic pathogen in immunocompromised patients, in the dental plaque of healthy children and children with cancer, and (ii) to determine the susceptibility of strains isolated from cancer patients to a range of antibiotics. PATIENTS AND METHODS Thirty-one children with cancer undergoing a first course of immunosuppressive chemotherapy and 30 healthy control children were included in the study. Samples were collected on days 0, 7, 14, and 21 of the cure (and equivalent dates in controls). Susceptibility to antibiotics was tested using an agar dilution method and galleries with predefined concentrations of selected antibiotics. RESULTS There was a significant drop in the total anaerobic cultivable flora on day 14 and in the prevalence of Capnocytophaga on days 14 and 21 in the children with cancer. The proportion of Capnocytophaga in the anaerobic flora, however, was high in certain cancer patients. Beta-lactam/beta-lactamase inhibitor combinations, imipenem, clindamycin, and tetracycline were the most effective against Capnocytophaga. CONCLUSION This study showed that Capnocytophaga decreased in prevalence and proportion in the dental plaque of cancer patients during chemotherapy but became predominant in some cases. It is recommended that imipenem or beta-lactam/beta-lactamase inhibitor combinations be used to treat Capnocytophaga bacteraemia.
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Affiliation(s)
- J L Sixou
- Department of Paediatric Dentistry, Rennes Cedex, France.
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Jolivet-Gougeon A, Buffet A, Dupuy C, Sixou JL, Bonnaure-Mallet M, David S, Cormier M. In vitro susceptibilities of Capnocytophaga isolates to beta-lactam antibiotics and beta-lactamase inhibitors. Antimicrob Agents Chemother 2000; 44:3186-8. [PMID: 11036049 PMCID: PMC101629 DOI: 10.1128/aac.44.11.3186-3188.2000] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The susceptibilities of 43 pharyngeal isolates of Capnocytophaga to beta-lactam antibiotics, alone or in combination with beta-lactamase inhibitors, were tested by an agar dilution method. The 34 beta-lactamase-positive strains were highly resistant to beta-lactams, but the intrinsic activities of clavulanate, tazobactam, and sulbactam against Capnocytophaga, even beta-lactamase producers, indicates that these beta-lactamase inhibitors could be used for empirical treatment of neutropenic patients with oral sources of infection.
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Affiliation(s)
- A Jolivet-Gougeon
- Laboratoire de Microbiologie Pharmaceutique, UPRES-EA 1254, Université de Rennes I, 35000 Rennes, France
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Abstract
The anaerobic cultivable flora of the dental plaque was investigated in 16 cancer children at days 0, 7, 14 and 21 of a first cure of chemotherapy. Results were compared with those obtained in 16 healthy children. Diseased children showed more quantitative variations of the flora than the controls, especially during the first week of chemotherapy. Whatever the day of sampling, the flora of the diseased children was significantly less complex than that of the controls. Viridans streptococci, Capnocytophaga, and to a lesser extent staphylococci, appeared to be the most strongly affected in diseased children. This could be explained by different mechanisms, uncontrolled recolonization of the dental plaque, selection of multidrug-resistant strains or nosocomial acquisition. These results indicate that variations in quantity, complexity and quality of the oral flora occur during chemotherapy, leading to a major imbalance of the ecosystem.
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Affiliation(s)
- J L Sixou
- Department of Pedodontics and Equipe de Biologie Buccale (UPRES-EA 1256), Rennes, France.
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Sixou JL, Robert JC, Bonnaure-Mallet M. Loss of deciduous teeth and germs of permanent incisors in a 4-year-old child. An atypic prepubertal periodontitis? A clinical, microbiological, immunological and ultrastructural study. J Clin Periodontol 1997; 24:836-43. [PMID: 9402506 DOI: 10.1111/j.1600-051x.1997.tb01198.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 4-year-old child was referred, in April 1988, to Rennes Dental School (France) for deciduous tooth mobility with premature loss of 4 deciduous teeth and germs of 2 permanent incisors. Microbiological examinations by culture revealed the presence of the periodontal pathogen Actinobacillus actinomycetemcomitans. Immunofluorescence of plaque samples revealed the presence of Porphyromonas gingivalis that had not been isolated by culture. Neutrophil functions were within normal ranges. Transmission electron microscopy of gingiva showed a disorganised epithelium. The connective tissue was infiltrated by inflammatory cells. The basement membranes were normal, but the connective tissue-epithelium interface was mainly composed of short rete pegs. Scanning electron microscopy of extracted deciduous teeth revealed lack of cementum, lacunae in the cementum and lack of fibrillar insertion on the middle part of the root. Skin lesions, mainly situated on face, were observed. Treatment was by extraction of mobile deciduous teeth combined with 3-week courses of metronidazole. Clinical and microbiological follow-up was continued over a 7-year period. No periodontal lesions have been detected since eruption of the permanent teeth. The present subgingival and lingual microflora (December 1995) is composed of bacteria associated with periodontal health. However, the future appearance of a hitherto undetected systemic disease is still possible.
