Assessment of dental and periodontal indices and Streptococcus mutans virulence in fragile X syndrome patients.

INTRODUCTION: Fragile X syndrome (FXS) is the most common cause of hereditary genetic disorder in a single gene characterised by intellectual disability. Behavioural features such as autism, hyperactivity and anxiety disorder may be present. Biofilm development and pathogenicity of Streptococcus mutans may be altered because FXS renders the dental approach and oral hygiene more complex. OBJECTIVES: The purpose of this study was to compare the levels of transcripts for VicRK and CovR of S. mutans isolated from FXS patients with the levels of transcripts for VicRK and CovR of standard strain ATCC, using a quantitative polymerase chain reaction (qPCR). METHODS: The caries experience index was assessed by the International Caries Detection and Assessment System (ICDAS), Periodontal Condition Index (PCI) and Invasive Dental Treatment Need Index (INI). RESULTS: The clinical index findings revealed a high rate of caries cavities and bleeding on probing of FXS patients. When VicRK and CovR transcript levels were compared with the reference strain, Fragile X patients were found to have significantly higher values. CONCLUSION: The present study demonstrated that FXS patients have more adverse clinical conditions, with increased biofilm accumulation and virulence. When combined with behavioural abnormalities, these patients become even more vulnerable to dental caries.

[Our experience with the uncemented isoelastic total hip prosthesis]. / Nostra esperienza con le protesi totali d'anca isoelastiche non cementate.

Between May 1981 and May 1987, 250 isoelastic hip prostheses were implanted. The first 180 (from May '81 till May '86) were called for a visit. 130 (72%) came and were assessed with a minimum review time of 1 year. We ignore the reasons for which 28% of the patients did not turn up (death or others). 81% of the patients had good or very good results after surgery. Three patients developed infections (2.3%); none of these was revised. Four developed loosening of the femoral component; two of these underwent revision surgery and are doing well now. We did not notice any loosening of the acetabular component. The recommended period of gait support was of 2 months of no weight bearing with two canes and of two months of partial weight bearing with one cane. No component had broken. We had 1 femoral fracture incurred during surgery which healed with routine management. These early results are very encouraging, but the effectiveness of this prosthesis will require longer follow-up data to be confirmed.