Special Issue "Oral Health for Special Needs, Compromised and Elderly Patients"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Stomatology".

Deadline for manuscript submissions: closed (30 September 2021).

Special Issue Editors

Prof. Dr. Gianrico Spagnuolo
E-Mail Website
Guest Editor
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Interests: dental materials; dental surgery; restorative dentistry and endodontics
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Francisco Javier Rodríguez Lozano
E-Mail Website
Guest Editor
Special Care Dentistry and Gerodontology Unit, School of Dentistry, University of Murcia, 30100 Murcia, Spain
Interests: oral health; special care in dentistry; gerodontology; oral health and diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Although in the last decade, preventive success strategies have been implemented to decrease the risk of caries, special needs, compromised, and elderly patients have limitations when it comes to maintaining a good oral health, with caries and periodontal diseases being highly prevalent in this population. Furthermore, special diets, medications, and oral motor habits can favor the development of dental problems for these patients.

Special needs or geriatric patients with extensive dental involvement tend to experience dental anxiety and can often be less cooperative due to physical limitations, mental disabilities or behavioral management problems, which make conventional dental treatment or oral examinations extremely difficult.

The geriatric or elderly patient is considered a frail patient; any type of treatment could lead to a medical or psychological collapse. During dental intervention, it is essential to maintain balance and, in this way, provide an adequate quality of life. Therefore, a new bioethical focus should be introduced into basic and preventive programs.

This Special Issue will focus on oral health for special needs, compromised, and elderly patients. Full papers of original articles, short communications, and review articles are all welcomed.

Prof. Dr. Gianrico Spagnuolo
Prof. Dr. Francisco Javier Rodríguez Lozano
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Oral health
  • Special need patients
  • Special care in dentistry
  • Geriatric dentistry
  • Oral rehabilitation in medically compromised patients
  • Elderly
  • Disability
  • Hemodialysis
  • Autism
  • Dental care for children with special needs
  • Simulation of medical emergencies in dental practice
  • Teledentistry
  • Feeding disorders

Published Papers (16 papers)

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Research

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Article
Association between Metabolic Syndrome and the Number of Remaining Teeth in Postmenopausal Women: A Cross-Sectional Analysis Using the Korean National Health and Nutritional Examination Survey
J. Clin. Med. 2021, 10(20), 4759; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10204759 - 17 Oct 2021
Viewed by 184
Abstract
There are very few studies on metabolic syndrome (MetS) and oral health in postmenopausal women. The purpose of this cross-sectional study was to determine the association between MetS and its components and the number of remaining teeth in postmenopausal women in Korea. The [...] Read more.
There are very few studies on metabolic syndrome (MetS) and oral health in postmenopausal women. The purpose of this cross-sectional study was to determine the association between MetS and its components and the number of remaining teeth in postmenopausal women in Korea. The study selected 3320 menopausal women (40–79 years old) from those who participated in the seventh Korea National Health and Nutrition Survey (2016–2018). Multiple regression and multiple logistic regression analyses were performed to determine the association between MetS and its components and the number of remaining teeth. According to the multiple regression analysis, the regression coefficient (B) values were −1.62 (p < 0.05), −1.31 (p < 0.05), −1.60 (p < 0.05), and −2.28 (p < 0.05) in the hypertension group, hyperglycemia group, low high-density lipoprotein (HDL) cholesterol group, and MetS prevalence group, respectively. This indicates that the number of remaining teeth was lower in the MetS prevalence group as compared to the non-prevalence groups. As observed in the multiple logistic regression analysis, the odds ratio of the number of remaining teeth (less than 20) was higher in the MetS prevalence group (1.82 (p < 0.05)) as compared to the non-prevalence groups (1.25 (p < 0.05) in the abdominal obesity group, 1.50 (p < 0.05) in the hypertension group, 1.36 (p <0.05) in the hyperglycemia group, and 1.72 (p < 0.05) in the low HDL cholesterol group). Therefore, our results indicate that abdominal obesity, hypertension, diabetes, dyslipidemia, and prevalence of MetS are associated with tooth loss in postmenopausal women. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
Article
Analyses of Swallowing Function and Its Related Factors in Community-Dwelling Elderly Patients: A Case-Control Study
J. Clin. Med. 2021, 10(15), 3437; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10153437 - 02 Aug 2021
Viewed by 390
Abstract
This retrospective case-control study evaluated the prevalence of declined swallowing function and the association with oral functions and gender in community-dwelling elderly patients. Their profiles, the results of swallowing function (Eating Assessment Tool: EAT-10) and other oral functions (oral dryness, maximum occlusal force [...] Read more.
