Manejo odontológico en paciente con síndrome de Cornelia de Lange / Dental treatment of a patient with Cornelia de Lange syndrome

El síndrome de Cornelia de Lange (SCdL) es un trastorno genético poco frecuente y se atribuye principalmente a mutaciones en los genes NIPBL, SMC3 y SMC1A. Sus principales características clínicas son múltiples anomalías congénitas, dimorfismo facial, hirsutismo, hipertricosis, retraso psicomotor, discapacidad intelectual, restricción del crecimiento prenatal y postnatal, anomalías de manos y pies, así como malformaciones congénitas que afectan a distintos órganos. En pacientes con SCdL es necesario hacer hincapié en la higiene oral debido a la discapacidad intelectual que puede presentarse y asegurarse de que se realiza una adecuada valoración y saneamiento dental de forma periódica con el fin de prevenir enfermedades bucodentales. El objetivo de este reporte de caso es describir el manejo odontológico de un paciente de 10 años con SCdL y revisar las características clínicas y hallazgos radiológicos presentes en la cavidad oral (AU)

Cornelia de Lange syndrome (CdLS) is a rare genetic disorder and is principally attributed to mutations in the NIPBL, SMC3 and SMC1A genes. The main clinical characteristics are multiple congenital anomalies, facial dimorphism, hirsutism, hypertrichosis, psychomotor retardation, intellectual disability, prenatal and postnatal growth restriction, hand and foot anomalies, as well as congenital malformations affecting different organs. In patients with CDLS, it is necessary to focus on oral hygiene due to the intellectual disability that may be present and to ensure that adequate dental valuation and hygiene is routinely performed in order to prevent oral diseases. The aim of this case report is to describe the dental management of a 10-year-old patient with CDLS and review the clinical characteristics and radiological findings that are present in the oral cavity (AU)

Antibiofilm properties of silver nanoparticles incorporated into polymethyl methacrylate used for dental applications.

BACKGROUND: Acrylic resins used in dental and biomedical applications do not have antimicrobial properties, their surface is susceptible to colonization of microorganisms. OBJECTIVE: The aim of this study was to evaluate the antibiofilm properties of silver nanoparticles (AgNPs) deposited in a polymethyl methacrylate (PMMA) surface against a Staphylococcus aureus biofilm. METHODS: The PMMA was impregnated with AgNPs by using the in-situ polymerization method. To determine the solubility of the incorporated silver (Ag+) atomic absorption spectrophotometry was used (AAS) at 24 h, 48 h, 7 days, and 30 days. Thirty specimens of PMMA with AgNPs and without NP (control group) were assembled in the CDC Biofilm Bioreactor system with a cell suspension of S. aureus. The specimens were removed at 6, 12, 24, 48, and 72 h to determine the viability profile and quantify the Arbitrary Fluorescence Units (AFU). RESULTS: The AgNPs showed an irregular and quasispherical shape with an average size of 25 nm. AAS analysis demonstrated a low solubility of Ag+. The formation of the S. aureus biofilm increased as the evaluation periods continued up to 72 h. The experimental group showed poor growth, and a decrease in the intensity of the fluorescence demonstrated a statistically significant inhibition of the formation of the biofilm (P < 0.05) in relation to the control group at 6, 12, 24, 48, and 72 h. CONCLUSION: AgNPs incorporated into PMMA decreased the growth and maturation of S. aureus biofilm.

Molar incisor hypomineralization (MIH): prevalence and degree of severity in a Mexican pediatric population living in an endemic fluorosis area.

OBJECTIVE: To estimate the prevalence and severity of molar incisor hypomineralization (MIH) in 8 years old children living in an endemic fluorosis area. METHODS: MIH prevalence rate was determined from a study sample comprising 613 participants. They were recruited from 11 urban public schools with similar socio-economic status. Oral evaluations were performed and diagnosed MIH teeth were classified under Ghanim et al.'s criteria. Statistical descriptive and comparative analyzes were carried out. RESULTS: First permanent molars were the tooth group most affected, followed by the upper central incisors, lower central incisors, lower lateral incisors, and upper lateral incisors. There was no significant statistical difference by gender and by maxillary/mandible arches (P = 0.82 and 0.26, respectively). The frequency of MIH was more in molars compared to incisors (P < 0.02). CONCLUSIONS: The MIH prevalence in this study was 12.4 percent. According to the MIH severity, degree 2 was the most frequently detected (76.4 percent).

Frequency of Pathogenic Microorganisms in Removable Orthodontic Appliances and Oral Mucosa in Children.