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Affiliation(s)
- J L Sixou
- Equipe de Biologie Buccale UPRES-EA 1256, Rennes, France
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Sixou JL, de Medeiros-Batista O, Bonnaure-Mallet M. Modifications of the microflora of the oral cavity arising during immunosuppressive chemotherapy. Eur J Cancer B Oral Oncol 1996; 32B:306-10. [PMID: 8944833 DOI: 10.1016/0964-1955(96)00006-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Infections are a major cause of mortality among immunosuppressed cancer patients. The oral cavity is a possible reservoir for those microorganisms, both commensal and acquired, whose virulence is exacerbated in the immunosuppressed patient. The mouth consists of multiple habitats offering ecological niches to a variety of organisms. The object of this article is to review the literature devoted to quantitative and qualitative variations in the flora of the oral cavity during immunosuppressive treatment of cancer patients. Examination of these different studies reveals modifications of the commensal flora, as well as an increase in Gram negative rods, in staphylococci and in yeasts. These data confirm the necessity for constant surveillance of the oral cavity during chemotherapy.
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Affiliation(s)
- J L Sixou
- Equipe de Biologie Buccale (EA 1256), Université de Rennes, France
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Abstract
Serum samples from 41 periodontally healthy children aged 1 to 16 years were examined by ELISA for the presence of antibodies against a glass bead-EDTA cell surface extract (GBE) and LPS of Porphyromonas gingivalis strain ATCC 33277. P. gingivalis was detected by immunofluorescence, using a species-specific monoclonal antibody, in 41% (17/41) of the children, and isolated from a single subject (2.4%). IgM, IgG, and IgA against GBE were detected in respectively 39/41 (95%), 41/41 (100%), and 27/41 (66%) of the sera. In 22/39 sera, the IgG titer was below 50% that of a reference pool of adult sera (RP). In 13/41, the IgM titer was higher than that of the RP, mostly in the deciduous dentition group. Detectable IgA titers were always below 67% that of the RP. A polarized distribution of the children appeared, separating 21 non- and low IgA responders (IgA titer below 10% that of the RP) from the remaining 20 subjects. Anti-LPS IgG, IgM, and IgA were detected in 41/41 (100%), 39/41 (95%), and 23/38 (61%) respectively of the children. In 32/41 sera, the anti-LPS IgG titer was below 50% that of the RP, while in 20/39 sera, IgM titers were higher. A clearcut dichotomy in IgA response was observed, allowing us to distinguish non-IgA responders (39%) and IgA responders to LPS (61%). Our results indicate that serum antibodies to P. gingivalis are highly prevalent in children, suggesting that an active primary immune response and a secondary immune response are well underway.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J L Sixou
- U.F.R. Odontologie, Université de Rennes, France
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Sixou JL, Robert JC. [Factors promoting infection in the dental office]. Chir Dent Fr 1991; 61:25-8. [PMID: 2070673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Robert JC, Mouton C, Sixou JL, Cormier M. [A comparison of culture and immunofluorescence technics in the study of Bacteroides with black pigmentation]. Bull Group Int Rech Sci Stomatol Odontol 1990; 33:83-8. [PMID: 2083384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The aim of that study was to compare culture and immunofluorescence (IF) methods to determine whether B. gingivalis and other B.P.B. can be detected in subgingival plaque of children. Samples were collected from the lingual sulcus of mandibular incisors, dispersed and diluted from 1 to 10(-5); 15 microliters of each dilution were plated on Trypticase soja agar and Todd-Hewitt agar supplemented with blood, Vit K 1 and hemin. The same dilutions were smeared on glass slides for indirect IF using an species-specific polyclonal rabbit whole cell antiserum to B. gingivalis ATCC 33 277. Representative colonies producing brown-to-black pigment were isolated, purified and further characterized. Using culture, BPB were detected in 46% of children (19/41). B. gingivalis was cultured from 6 children. Using immunofluorescence test (Fluotec*), 90% of 309 children 3 years old and more harbour detectable B.P.B., but B. gingivalis don't react with that test. B. gingivalis were detected by immunofluorescence in 72% of children (30/41) in the incisor plaque.
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Sixou JL, Milon D, Robert JC. [Pharmacokinetics and antibiotic therapy of the child]. Actual Odontostomatol (Paris) 1989; 43:433-48. [PMID: 2635561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Pharmacokinetics is too often unknown while ordering antibiotics, particularly to children. The aim of that paper is to recall the pharmacokinetic characteristics of the most ordered families in pediatric dentistry: penicillin A and macrolides, as well as the modifications peculiar to children, due to pathology, or subsequent to drug interactions.
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