This retrospective case-control study evaluated the prevalence of declined swallowing function and the association with oral functions and gender in community-dwelling elderly patients. Their profiles, the results of swallowing function (Eating Assessment Tool: EAT-10) and other oral functions (oral dryness, maximum occlusal force (MOF), tongue–lip motor function (oral diadochokinesis: ODK), maximum tongue pressure (MTP) and masticatory performance (MP)) were extracted for analyses. The patients were categorized into three groups according to EAT-10 score (Group 1: 0, Group 2: 1 and 2, Group 3: ≥3). In total, 242 patients were enrolled and 46 of them (19.0%) were categorized into declined swallowing function (Group 3). In two-group comparisons (Group 1, 2 versus Group 3), significant differences were identified in age and the number of remaining teeth, but they were not identified in three-group comparisons. The patients with declined swallowing function (Group 3) had significantly lower function in ODK and MTP. Multiple logistic regression analyses identified that declined swallowing function was independently associated with declined functions in ODK /ka/ (OR: 5.31, 95% CI: 1.03–27.23, p = 0.04) and in MTP (OR: 2.74, 95% CI: 1.12–6.66, p = 0.03). This study could confirm the critical role of tongue functions in swallowing in community-dwelling elderly patients. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
Article
Caries Experience of Adults with Intellectual Disability in the Western Part of Germany
J. Clin. Med. 2021, 10(12), 2602; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10122602 - 12 Jun 2021
Cited by 1 | Viewed by 501
Abstract
Background: In Germany, there is limited evidence on the oral health of adults with intellectual disabilities (AwID). Methods: In 2017/18, dental examinations of AwID and a questionnaire survey of their legal guardians were carried out. The mean D3MFT values were calculated to describe [...] Read more.
Background: In Germany, there is limited evidence on the oral health of adults with intellectual disabilities (AwID). Methods: In 2017/18, dental examinations of AwID and a questionnaire survey of their legal guardians were carried out. The mean D3MFT values were calculated to describe the caries experience. The prevalence of AwID with at least one fissure sealant (FS) was determined and associations between caries experience and various sociodemographic factors (e.g., age, gender, living arrangements) were investigated. Results: The data of 132 AwID (mean age 35.2 years; range 18–69 years) could be included. For all AwIDs the mean D3MFT value was 9.5 (95% CI 8.1–11.0). The mean D3MFT value for the 35–44-year-olds was 10.9 (95% CI 8.4–13.4). All caries-free persons (n = 14) were younger than 45 years. Furthermore, the mean D3MFT value for AwID living with their parents was lower at a statistically significant level than that of AwID in independent living arrangements. Moreover, younger AwIDs (18–34-year-olds) with at least one FS had a statistically significantly lower mean D3MFT value compared to those without any FS (D3MFT: 3.0 vs. 6.7). Conclusions: The dental health of AwID has improved in Germany in recent years, but, on average, AwIDs still have more missing teeth than their peers in the general population. Oral epidemiological studies on AwID should include information on their living arrangements to assess potential associations between sociodemographic factors and oral health. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Article
Identification of Fungi Isolated from Oral Cavity of Patients with HIV Using MALDI–TOF MS
J. Clin. Med. 2021, 10(8), 1570; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10081570 - 08 Apr 2021
Viewed by 453
Abstract
Background: A growing incidence of invasive fungal infections, especially among immunocompromised patients, has given increased significance to microbiological diagnostics of yeast-like fungi. More accurate and faster fungi identification methods that can compete with classical methods are being searched for. In this paper, classical [...] Read more.