OBJECTIVE: The aim of this study was to evaluate the frequency of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida species in removable orthodontic appliances (ROA) and the support oral mucosa in children. STUDY DESIGN: The study participants comprised 55 patients aged 6-12 years requiring ROA. The samples of biofilm colonization from the support oral mucosa and the ROA were taken prior to the use of the ROA (T0) and 4 weeks (T1) after ROA placement. The biofilm samples were seeded on chromogenic culture plates and incubated for 24-48 h. RESULTS: The microbial species evaluated were not present in either the support oral mucosa nor in the ROA at T0. After 4 weeks, P. aeruginosa was found in the support oral mucosa with a frequency of 60%, Candida spp. with 30.9% and S. aureus with 89.09%; in the ROA, P. aeruginosa with 67.7%, Candida spp. with 32.7%, while S. aureus with 90.9%. In the ROA were found C. glabrata in 15 cases, C. albicans in 14 cases, C. tropicalis in two cases, and C. krusei in one case. In the oral mucosa there were 10 cases of C. glabrata, 14 cases of C. albicans, one case of C. tropicalis, and 0 cases of C. krusei. CONCLUSIONS: The frequency of S. aureus, P. aeruginosa, and Candida spp. increased after the orthodontic treatment in either the ROA and or in the support oral mucosa. There is a direct relation between the use of the ROA and the increase of periodontal-pathogenic microorganisms.

Antimicrobial effect of gold nanoparticles in the formation of the Staphylococcus aureus biofilm on a polyethylene surface.

The main of this study was to evaluate the inhibitory effect on the in vitro formation of the Staphylococcus aureus biofilm formed on a polyethylene (PE) surface with a nanostructured Gold (Au) coating for medical devices. An experimental in vitro study was carried out using PE discs with an Au nanoparticle coating (AuNPs) on one side (experimental group) and without coating on the other (control group); the discs were mounted in the CDC biofilm reactor adding broth of yeast-dextrose-peptone (YPD) sterile culture inoculated with S. aureus in a cell suspension (5 × 108 cells/ml). The specimens were evaluated at different times (6, 12, 24, 48, 72 h) and stained with the Live/Dead Bacterial Viability Kit (Invitrogen) for observation, analysis, and quantification with confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). The results showed that as evaluation time passed an increasing of S. aureus biofilm formation was observed in the control group, in the experimental group, a statistically significant biofilm inhibition was observed with respect to the AuNPs uncoated specimens (p ≤ 0.05) and showed a ratio of almost 4:1 viable/nonviable in the biofilm of the uncoated surfaces, with a difference > 5 Log10 in the CFU counts. The PE with AuNP coating showed an inhibitory effect on the biofilm formation of S. aureus.

Effect of Five Commercial Probiotic Formulations on Candida Albicans Growth: In Vitro Study.

PURPOSE: The objective was to evaluate the antagonistic effect of Lactobacillus and Bifidobacterium recovered from five commercial probiotics on the growth of C. albicans. STUDY DESIGN: The Lactobacillus and Bifidobacterium strains of five commercial probiotics were recovered and grown: Probio Hp+®, ProBiseis®, Lactipan®, Liolactil®, and Lacteol Fort®; 50 mg of each was hydrated and grown in Lactobacilli MRS (De Man, Rogosa and Sharpe) broth and incubated at 37°C with stirring (120 RPM) for 24 hours. Serial dilutions of 10-1 to 10-7 were made and viability was verified and quantified. For the antagonism tests, a suspension/inoculum of Lactobacillus strains recovered from each commercial preparation (4-30 × 109) and C. albicans ATCC 90028 (1.5-8 × 108) was prepared in MRS broth and incubated for 48 hours at 36°C, then plated on Dextrose Sabouraud Agar with Chloramphenicol and Rogosa Agar and the colony-forming units (CFU) were quantified. Additionally, viability was evaluated using the LIVE/DEAD® Yeast and Bacterial Viability kit. RESULTS: The probiotic that produced the highest acidity of the medium was Lactipan®, followed by Probiseis® and Liolactil®, while Probio Hp+® showed the least change. Probiseis® was determined to have the highest growth of probiotic bacteria and the highest inhibition on C. albicans, followed by Lactipan®; Liolactil® and ProbioHp+® showed the least effect. In fluorescence tests, ProBiseis® showed the best effect, followed by Liolactil® and Lactipan®; Probio Hp+® had less of an effect. CONCLUSIONS: Two commercial products (ProBiseis and Lactipan) whose formulations have L. acidophilus, L. casei, L. rhamnosus, L. plantarum, B. infantis, and S. thermophilus have a greater inhibitory effect on C. albicans ATCC 90028.

