Dental Trauma in Children with Autistic Disorder: A Retrospective Study.

BACKGROUND: The oral health care of autistic children is elaborated; they often fail to define dental problems, and a family-centered approach can be useful to improve and intercept these disorders. AIM: To assess the oral status of autistic children, comparing it with no autistic patients. MATERIALS AND METHODS: A retrospective study analyzed the oral health status of 70 children, 35 with autism and 35 without the disorder. Conditions assessed were dental trauma type, periodontal tissue injuries, soft tissue lip injuries, different treatments carried out, associated soft tissue findings and disorders, and the long-term management. All patients (≤15 years of age) were chosen consecutively. RESULTS: Females (57%) suffered more traumatic injuries than males (43%) in the autistic group, whereas males affected by dental trauma (54%) are predominant in the control group. The enamel fracture was the main finding among the dental trauma types in both groups followed by enamel/dentin/pulp fracture (31%), root fracture (11%), and avulsions (3%) in the autistic group and by avulsions (20%), root fracture (11%), and enamel/dentin/pulp fracture (6%) in the control group. The comparison of all variables of the two groups showed a statistically significant difference (P < 0.012). The lower lip was statistically more injured than the upper lip (P < 0.005). CONCLUSIONS: The composite restorative technique was the most common approach carried out; the long-term evaluation, when possible, was predominantly managed through root canal therapy in the control group (81%), and root canal therapy (50%) and tooth extraction (50%) in the sample group.

Two load sharing plates fixation in mandibular condylar fractures: biomechanical basis.

Mandibular condylar fractures have a high incidence but there is no consensus regarding the best choice of osteosynthesis. From a review of the literature, it is evident that the technique used most frequently for fixation is the positioning of a single plate despite complications concerning plate fracture or screw loosening have been reported by various authors. Different studies have highlighted that the stability of osteosynthesis is correlated with the mechanical strains occurring in the condylar region, generated by the muscles of mastication. The aim of our study was, through a mandibular finite element model (FEM), to confirm this correlation and to analyse the behaviour of single and double elements of union in the fixation of mandibular subcondylar fractures. We concluded that the use of two plates provides greater stability compared with the single plate, reducing the possibility of displacement of the condylar fragment. Therefore we recommend that this technique should be adopted whenever possible.