Background: A growing incidence of invasive fungal infections, especially among immunocompromised patients, has given increased significance to microbiological diagnostics of yeast-like fungi. More accurate and faster fungi identification methods that can compete with classical methods are being searched for. In this paper, classical microbiological methods are compared to MALDI–TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). Methods: The diagnostic material was collected from buccal mucosa from 98 adults, including 69 with HIV. Only positive cultures were included in the study. Results: Matching results were obtained in 45 samples, and there were nonmatching results in 35 samples, with the majority of these in the study group, constituting 50% of identifications within this group. A particularly common mistake resulting from the use of classical methods is the false identification of C. dubliniensis as C. albicans. Additionally, C. tropicalis proves to be difficult to identify. Conclusions: Our results and literature data suggest that MALDI–TOF MS should be considered an effective alternative to classical methods in terms of fungi identification, especially among HIV-positive patients, due to the different morphology of fungal colonies. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Article
Oral Health-Related Quality of Life, Oral Conditions, and Risk of Malnutrition in Older German People in Need of Care—A Cross-Sectional Study
J. Clin. Med. 2021, 10(3), 426; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10030426 - 22 Jan 2021
Cited by 3 | Viewed by 766
Abstract
Background: The present cross-sectional study assessed oral health, nutritional condition, and oral health-related quality of life (OHRQoL) in older German people in need of care. Methods: The participants were recruited from eight nursing homes (including three nursing homes with assisted living) and one [...] Read more.
Background: The present cross-sectional study assessed oral health, nutritional condition, and oral health-related quality of life (OHRQoL) in older German people in need of care. Methods: The participants were recruited from eight nursing homes (including three nursing homes with assisted living) and one mobile nursing service. Oral health, including dental status (decayed, missing and filled teeth (DMF-T), root caries), periodontal treatment needs, and prosthetic conditions, was recorded. Nutritional status was assessed using the screening of the “Mini Nutritional Assessment” (MNA). The OHRQoL was measured using the German short-form of the Oral Health Impact Profile (OHIP-G14) and summarized as a total sum score as well as the four dimensions “oral function”, “psychosocial impact”, “pain” and “orofacial appearance”. Statistics: Linear logistic regression analyses. Results: A total of 151 participants (age: 84.17 ± 7.8 years) were included. Most participants (60.3%) were nursing home residents. Nearly half of the individuals (47%) were edentulous and 75.4% of the dentate subjects required periodontal treatment. A total of 115 of the subjects had at least one denture. According to the MNA screening, 107 (70.9%) older people were at risk of malnutrition or already suffered from malnutrition. The median OHIP-G14 sum score was 3 (mean 5.7 ± 7.67). Regression analysis revealed MNA to be influenced by DMF-T, D-T, M-T and OHIP G14 sum score and root caries (pi < 0.01). Within the regression model, missing teeth (β: −11.9, CI95: −6.4–−1.9; p < 0.01) were the strongest influential factor on MNA, followed by DMF-T (β: 5.1, CI95: 1.7–6.2; p < 0.01). Conclusions: Older people in nursing settings show a high prevalence of oral diseases, risk of malnutrition and nearly unimpaired OHRQoL. Dental care should be fostered in these individuals, whereby OHRQoL might be a further hint for increased risk of malnutrition. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
Article
Dental Treatments under General Anesthesia on Children with Special Health Care Needs Enrolled in the Spanish Dental Care Program
J. Clin. Med. 2021, 10(2), 182; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10020182 - 06 Jan 2021
Cited by 6 | Viewed by 885
Abstract
The purpose is to analyze the medical characteristics of children with special health care needs (CSHCN) recommended for dental treatment under general anesthesia (GA), postoperative complications, and dental treatment outcomes under the regulation of the Spanish Dental Care Program (PADI). 111 clinical records [...] Read more.
