A description of two surgical and anesthetic management techniques used for a patient with fibrodysplasia ossificans progressiva

Fibrodysplasia ossificans progressiva (FOP) is a rare and debilitating genetic disorder of skeletal malformations and progressive heterotopic ossification. Flare‐ups are episodic, with bone formation in skeletal muscle and connective tissue leading to ankylosis of major joints of the axial and appendicular skeleton. This report outlines the management of a patient with FOP who had ankylosis of the temporomandibular joint and progressive ossification of the neck structures. The patient underwent two different surgical and anesthetic procedures within a 10‐year period to manage his oral pain. The authors compare the surgical techniques, osteotomy versus the more conservative buccal approach, anesthesia techniques, and conventional intubation versus sedated fiberoptic intubation. This report emphasizes the importance of a less invasive surgical technique and an appropriate anesthetic management that reduces the risks, cost, and morbidity associated with routine surgical management of patients with FOP.     

Orthognathic treatment of dentofacial disharmonies: its impact on temporomandibular disorders,quality of life,and psychosocial wellness

Aim: The objective of this literature review was to assess the effect of orthognathic surgical treatment on temporomandibular disorders (TMD), quality of life (QoL), and psychosocial wellness.

Methods: Journal articles and systematic reviews published in English between 1982 and 2015 were searched using PubMed, MEDLINE, and Cochrane database using the search terms “orthognathic,” “temporomandibular disorders,” “quality of life,” and “psychosocial.” The articles were then reviewed and discussed.

Results: Both objective and subjective parameters play a role in orthognathic treatment outcome satisfaction and QoL. Psychological factors and TMD exerted a stronger influence on patients’ QoL more than objective treatment outcome measures.

Conclusion: A paradigm shift in clinical mindset from solely objective measures to a more holistic, patient-centric approach of addressing patients’ expectations and improving QoL is warranted when treating patients with dentofacial disharmonies.     

Attitudes of dentists, working in Riyadh, toward people with a sensory impairment

This study was conducted to determine the attitudes of dentists, working in Riyadh, toward people with a sensory impairment (SI), according to the Scale of Attitude Towards Disabled Persons (SADP). The SADP scale was modified to focus solely upon sensory impairment. The modified scale was pre-tested and then incorporated into a self-administered questionnaire. This was then administered to 600 dentists (response rate, 73.7%) working in the city of Riyadh, Saudi Arabia. The modified scale showed itself to be reliable, with a Chronbach's coefficient α 0.616 and four-factor analysis, which accounted for 38.5% of the variance. Ninety-four percent of the dentists were generally positive toward SI in the society. There were, however, significant variations in attitudes, with a more positive score for dentists who had worked for 30 years or more ( p ± 0.005), were specialists ( p < 0.005), received little or no undergraduate training in this subject ( p < 0.05), and who received their undergraduate training in Europe/North America ( p < 0.001). However, in a stepwise regression model, all these variables were significant except for the years of practice. The modified SADP showed dentists, working in Saudi Arabia, having a positive attitude toward people with SI.     

The effect of antiretroviral therapy on the prevalence of oral manifestations in HIV-infected patients: A UK study

OBJECTIVE: The purpose of this study was to compare the prevalence of oral manifestations in human immunodeficiency virus (HIV)-infected patients on monotherapy, dual therapy, or triple therapy with the prevalence of those not on antiretroviral therapy (ART). STUDY DESIGN: A cross-sectional study of the oral manifestations of HIV was carried out on 284 HIV-infected patients, 89 of whom were undergoing ART (12 on monotherapy, 41 on dual therapy, and 36 on triple therapy) and 195 who were not undergoing ART. Oral manifestations were recorded by using established presumptive clinical criteria. Chi-square statistical tests and separate bivariate analyses were conducted by using the Spearman rank correlation to describe the relationship between the prevalence of oral lesions and ART. RESULTS: The detection of oral manifestations was significantly decreased in subjects on dual therapy and subjects on triple therapy in comparison with patients on monotherapy (P <.05) and those on no ART regimen (P =.014). Oral manifestations were also significantly increased, with CD4 counts <200 cells/mm(3) and a viral load >3000 copies/mL (P <.001). CONCLUSIONS: Compared with the non-ART group, subjects on combination ART had significantly fewer HIV-related oral manifestations-probably as a result of an expression of their reconstituted immune system.