Improvement in Oral Health and Compliance in a Child with Congenital Hypothyroidism. Case Report / Progreso del cuidado oral y el comportamiento en un niño con hipotiroidismo congénito. Reporte de caso

ABSTRACT Congenital hypothyroidism is a metabolic disorder that requires special health care interventions. It has influence in overall growth and oral conditions in pediatric patients, and also can affect child cooperation during dental treatment because this metabolic condition is the most common preventable cause of mental retardation. The aim of this paper is to report the dental treatment of a child with congenital hypothyroidism who is four years and five months old, with many facial and oral characteristics of the metabolic condition, including severe early childhood caries and malocclusion. At first, it was observed a lack of cooperation of the patient with speech and learning impairment, but with the help of the Pedagogy team at the Pediatric Dental Clinic Playroom, he developed confidence and diminished anxiety every appointment. We present the follow-up during 15 months, where we could observe favorable outcomes in oral health and compliance of the child.

RESUMEN El hipotiroidismo congénito es una alteración metabólica que representa una necesidad especial en salud. Tiene influencia en el crecimiento general y las condiciones orales de los pacientes pediátricos, así como también puede afectar en el grado de cooperación del niño durante la consulta porque esta condición metabólica es la causa prevenible más común de retraso mental. El propósito de este artículo es reportar el tratamiento odontológico de un niño con hipotiroidismo congénito de cuatro años y cinco meses de edad, con varias características de la condición metabólica, incluyendo caries de la infancia temprana severa y maloclusión. Al principio se observó una falta de cooperación por parte del paciente, con dificultades para el habla y el aprendizaje, pero con la ayuda del equipo pedagógico de la Sala Lúdica, el niño desarrolló confianza con disminución de la ansiedad en cada cita. Presentamos un seguimiento a lo largo de 15 meses, donde hemos observado resultados favorables en la salud oral y en el comportamiento del paciente.

Prevalencia de Bruxismo y Trastornos Temporomandibulares Asociados en una Población de Escolares de San Luis Potosí, México / Prevalence of Bruxism and Associated Temporomandibular Disorders in a Population of School Children of San Luis Potosí, México

RESUMEN: El término "Transtornos Temporomandibulares" (TTM) incluye numerosos problemas clínicos asociados con las articulaciones temporomandibulares, músculos de la masticación y otras estructuras asociadas. El bruxismo, un hábito oral parafuncional, consiste en rechinar o apretar de manera rítmica e involuntaria los dientes, lo que puede conducir a trauma oclusal y problemas articulares. El objetivo del estudio fue determinar la frecuencia y prevalencia de signos y síntomas de TTM y bruxismo en niños escolares de 6 a 12 años, en una población de San Luis Potosí, México. Se empleó un diseño transversal descriptivo en una muestra de 314 participantes, estudiantes de una escuela primaria de la ciudad de San Luis Potosí, México. Los participantes fueron seleccionados aleatoriamente en forma estratificada y polietápica. La muestra total consistió en 153 femeninos y 161 masculinos. Los signos y síntomas de TTM más frecuentes fueron la alteración de la función de la ATM (35 %), seguido por los ruidos y chasquido articulares (29,2 %). En los sujetos con diagnóstico de bruxismo, la alteración más frecuente fueron molestias asociadas en la ATM (19,4 %), dolor de cabeza (17,8 %) y atrición dental (16,5 %).

ABSTRACT: The term "Temporomandibular disorders" (TTM) includes numerous clinical problems associated with joint temporomandibular, muscles of mastication and other associated structures. Bruxism, oral parafunctional habit, consists of grinding or clenching of involuntary, rhythmic manner, which can lead to trauma, occlusal and problems joint. The objective of the study was to determine the frequency and prevalence of signs and symptoms of DTM and bruxism in school children aged 6 to 12, in a population of San Luis Potosí, México. A crosssectional descriptive design was used in a sample of 314 participants, students of a primary school in the city of San Luis Potosi, Mexico. The participants were randomly selected in tiered form and conglomerated. The total sample consisted of 153 female and male 161. The signs and symptoms of TMD frequent were alteration of the function of the ATM (35 %), followed by noise and snap joint (29.2 %). In subjects with a diagnosis of bruxism, the most frequent alteration was associated with TMJ discomfort (19.4 %), headache (17.8 %) and dental attrition (16.5 %).

