Long term oral health related quality of life after TMJ arthrocentesis with hyaluronic acid. A retrospective cohort study

The purpose of the study was to assess the long-term oral health-related quality of life (oQoL) in patients with temporomandibular joint (TMJ) internal derangement (ID) after TMJ arthrocentesis plus hyaluronic acid (HA).Patients were analysed at different follow-up times using an analytical observational design. The Oral Health Impact Profile?14 (OHIP-14) score was evaluated according to age, sex, disc position, presence of degenerative joint disease (DJD), joint pain, maximum mouth opening and follow-up time.A total of 60 participants were enrolled, 88% female, with a mean age of 38 years (SD = 13.48).In an average follow-up of 25.02 months (SD = 5.32), the OHIP-14 total score decreased 8.67 (95% confidence interval [CI]: ?11.21 to ?6.11) after the intervention (Cohen's d = 1.22; 95% CI = 0.81 to 1.64). All OHIP-14 domain scores decreased (p < 0.05) except for the Functional limitation domain (p = 0.378). The oQoL after the intervention worsened in female patients (p = 0.039) and with a higher level of pain at baseline (p = 0.002).Self-perceived QoL improvement should be considered stable long term after temporomandibular joint arthrocentesis plus HA, regardless of concurrence with DJD or ID subtype. QoL should be used as clinical assessment measure of ID patients, with special attention to those with higher levels of pain.     

Assessment of salivary total antioxidant levels and oral health status in children with Down syndrome

Down syndrome (DS) is an autosomal chromosomal disorder caused by trisomy of all or a critical part of chromosome 21. Individuals with DS have high levels of oxidative stress throughout their lifespan. It has been suggested that levels of antioxidants could be altered in response to an infection or disease. Aim: To assess the total antioxidant capacity (TAC), nitric oxide (NO), and sialic acid (SA) of saliva in children with DS and its relation to their oral health status. Materials and methods: Thirty‐four noninstitutionalized children in the age group of 7–12 years having DS formed the study group. The control group consisted of 34 normal, healthy children. The W.H.O. criteria were used for diagnosis and recording of dental caries. Oral hygiene status was assessed using the simplified oral hygiene index. Estimation of TAC, NO, and SA levels in saliva was done. Data obtained were subjected to statistical analysis. Results: In comparison to normal children, DS children showed significantly lower TAC of saliva and significantly higher salivary SA levels. In both groups of children, dental caries was higher in primary dentition when compared to their permanent dentition.     

Clinicopathologic factors associated with malignant transformation of oral leukoplakias: a retrospective cohort study

It is clinically challenging to identify oral leukoplakias that have a high risk of undergoing malignant transformation. The aim of this retrospective study was to elucidate the associations between malignant transformation of oral leukoplakias and various clinicopathologic factors. Patients with a diagnosis of clinical oral leukoplakia, verified through histopathologic examination and with access to digital images of the lesion, were retrospectively included for the period 2003–2013. Using the clinical images, all lesions were re-evaluated regarding diagnosis and clinical subtype. Of the 234 included patients, with a median follow-up of 9 years, 27 (11.5%) developed oral squamous cell carcinoma. Among the clinicopathologic factors investigated, non-homogeneous oral leukoplakia (OL), OL with dysplasia, and OL localized to the tongue showed statistically significant increased rates of malignant transformation in the multivariate Cox regression analysis. Non-homogeneous OL showed a 15.2-times higher transformation rate than homogenous OL (P < 0.001). Dysplastic leukoplakias developed into carcinomas 2.4-times more often than did non-dysplastic leukoplakias (P = 0.048). OL located on the tongue showed a 2.8-times higher malignant transformation rate than OLs at other oral locations (P = 0.018), when other locations were combined into one group. Non-homogeneous OL, OL with dysplasia, and OL localized to the tongue have higher transformation rates.     