The purpose is to analyze the medical characteristics of children with special health care needs (CSHCN) recommended for dental treatment under general anesthesia (GA), postoperative complications, and dental treatment outcomes under the regulation of the Spanish Dental Care Program (PADI). 111 clinical records were selected. The study population was divided into three age groups. The quantitative data was specified as the mean ± SD. For the qualitative variables, the Chi-Square test was used. One-way ANOVA and Bonferroni tests were used to examine the effect of the “age group” and the number of treatment procedures. A total of 1473 treatment procedures were performed, of which 110 (7.5%) were cleanings, 898 (61%) were restorative procedures, 332 (21.7%) were extractions, 22 (1.6%) were endodontic treatments, 62 (4.2%) were pulpotomies, and 59 (4%) were stainless steel crowns. Regarding the mean number of incisor root canal treatments (RCT), age group 3 received a significantly higher mean number of incisor RCTs than age group 1 (p = 0.02). Age group 1 received a higher average of pulpotomies and stainless-steel crowns (p = 0.00) compared to groups 2 and 3. GA is a safe procedure for the dental treatment of CSHCN, with minimal postoperative complications, which should be included among dental public programs. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Article
Oral Manifestations of Wolf-Hirschhorn Syndrome: Genotype-Phenotype Correlation Analysis
J. Clin. Med. 2020, 9(11), 3556; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9113556 - 04 Nov 2020
Cited by 2 | Viewed by 1645
Abstract
Background: Wolf-Hirschhorn syndrome (WHS) is a rare disease caused by deletion in the distal moiety of the short arm of chromosome 4. The objectives of this study were to report the most representative oral findings of WHS, relate them with other clinical characteristics [...] Read more.
Background: Wolf-Hirschhorn syndrome (WHS) is a rare disease caused by deletion in the distal moiety of the short arm of chromosome 4. The objectives of this study were to report the most representative oral findings of WHS, relate them with other clinical characteristics of the disease, and establish possible phenotype-genotype correlation. Methods: The study was conducted at 6 reference centers distributed throughout Spain during 2018–2019. The study group consisted of 31 patients with WHS who underwent a standardized oral examination. Due to behavioral reasons, imaging studies were performed on only 11 of the children 6 years of age or older. All participants had previously undergone a specific medical examination for WHS, during which anatomical, functional, epilepsy-related, and genetic variables were recorded. Results: The most prevalent oral manifestations were delayed tooth eruption (74.1%), bruxism (64.5%), dental agenesis (63.6%), micrognathia (60.0%), oligodontia (45.5%), and downturned corners of the mouth (32.3%). We detected strong correlation between psychomotor delay and oligodontia (p = 0.008; Cramér’s V coefficient, 0.75). The size of the deletion was correlated in a statistically significant manner with the presence of oligodontia (p = 0.009; point-biserial correlation coefficient, 0.75). Conclusion: Certain oral manifestations prevalent in WHS can form part of the syndrome’s phenotypic variability. A number of the characteristics of WHS, such as psychomotor delay and epilepsy, are correlated with oral findings such as oligodontia and bruxism. Although most genotype-phenotype correlations are currently unknown, most of them seem to be associated with larger deletions, suggesting that some oral-facial candidate genes might be outside the critical WHS region, indicating that WHS is a contiguous gene syndrome. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Article
Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study
J. Clin. Med. 2020, 9(10), 3205; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9103205 - 04 Oct 2020
Cited by 3 | Viewed by 570
Abstract
Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and [...] Read more.
Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. Materials and Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3–4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2–1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5–49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1–1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6–1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8–1.7; p = 0.49) were associated with MetS. Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
Article
Salivary Cytokines in Children with Nephrotic Syndrome versus Healthy Children: A Comparative Study
J. Clin. Med. 2020, 9(9), 2691; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9092691 - 20 Aug 2020
Cited by 2 | Viewed by 648
Abstract
Background: The aims of this study were to compare salivary cytokines and total protein between children with nephrotic syndrome (NS) and healthy children, and to examine whether saliva parameters can differentiate between steroid sensitivity and resistance and between disease remission and relapse. Methods: [...] Read more.
