Subject(s)
Celiac Disease/diagnosis , Dental Enamel/pathology , Tooth Diseases/diagnosis , Adolescent , Adult , Child , Female , Humans , Italy , Male , Mass Screening/methods , Middle Aged , Tooth Diseases/classificationABSTRACT
Twenty Down's syndrome dental patients between 9 and 20 years of age have been identified in order to evaluate anxiety and pain induced by various kinds of dental treatment such as some "moderately painful" dental out-patient procedures (10 subjects), general anaesthesia dental treatment (5 subjects) and painless out-patient visit or routine orthodontic services (5 subjects). Each patient received a previous psychological evaluation to assess his intellectual and cognitive developmental degree. Anxiety was assessed twice, before and after intervention by means of a questionnaire; pain was tested in a subjective way during the procedure (or the control oral visit 12 hours after the g.a. treatment) and by a questionnaire in the post-treatment phase. This investigation indicates that anxiety increased in Down's syndrome subjects receiving out-patient interventions, remained at the original level in the general anaesthesia hospitalized patients, while it showed a clear reduction in the out-patient painless control group. Anxiety, however, proves to be influenced also by the patient's effective mental age so it my be lessened after painful dental treatment when the intellectual development is about or above that of a 7 year old boy. Our study could prove to be important since it underlines the need to assess, at least approximately, the Down's syndrome patient's cognitive development before giving dental treatment, especially if it is an out-patient intervention. This may not be necessary for routine free of pain dental visits.
Subject(s)
Dental Anxiety/psychology , Dental Care/psychology , Pain/psychology , Perception , Adolescent , Adult , Child , Child Development , Female , Humans , Male , Pain Measurement , Surveys and Questionnaires , Wechsler ScalesABSTRACT
Following an introductory illustration of the clinical characteristics of the 18q syndrome (De Grouchy syndrome), the paper describes the treatment carried out in a young patient with harelip and cleft palate in addition to chromosomopathy. Although the facial malformation and the karyotype with the deletion of a portion of the long arm of chromosome 18 were diagnosed in utero, the parents, having been correctly informed of the mental retardation usually associated with this syndrome and the possibility of surgical correction of the facial malformation, decided not to abort. The case offers an occasion for analysing the various stages and results obtained to date using a multi-specialised diagnostic approach and functional and surgical treatment of the harelip and cleft palate which have enabled much of the congenital handicap to be corrected.
Subject(s)
Abnormalities, Multiple/rehabilitation , Chromosome Aberrations/rehabilitation , Chromosome Deletion , Chromosomes, Human, Pair 18 , Cleft Lip/rehabilitation , Cleft Palate/rehabilitation , Fetal Diseases/diagnosis , Prenatal Diagnosis , Abnormalities, Multiple/diagnosis , Child, Preschool , Chromosome Aberrations/diagnosis , Chromosome Disorders , Cleft Lip/diagnosis , Cleft Palate/diagnosis , Female , Humans , Karyotyping , Pregnancy , SyndromeABSTRACT
The Authors report an unusual case of median cleft of the upper lip with pedunculated skin and muscle contracting mass. About one hundred cases of true median cleft lip have been reported, only six showing a median pedunculated mass. As the embryogenesis of this malformation is still not completely clear, we think that any case with this characteristic has to be described. Besides the usual characteristic of the median "hare lip" this case shows a big egg-like pedunculated mass in which muscular tissue has been found well represented, and a wide incomplete maxillary cleft.
Subject(s)
Cleft Lip/pathology , Lip/abnormalities , Child, Preschool , Cleft Lip/surgery , Female , Humans , Lip/surgeryABSTRACT
The authors report their experience of the reconstruction by z-plasty in cases of shortness of the lip frenum. Amongst several techniques they used for this correction they got best results utilizing a z-plasty, with wide flaps, planned so that after the transposition of the flaps the medial branch of the z-plasty falls horizontally into the deeper vestibular fornix. In all cases treated by that z-plasty the A. obtained a widening of the adherent part of the gingiva, deepening of the vestibulum, no recurrence of the shortness was observed.
Subject(s)
Labial Frenum/surgery , Humans , Labial Frenum/abnormalities , Surgical Flaps/methodsABSTRACT
The paper describes a simple direct method for the preparation of a functional filling plate in the neonatal orthopedic treatment of cleft palate harelip. This method allows the corrective plate to be realised so as to reproduce the complex deformed anatomical structure in the smallest detail, thus avoiding the major problems of acceptance, function and load distribution on the delicate neonatal mucosa.
Subject(s)
Cleft Lip/therapy , Cleft Palate/therapy , Orthodontics/methods , Palatal Obturators , Dental Impression Technique , Equipment Design , Humans , Infant, NewbornABSTRACT
On the basis of a full analysis of recently reported data, it is shown that manifold and quite characteristic problems of dental and orofacial nature requiring global consideration coexist in Down's syndrome. These are addressed one by one in order to stress the need for dental treatment and to provide for correct planning of interventions right from the early months of life in the case of a patient with Down's syndrome.
Subject(s)
Dental Care/methods , Down Syndrome/rehabilitation , Stomatognathic Diseases/rehabilitation , Abnormalities, Multiple/etiology , Abnormalities, Multiple/rehabilitation , Adolescent , Adult , Child , Dental Caries/etiology , Dental Caries/therapy , Down Syndrome/complications , Humans , Jaw Abnormalities/etiology , Jaw Abnormalities/rehabilitation , Patient Care Planning/methods , Periodontal Diseases/etiology , Periodontal Diseases/therapy , Stomatognathic Diseases/etiology , Tooth Abnormalities/etiology , Tooth Abnormalities/rehabilitationABSTRACT
In this second part, the principles and modalities of a personal contribution to the realisation of a specific protocol that uses preventive and interceptive criteria to plan odontostomatological treatment in patients with Down's syndrome are presented. A special type of treatment is proposed. This is distinguished chronologically into five stages with periodic visits to specialist hospital structures, implying the start of treatment in Down's children at the age of 2-3 months and programmed continuation of such treatment right up to the age of at least 18 years.
Subject(s)
Dental Care/methods , Down Syndrome/rehabilitation , Patient Care Planning/methods , Adolescent , Adult , Child , Child, Preschool , Combined Modality Therapy/methods , Down Syndrome/complications , Humans , Orthodontics, Interceptive/methods , Orthodontics, Preventive/methods , Palatal Expansion TechniqueABSTRACT
The Authors describe a standardized registration system applied to gnathoplasty and its follow-up. That allows both longitudinal growth study and clinical evaluations on the surgical method. If similar standardized registration systems could be adopted by several clinical teams, a comparison between different gnathoplasty methods should be possible and obviously useful.
