Clinical features of oral management to oral complications of Sjögren's syndrome / 北京大学学报(医学版)

OBJECTIVE@#To understand the clinical characteristics about sequence diagnosis and treatment of oral complications in patients with Sjögren's syndrome (SS) through retrospective analysis, and to provide some guidance for clinical work.@*METHODS@#Some SS patients who underwent oral sequence management in the Department of General Dentistry, Peking University School and Hospital of Stomatology from January 2015 to September 2021 were enrolled. For the SS patients included in this study, a comprehensive oral examination was performed, including parotid region examination, oral mucosal exa-mination, dentition examination, dental examination, periodontal examination, unstimulated salivary flow rate, Candida infection and radiological imaging examination. According to the examination results, the patients were given fluoride application, antifungal treatment, root canal therapy, direct filling repair, and indirect repair treatment in sequence and the results recorded.@*RESULTS@#A total of 9 patients with SS, with 4 primary SS patients (pSS) and 5 secondary SS patients (sSS) were enrolled in the study. For all the 9 patients, the average age was (49.2±16.2) years and the median xerostomia duration 5 years. The unstimulated salivary flow rate of the 9 patients was all less than 1 mL/10 min. Eight of the 9 cases was diagnosed as oral Candidiasis, with positive salivary Candida culture result (>200 cfu/mL), and 1 of the 9 cases was not. The average decay, missing, filling teeth (DMFT) was 24.8±4.2; the average decay, missing, filling tooth surfaces (DMFS) was 59.2±21.9, the average incisal caries was 2.5±1.3, and the average number of crown restorations at baseline was 4.5±3.6. All the 9 SS patients were applied with topical fluoride usage, and 8 were prescribed with antifungal treatment. One sSS patient was conducted with filling restoration treatment, one pSS patient was conducted with full mouth rehabilitation, and the remaining 7 patients were conducted with direct filling combined with fixed repair treatment. The average 3.2 full crown restorations in 6 patients had to be removed and restored because of secondary caries, and 3 of the 9 patients underwent implant denture restorations finally.@*CONCLUSION@#Management of oral complications in SS patients needs to be carried out in sequence. A comprehensive examination and diagnosis should be carried out first, followed by infection control, and then restoration of oral function at last.

Oral Care Management of Head and Neck Cancer Patients at Hospital Universiti Sains Malaysia: A 7-Year Retrospective Study

ABSTRACT@#Head and neck cancer patients require oral assessment and management prior, during and after cancer treatment to minimise oral complications. Hence, this study aimed to evaluate sociodemographic data, oral health management, oral complications derived from cancer treatment, time frame in completing dental treatment and association between oral management and complications. Purposive record sampling of head and neck cancer patients who completed radiotherapy and/or chemotherapy at Hospital Universiti Sains Malaysia (HUSM) from 2011 to 2017 were reviewed. A checklist was used to record the data and analysed using descriptive statistics and Pearson Chi-square test. A number of 194 patient records were reviewed with majority were Malays (88.1%), males (61.3%) with the mean age of 57.18 years old. Only 21% of the patients had oral assessment prior to cancer treatment. About 84% of the referred patients were dentally fit within 1 month. Mucositis and fungal infections were the most prevalent complications. The relationship between oral assessment prior to cancer treatment and oral complications was not significant (p = 0.134). Despite the insignificant association due to several limitations, oral assessment and management prior, during and after cancer therapy are recognised as crucial for improving quality of life. A standard institutional operating procedure is recommended to improve patient care.

Dental Problems Associated with Radiation Therapy / 대한연하장애학회지

Dental problems associated with radiation therapy are difficult to treat because of the irreversible nature of radiation therapy and permanent tissue damage. Common oral complications include oral mucosa ulceration, xerostomia, and radiation caries. Other oral complications found infrequently are mouth opening limitation and osteonecrosis of the jaw bone. The acute complication of oral ulceration is associated with dysphagia. In addition, delayed complications, such as xerostomia and dental caries, could lower the quality of life, particularly in terms of chewing and swallowing. The treatment of each complication is dependent on the condition and severity. Symptomatic treatment to relieve pain and discomfort is typical for oral complications. Surgical and radical resection is required for the advanced stage of osteoradionecrosis. In this review, oral complications and their treatments are suggested for clinical guidance.

Dental Management in a Patient with Infantile Osteopetrosis : A Case Report with a 7-Year follow-up / 대한소아치과학회지

Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span.A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oral-rehabilitation with a removable partial denture was initiated.Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development.Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.