Background: The aims of this study were to compare salivary cytokines and total protein between children with nephrotic syndrome (NS) and healthy children, and to examine whether saliva parameters can differentiate between steroid sensitivity and resistance and between disease remission and relapse. Methods: Twenty-seven children with nephrotic syndrome were classified according to steroid sensitivity and resistance, and disease remission and relapse. Twenty healthy children served as controls. Whole saliva samples were collected from all the participants. Urine and blood tests done on the same day as the saliva collection were recorded. Salivary total protein was quantified using bicinchoninic acid and IFNγ, IL-4, IL-8, IL-6, and IL1β levels using ELISA. Results: The mean ages of the nephrotic syndrome and control groups were 11.3 ± 2.4 and 9 ± 4.2, respectively. Compared to the control group, for the nephrotic syndrome group, total salivary protein was significantly lower, as were the levels of all the cytokines examined except IFNγ. Statistically significant differences were not found in any of the salivary markers examined between the children with nephrotic syndrome who were treatment sensitive (n = 19) and resistant (n = 8). Protein and IL-8 salivary levels were lower in the active (n = 7) than in the remission (n = 20) group. Conclusions: Salivary parameters distinguished children with nephrotic syndrome in relapse from healthy children. This may be due to decreased salivary protein excretion, which reflects decreased plasma levels, consequent to proteinuria. Accordingly, salivary markers may be developed as a diagnostic or screening tool for NS activity. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Article
Using Genetics in Periodontal Disease to Justify Implant Failure in Down Syndrome Patients
J. Clin. Med. 2020, 9(8), 2525; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9082525 - 05 Aug 2020
Cited by 2 | Viewed by 673
Abstract
Peri-implant bone loss leading to dental implant failure does not develop in the same way across subjects who apparently present the same condition—specifically, in the case of Down syndrome patients with the same genetic disorder—given that they do not necessarily develop immune–inflammatory disorders [...] Read more.
Peri-implant bone loss leading to dental implant failure does not develop in the same way across subjects who apparently present the same condition—specifically, in the case of Down syndrome patients with the same genetic disorder—given that they do not necessarily develop immune–inflammatory disorders to the same extent. Methods: This retrospective case-control study was aimed at identifying the possible genes involved in implant failure in Down syndrome patients by matching the periodontal disease variable by means of a retrospective case-control study. This process involved using the functional analysis of gene expression software Transcriptome Analysis Console (TAC, Affymetrix, Thermo Fisher Scientific, Waltham, MA, USA) and a search for the possible candidate genes involved. Focus was placed on the 92 genes related to the inflammation identified from the TaqMan™ Array Plate Human Inflammation Kit (Thermo Fisher Scientific, Waltham, MA, USA). Results: Six genes showed statistically significant results (p < 0.05) in our comparison. Three of them—PLCG2 (p = 0.0333), ALOX5 (p = 0.03) and LTAH4 (p = 0.0081)—were overexpressed in the implant reject group, and the following three were down-regulated: VCAM1 (p = 0.0182), PLA2G2A (p = 0.0034) and PLA2G10 (p = 0.047). Conclusion: Statistically significant differences exist in the gene expression involved in osteoclastogenesis, inflammatory response and host defensive response. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
Article
The Subgingival Microbiome in Patients with Down Syndrome and Periodontitis
J. Clin. Med. 2020, 9(8), 2482; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9082482 - 02 Aug 2020
Cited by 5 | Viewed by 982
Abstract
Objective: To describe the subgingival microbiome of individuals with Down syndrome (DS). Methods: We conducted a cross-sectional observational study that obtained bacterial DNA samples from 50 patients with DS, 25 with periodontitis (PDS) and 25 with a healthy periodontal condition (HDS). The samples [...] Read more.
