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Special Care Advocates in Dentistry 2011 Lit. Review

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Special Care Advocates in Dentistry 2011 Lit. Review 2011 ANNUAL SEMINAR LOUISVILLE KENTUCKY Special Care Advocates in Dentistry 2011 Lit. Review (SAID’s Search of Dental Literature Published in Calendar Year 2010*) Compiled by: Dr. Robert G. Henry Dr. Douglas Veazey 1 2011 SAID Literature Review – Annual Seminar Louisville, Kentucky Recent journal articles related to oral health care for people with mental and physical disabilities. Search Program = PubMed Database = Medline Journal Subset = Dental Publication Timeframe = Calendar Year 2010* Language = English SAID Search-Term Results 4,871 Initial Selection Result = 525 articles Final Selection Result = 184 articles SAID Search-Terms Employed: 1. Intellectual disability 22. Protective devices 2. Mental retardation 23. Moderate sedation 3. Mental deficiency 24. Conscious sedation 4. Mental disorders 25. Analgesia 5. Mental health 26. Anesthesia 6. Mental illness 27. Dental anxiety 7. Dental care for disabled 28. Nitrous oxide 8. Dental care for chronically ill 29. Gingival hyperplasia 9. Self-mutilation 30. Gingival hypertrophy 10. Disabled 31. Glossectomy 11. Behavior management 32. Sialorrhea 12. Behavior modification 33. Bruxism 13. Behavior therapy 34. Deglutition disorders 14. Cognitive therapy 35. Community dentistry 15. Down syndrome 36. State dentistry 16. Cerebral palsy 37. Gagging 17. Epilepsy 38. Substance abuse 18. Enteral nutrition 39. Syndromes 19. Physical restraint 40. Tooth brushing 20. Immobilization 41. Pharmaceutical preparations 21. Pediatric dentistry 42. Public health dentistry Program: EndNote X3 used to organize search and provide abstract. Copyright 2009 Thomson Reuters, Version X3 for Windows. *NOTE: The American Dental Association is responsible for entering journal articles into the National Library of Medicine database; however, some articles are not entered in a timely manner. Some articles are entered years after they were published and some are never entered. - 2 - 2011 SAID Literature Review – Annual Seminar Louisville, Kentucky 1. Acharya, B. S., P. Ritwik, et al. (2010). "Dental trauma in children and adolescents with mental and physical disabilities." Tex Dent J 127(12): 1265-1272. AIM: to determine the occurrence of dental trauma in children and adolescents with a mental and/or physical disability compared to otherwise healthy children, and to assess factors associated with and mechanism of such trauma. METHODS: Eighty-six subjects consisting of 43 special needs and 43 otherwise healthy children between the ages of 8 and 15 years were chosen from the patient pool at Special Children's Dental Clinic within Children's Hospital, New Orleans. The study utilized a parent interview questionnaire and a clinical exam of the patient. RESULTS: Although healthy children had a higher number of injuries than children with special needs on average, the difference was not statistically significant. Neither healthy children nor children with special needs exhibited a significant correlation between the number of injuries and the size of the overjet (mm) (p=0.722, 0.712). There was not a significant difference in the number of injuries for children with different oral profiles (p=0.949), or adequate versus inadequate lip coverage (p=0.940). CONCLUSION: In this study population, the children with special needs living at home may have had the same amount of trauma as the otherwise healthy children and studies with larger sample sizes may be needed to further explore this possibility. Excessive overjet, type of facial profile, and adequacy of lip coverage did not seem to increase the amount of trauma noted in our study population. 2. Adeyemo, W. L., M. O. Ogunlewe, et al. (2010). "A comparative study of surgical morbidity associated with mandibular third-molar surgery in young and aging populations." J Contemp Dent Pract 11(4): E001-008. AIM: Prophylactic surgical extraction of impacted third molars is a common practice throughout the world justified on the presumption that the risk of surgical morbidity increases with increasing age, among other reasons. The aim of this study was to analyze and compare surgical morbidity associated with third-molar extractions in young and aging populations. METHODS AND MATERIALS: A review of records for all patients who underwent the surgical extraction of impacted third molars between April 2001 and June 2006 at the Lagos University Teaching Hospital was carried out. RESULTS: A total of 506 patients had surgical extractions of impacted third molars under local anaesthesia during the period of the study. Of these, 470 (92.9 percent) patients were below the age of 40 years (Group A) and 36 (7.1 percent) patients were 40 years of age and older (Group B). No incidences of severe