Dental anomalies in craniofacial microsomia: A systematic review.

OBJECTIVE:  To provide an overview on the prevalence and types of dental anomalies in patients with craniofacial microsomia (CFM). Eligibility criteria: Inclusion criteria were CFM and dental anomalies. The following data were extracted: number of patients, methodology, mean age, sex, affected side, severity of mandibular hypoplasia, dentition stage and dental anomalies. INFORMATION SOURCES: Cochrane, EMBASE, PubMed, MEDLINE Ovid, Web of Science, CINAHL EBSCOhost and Google Scholar, searched until the 30 August 2019. Risk of bias: The quality was examined with the OCEBM Levels of Evidence. INCLUDED STUDIES: In total, 13 papers were included: four retrospective cohort studies, four prospective cohort studies, four case-control studies and one case series. Synthesis of results: The studies reported information on dental agenesis, delayed dental development, tooth size anomalies, tooth morphology and other dental anomalies. Description of the effect: Dental anomalies are more often diagnosed in patients with CFM than in healthy controls and occur more often on the affected than on the non-affected side. Strengths and limitations of evidence: This is the first systematic review study on dental anomalies in CFM. However, most articles were of low quality. INTERPRETATION: Dental anomalies are common in CFM, which might be linked to the development of CFM. The pathophysiology of CFM is not entirely clear, and further research is needed.

[Adjusting medication at the end of life: towards optimalisation of healthcare in the final fase of life]. / Medicatie aanpassen aan het einde van het leven.

Patients with a limited life expectancy use many medications. Especially medications with a focus on the prevention and treatment of illnesses may be inappropriate in this last phase of life. We present the cases of three patients in which we highlight that such medication reconsideration 1) is quite often done shortly before death, 2) is not without potential disadvantages, and 3) should be accompanied with a patient centered and positive communication style. We argue that the use of medications should be reconsidered in a timely phase, ideally as part of advance care planning.