Objective: To describe the subgingival microbiome of individuals with Down syndrome (DS). Methods: We conducted a cross-sectional observational study that obtained bacterial DNA samples from 50 patients with DS, 25 with periodontitis (PDS) and 25 with a healthy periodontal condition (HDS). The samples were analyzed by sequencing the 16S rRNA gene V3–V4 hypervariable region using the MiSeq System. Taxonomic affiliations were assigned using the naïve Bayesian classifier integrated in QIIME2 plugins. We evaluated the difference in bacteria abundance between the sample groups using Wilcoxon and Kruskal–Wallis tests. We evaluated the alpha diversity of the identified species using the Observed, Chao1metric, ACE and Shannon indices and evaluated beta diversity with principal coordinate analysis (registration code: 2018/510). Results: Twenty-one genera and 39 bacterial species showed a significantly different abundance between the study groups. Among the genera, Porphyromonas, Treponema, Tannerella and Aggregatibacter were more abundant in the PDS group than in the HDS group, as were the less commonly studied Filifactor, Fretibacterium and Desulfobulbus genera. Among the species, Porphyromonas spp. and Tannerella spp. were the most abundant in the PDS group; the most abundant species in the HDS group were Pseudomonas spp., Granulicatella spp. and Gemella spp. Conclusion: Well-recognized periodontal pathogens and newly proposed pathogenic taxa were associated with periodontitis in patients with DS. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
Article
Allogeneic Bone Marrow Mesenchymal Stem Cell Transplantation in Tooth Extractions Sites Ameliorates the Incidence of Osteonecrotic Jaw-Like Lesions in Zoledronic Acid-Treated Rats
J. Clin. Med. 2020, 9(6), 1649; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9061649 - 31 May 2020
Cited by 5 | Viewed by 1345
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is defined as the exposed necrotic bone involving the maxillofacial structures in bisphosphonate treated patients, and the pathophysiology of this disease remains unclear. The aim of this study was to assess the effects of the allogeneic transplantation [...] Read more.
Medication-related osteonecrosis of the jaw (MRONJ) is defined as the exposed necrotic bone involving the maxillofacial structures in bisphosphonate treated patients, and the pathophysiology of this disease remains unclear. The aim of this study was to assess the effects of the allogeneic transplantation of bone marrow-derived mesenchymal stem cells (BM-MSCs) in a model of Wistar mice with induced MRONJ disease. BM-MSCs from five male Wistar rats were characterized and cultured on β-tricalcium phosphate (β-TCP) granules. Thirty female Wistar rats were injected intraperitoneally with zoledronic acid and afterwards upper jaw molars were extracted. The animals were randomized to receive: Group 1: 1 × 106 BM-MSCs/β-TCP construct in the alveolar socket; and Group 2: Saline solution/β-TCP construct. A clinical and histological analysis was performed. Nested polymerase chain reaction (PCR) was assessed to verify the presence of transplanted male rat cells in the female recipient jaws. Clinical and histological findings evidenced that none of the animals in Group 1 exhibited uncovered sockets or bone exposure associated to MRONJ, whereas we detected 33% of MRONJ cases in Group 2. In addition, male rat cells were detected in the maxillae site four weeks after transplantation in the BM-MSCs-group. Allogeneic BM-MSCs in extractions sites ameliorates MRONJ incidence in zoledronic acid-treated rats compared to non-MSC treatments. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Review

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Review
Association between Pulpal-Periapical Pathology and Autoimmune Diseases: A Systematic Review
J. Clin. Med. 2021, 10(21), 4886; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10214886 - 23 Oct 2021
Viewed by 230
Abstract
Several studies have linked apical periodontitis and systemic diseases. The aim of this study is to present a systematic review of the available literature investigating whether there is an association between pulpal-periapical pathology and autoimmune disease. The review was conducted following the PRISMA [...] Read more.