Estudio comparativo de tres materiales de impresión en su capacidad para reproducir el margen cervical de la preparación mediante las técnicas de doble hilo y cofia de trasferencia / Comparative study of three impression materials in their capacity to reproduce the cervical margin of preparation using techniques of coping and double cord

En prótesis fija la integridad marginal o perfección del margen es de suma importancia así como una impresión que copie perfectamente el terminado de la preparación ya que de esto depende la adaptabilidade de la prótesis que permita la supervivencia de la restauración y el mantenimiento de la salud periodontal en la boca del paciente. En este estudio se compara la capacidad de tres materiales de impresión (2 siliconas por adición y 1 poliéter) para copiar el margen cervical de la preparación mediante las técnicas de doble hilo y cofia de trasferencia. Se utilizaron 96 primeros molares inferiores izquierdos divididos en 6 grupos de 16 c/u se restauraron los dientes con ionómero de vidrio, resina o poste colado según fuera el caso, se prepararon los dientes con terminación en chamfer, el grupo 1: técnica de doble hilo con silicone por adición (Silicona 1), grupo 2: técnica de doble hilo con poliéter, grupo 3: técnica de cofia de transferência con silicona (Silicona 1), grupo 4: técnica de cofia de transferencia con poliéter, grupo 5: Técnica de doble hilo con silicona (Silicona 2), grupo 6: Técnica de cofia con silicona (Silicona 2). Posteriormente fueron observados en el estereomicroscopio para evaluar la cantidad de burbujas e irregularidades en el margen cervical según la escala de Jokstad. Donde la prueba estadística de Chi-cuadrada con un nivel de confianza de < 0.05 no mostró diferencia estadística significativa entre las técnicas de impresión de doble hilo y la de cofia de trasferencia, independientemente del material usado. Aunque numéricamente la técnica de doble hilo se comportó mejor que la técnica de cofia por lo que se sugiere su uso.

In fixed prosthesis, the integrity of perfection of the margin is of utmost importance, as well as an impression that perfectly copies the finish of the preparations, since the adaptability of the prosthesis that ensures survival of the restoration and periodontal health depends on this. This study compares the capacity of 3 different materials (2 silicones addition and 1 polyether) to copy the cervical margin of the preparation in the impression between the techniques of double cord and coping. We used 96 lower left molars divided into 6 groups of 16 each. The teeth were restored with glass ionomer, resin or cast post and core depending on the case, the margins were finished in a chamfer (group 1), double thread with addition silicone (group 2), double thread with polyether, (group 3), coping with PVS, (group 4), coping with polyether, (group5) double cord with PVS (group 6), coping With PVS. They were subsequently evaluated in a stereomicroscope to observe the number of bubbles and irregularities in the cervical margin according to the Jockstad scale, where the Chi-square test with a confidence level of <0.05 showed no statistically significant difference between impression techniques and coping regardless of material used. Although numerically the double-thread technique behaved better than coping technique, so it is suggested its use.

Dental Management of a Young Child Affected by Galactosialidosis and a Gigantic Abdominal Growth.

Galactosialidosis (GS) is a rare form of lysosomal storage disease that involves a broad spectrum of skeletal and soft tissue abnormalities. We report here on a 4-year 7-month-old boy with mild mental retardation, exhibiting multiple caries cavities and associated infectious foci and macroglossia. A huge abdominal enlargement due to peritoneal ascites was evident. Behavioral management and patient positioning on the dental chair represented a true challenge. The patient was treated under general anesthesia. However, life-threatening postoperative complications occurred because of the impossibility of extubating the patient. A very careful preanesthetic assessment is crucial in children affected by general conditions associated with airway anomalies, such as GS.

Dental Management of a Child with Incidentally Detected Hemophilia: Report of a Clinical Case.

Children with hemophilia (A or B) are at risk for bleeding episodes, which rank from mild mucosal/soft tissues bleeding to life-threatening hemorrhages. This report describes the dental/medical management provided to an 8.10-year-old patient suffering from uncontrolled bleeding after a surgical procedure to expose both permanent upper central incisors, in which hemophilia was a pure incidental finding. Additionally, diverse precautions to be considered during the dental clinical treatment of hemophilic children are discussed.

Dentist attitudes and responsibilities concerning child sexual abuse. A review and a case report.

According to the World Health Organization, child abuse and neglect is "every kind of physical, sexual, emotional abuse, neglect or negligent treatment, commercial or other exploitation resulting in actual or potential harm to the child's health, survival, development or dignity in the context of a relationship of responsibility, trust or power". The aim of the present report is to inform about the most relevant aspects of child abuse and the characteristics of injuries to the head, neck, and orofacial regions, in addition to the suggested role of, and management by, the dentist for the evaluation of this condition, and also for reporting a case of a physically and sexually abused girl aged 5 years 8 months. Throughout the appointments, some type of abuse in this patient was suspected by the treating dentists at the clinic, mainly due to the initial behavior exhibited by the patient in the dental chair. Based on the clinical diagnostic an intensive preventive plan and restorative treatment was realized. The timely detection of the signs and symptoms of sexual abuse, often present in the orofacial region, place the pediatric dentist in a strategic situation, with the capacity to recognize, register, and later report those cases considered as suspect, including the dental treatment delivered and the intensive behavioral-psychological management, in order to achieve acceptation by the otherwise very anxious patient of the indicated restorative and preventive dental procedures. Key words:Child abuse, dentistry, behavior management.