intraoperative complications (excessive bleeding or mandibular fractures) were recorded in either group, but other postoperative complications were reported in 70 (13.8 percent) patients. Of these 70 patients, 65 (92.9 percent) were from Group A and 5 (7.1 percent) were from Group B, and their complications included infected socket, dry socket, paraesthesia, and buccal space abscess. CONCLUSION: No significant difference in post-operative complications following surgical removal of mandibular third molars was found between patients 40 years old and greater and those below age 40. Prophylactic surgical extraction of impacted mandibular third molars, based on the assumption that surgical morbidity increases with age, may not be justifiable. CLINICAL SIGNIFICANCE: Age does not predispose patients who had surgical extraction of mandibular third molars above 40 years of age to any additional surgical complications when compared to patients below the age of 40 years receiving comparable treatment. 3. Aframian, D. J., B. Mizrahi, et al. (2010). "Evaluation of a mucoadhesive lipid-based bioerodable tablet compared with Biotene mouthwash for dry mouth relief--a pilot study." Quintessence Int 41(3): e36-42. OBJECTIVE: Salivary gland impairment is a major problem that can result in hyposalivation and a decrease in quality of life. Causes for mouth dryness can be grossly classified into three major groups: iatrogenic, immunogenic, and metabolic. At present, insufficient therapies exist to ease morbidity in this growing number of affected individuals. A need for new products to relieve oral dryness is mandatory. The aim of this study was to evaluate a mucoadhesive lipid-based bioerodable tablet as a novel device to decrease signs and symptoms associated with mouth dryness. METHOD AND MATERIALS: Twenty xerostomic patients were divided into two groups. In group 1, the mucoadhesive tablet was applied to the hard palate, while in group 2, Biotene mouthwash was applied and served as a control. Sialometry measurements, as well as a questionnaire assessing mouth dryness, were obtained before and after treatment. RESULTS: Application of the mucoadhesive tablets resulted in a significant reduction in the sensation of the mouth dryness (P = .016) compared to Biotene. Moreover, a 1.5-fold increase in unstimulated whole saliva flow was obtained after 30 minutes in the treatment group. CONCLUSION: A lipid-based mucoadhesive tablet has a beneficial role in reducing the sensation of dryness in patients with xerostomia. 4. Aggarwal, V., M. Singla, et al. (2010). "Comparative evaluation of anesthetic efficacy of Gow-Gates mandibular conduction anesthesia, Vazirani-Akinosi technique, buccal-plus-lingual infiltrations, and conventional inferior alveolar nerve anesthesia in patients with irreversible pulpitis." Oral Surg Oral Med Oral Pathol Oral Radiol Endod 109(2): 303-308. - 3 - 2011 SAID Literature Review – Annual Seminar Louisville, Kentucky OBJECTIVE: Conventional inferior alveolar nerve block (IANB) has a poor success rate in inflamed pulps. Three alternative techniques of providing anesthesia to mandibular molars were evaluated and compared with conventional IANB. STUDY DESIGN: Ninety-seven adult volunteer subjects, actively experiencing pain, participated in this prospective, randomized, double-blinded study. Twenty-five patients received Gow-Gates mandibular conduction block anesthesia, 24 patients received "high" Vazirani-Akinosi inferior alveolar nerve block, 26 received only buccal-plus- lingual infiltrations, and 22 patients (control) received conventional IANB anesthesia. Endodontic access preparation was initiated after 15 minutes of anesthesia. Pain during treatment was recorded using a Heft-Parker visual analog scale. Success was recorded for "none" or "mild" pain. RESULTS: Statistical analysis using nonparametric McNemer tests showed that Gow-Gates gave a success rate of 52%, which was statistically higher than control IANB (36%) (P < .05). Vazirani-Akinosi and infiltrations gave 41% and 27% success rates, respectively, with no statistically significant differences from control IANB. CONCLUSIONS: Gow-Gates mandibular conduction anesthesia may increase the success rates in patients with irreversible pulpitis compared with conventional IANB. None of the techniques provided acceptable success rates. 5. Aggarwal, V., M. Singla, et al. (2010). "Comparative evaluation of effect of preoperative oral medication of ibuprofen and ketorolac on anesthetic efficacy of inferior alveolar nerve block with lidocaine in patients with irreversible pulpitis: a prospective, double-blind, randomized clinical trial." J Endod 36(3): 375-378. INTRODUCTION: Anesthetic efficacy of inferior alveolar nerve block decreases in patients with irreversible pulpitis. It was hypothesized that premedication with nonsteroidal anti-inflammatory
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