Several studies have linked apical periodontitis and systemic diseases. The aim of this study is to present a systematic review of the available literature investigating whether there is an association between pulpal-periapical pathology and autoimmune disease. The review was conducted following the PRISMA statement. A literature search was performed in five databases. Studies involving patients with pulpal-periapical pathology and autoimmune diseases were included in the review. Based on the PICO model, the research question aimed to assess whether there is an increased risk of developing pulpal-periapical pathology in patients with autoimmune disease. Article selection, data extraction, and quality assessment were performed using an adapted version of the STROBE guidelines. A total of seven studies were included in our review. The types of articles were five case-control and two cross-sectional studies. Periapical pathologies were associated to three autoimmune diseases (diabetes mellitus I, rheumatoid arthritis, and inflammatory bowel disease). Among the included studies, four show a low risk of bias, while three present a moderate risk. There could be an association between apical periodontitis and autoimmune diseases, although most studies report statistically non-significant associations. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Review
Investigation of the Effectiveness of Surgical Treatment on Maxillary Medication-Related Osteonecrosis of the Jaw: A Literature Review
J. Clin. Med. 2021, 10(19), 4480; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10194480 - 29 Sep 2021
Viewed by 372
Abstract
Aim: Medication-related osteonecrosis of the jaw (MRONJ) occurs after exposure to medication (antiresorptive or antiangiogenic agents) for bone-related complications. It is more common in the mandible than in the maxilla. The present study investigated maxillary MRONJ in elderly patients through a meta-analysis. Methods: [...] Read more.
Aim: Medication-related osteonecrosis of the jaw (MRONJ) occurs after exposure to medication (antiresorptive or antiangiogenic agents) for bone-related complications. It is more common in the mandible than in the maxilla. The present study investigated maxillary MRONJ in elderly patients through a meta-analysis. Methods: Keywords, including “MRONJ”, “maxilla”, and “surgery”, were entered into databases, including Embase, PubMed/MEDLINE, Cochrane Library, and ProQuest, which were searched systematically. Results: Investigating 77 studies, we found that 18 (2 case reports and 16 case series) papers conformed to the standards. The results revealed a 2.6:1 female-to-male ratio of disease occurrence. The average age of patients was 70.6 ± 5.5 years, and most patients were in the third stage (43.6%). The average time of medication usage was 50.0 ± 20.1 months. The pooled proportion of clinical efficacy of surgery was 86%. Conclusion: To prevent and manage MRONJ, all elderly patients should maintain proper oral hygiene and receive dental examinations regularly. Risk assessment and safety management of MRONJ should be performed by medical teams. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Review
Considerations for the Prosthetic Dental Treatment of Geriatric Patients in Germany
J. Clin. Med. 2021, 10(2), 304; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10020304 - 15 Jan 2021
Cited by 3 | Viewed by 869
Abstract
Demographic changes in the industrialized countries require that dentists adapt to the growing and heterogeneous group of elderly patients and develop concepts for the dental care of fit, frail, and dependent old and very old people. In general, dental care for old and [...] Read more.
Demographic changes in the industrialized countries require that dentists adapt to the growing and heterogeneous group of elderly patients and develop concepts for the dental care of fit, frail, and dependent old and very old people. In general, dental care for old and very old people should be based on their individual everyday life. As a result of demographic changes, improved oral hygiene at home, and the establishment of professional teeth and denture cleaning, tooth loss occurs increasingly in higher ages, which implies that first extensive prosthetic rehabilitation with fixed or/and removable dental prostheses is shifting to a higher average age than ever before. This phenomenon requires that the individual diseases, potential multimorbidity and polypharmacy, and associated limitations are taken into consideration. Against this background, the current survey aims to summarize epidemiological trends associated with tooth loss, using Germany as a highly representative country for demographic changes as an example. Furthermore, the current narrative summary outlines general principles that should be followed in dental care, treatment of geriatric patients, and outlines current therapeutic options in prosthetic dentistry. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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Review
Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis
J. Clin. Med. 2020, 9(10), 3179; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm9103179 - 30 Sep 2020
Cited by 2 | Viewed by 795
Abstract
Aim: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. Material and Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had [...] Read more.
Aim: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. Material and Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17–10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. Conclusions: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution. Full article
(This article belongs to the Special Issue Oral Health for Special Needs, Compromised and Elderly Patients)
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