Implant-supported oral rehabilitation in oncology patients: a retrospective cohort study

Oral rehabilitation after treatment for head and neck cancer can be challenging. Implant-supported rehabilitation can considerably improve oral health-related quality of life, but there is a dearth of contemporary evidence of reported outcomes and trends in this cohort. In this study we retrospectively investigated the outcomes of 115 patients (376 dental implants) with a mean (range) follow up of 3.91(0.11-12.76) years. We considered survival of the implants, percentage of those used for prosthetic rehabilitation, time from diagnosis to placement and restoration, additional operations involving soft-tissue revision, and the effects of radiotherapy, chemotherapy, and reconstructive flaps on these outcomes. Implant survival was 97%. A total of 32% of patients had radiotherapy with a mean dose of 61 Gy. A total of 94% of cases were restored with all the implants placed. Computed coefficients from a multinomial logistic regression model suggested that a trend towards radiotherapy, implant placement in the graft, and placement in the maxilla had a negative influence on success, but this was not significant (p > 0.05). The placement of implants in a reconstructive flap was strongly associated with the need for soft tissue revision. The approach used (placement during primary cancer resection or after) significantly influenced the time to placement and restoration (p = 0.016). These data suggest a local trend towards earlier placement of implants (during primary cancer resection) resulting in earlier restorative rehabilitation. Outcome data show that the survival of implants is comparable to that in non-oncological cases, and that radiotherapy and location of the implant have less influence on implant survival than previous studies have suggested.     

Assessment of the oral health status of the medically compromised homebound geriatric patient: A descriptive pilot study

This pilot study was designed to assess the oral health status of homebound elderly and determine their dental care needs. Fifty-one subjects enrolled in a hospital-based home care program were recruited for this study. Subjects were visited in their homes by both a dentist and a physician. Care plans and medications were reviewed for each subject. Initial assessments to receive informed written consent were conducted by the physician. Oral health assessments by the dentist included comprehensive examinations for sot? tissue pathology, periodontal health, caries, restoration, and tooth condition, as well as existing prosthesis assessment, plaque index, and grip strength. A Physical Self-Maintenance Scale was administered in order to determine the level of dependence of this population for their oral hygiene self-care. The oral health status of these homebound elderly was found to be poor, with 84% of the subjects requiring dental care.     

Impact of prosthodontic status on oral wellbeing: a cross-sectional cohort study

Summary  To assess the impact of the prosthodontic status on oral health-related quality of life and satisfaction. We performed a cohort study at the University Clinic in Salamanca in which a group requesting prosthetic treatment (P0; n  = 31) was compared with a group treated with conventional prostheses (P1; n  = 29) and a control group (C; n  = 18) not requesting or treated with prostheses. A clinical examination for the presence of caries, periodontal disease and edentulism was carried out. An assessment was made on the impact on the quality of life employing the oral impacts on daily performance-Spanish version and the oral health impact profile 14-Spanish version, and wellbeing was assessed by the self-rated satisfaction on a 0–10 scale. The P0 cohort was significantly less satisfied and suffered a greater level of impact as regard their quality of life than the other cohorts. The main benefit of conventional prosthetic treatment was perceived by most of the treated patients (P1) in dimensions related to chewing, the aesthetic function and the assessment of the general state of the mouth. However, an unexpected proportion of patients underwent a worsening of their oral wellbeing after prosthetic treatment, mainly in the chewing ability (23%) and pain discomfort (19%) dimensions. Satisfaction and quality of life were higher in the treated group (P1) and controls (C) than in those requesting prosthetic treatment (P0).     

Immunoglobulin A deficiency and oral health status: a case–control study

Introduction: Immunoglobulin A (IgA) is important for mucosal health. Selective IgA deficiency (IgAD) is the most common primary immunodeficiency but its effect on oral health is unclear. The aim of this study was to investigate dental, periodontal and oral mucosal health in IgAD individuals.
Material and methods: In total, 32 adult IgAD subjects were compared with 63 randomly selected individuals. Participants answered questionnaires regarding general and oral health and underwent oral examination, including examination using the periodontal screening and recording (PSR) system and dental examination using the DMF system.
Results: The IgAD individuals had significantly more often undergone tonsillectomy (44% versus 24%, p= 0.046 ) and adenoidectomy (31% versus 8%, p= 0.003 ) compared with the controls. Furthermore, the IgAD subjects reported having pharyngitis, stomatitis and herpes labialis significantly more often. There was no significant difference in periodontal health ( mean PSR index ; 1.87 versus 1.77) or dental health ( mean DMFS ; 51.3 versus 53.7 ) between the two cohorts. A positive correlation between Helicobacter pylori infection and severity of periodontitis was found ( p= 0.036).
Conclusion: IgAD predisposes to oral mucosal infections but does not influence periodontal or dental health. This is the first controlled study to include detailed clinical history and investigations, together with full oral and dental examination, in adults with IgAD.