9-year follow-up of uncommon cleft palate in Aarskog-Scott syndrome.

Aarskog-Scott syndrome (AAS) is characterized by different facial, skeletal and genital anomalies and may have oral manifestations. A 7-year-old boy was referred to the University General Hospital for treatment of speech difficulties and frequent regurgitation. Characteristics such as a triangle-shaped face, hypertelorism, low-set ears, flattened nose, shawl scrotum and partial syndactylia on hands and feet were observed. Based on these clinical features, the child was diagnosed with AAS. Upon intraoral examination, maxillary atresia and an incomplete cleft palate were observed. The mixed dentition was characterized by extensive coronary destruction of primary teeth and caries lesions on permanent teeth. Here, the case of a 9-year follow-up of this child with uncommon AAS associated with cleft palate is reported. The child was referred to a multidisciplinary team for planning and carrying out the treatment. In the follow-up visit after 9 years from the beginning of the treatment, the child showed greater sociability, with significant improvement in spontaneous speech and pronunciation of phonemes. However, the patient continues until now with articulation and spontaneous speech training. The correction of class II malocclusion, better dental alignment and canine extrusion were achieved. At the moment, the patient uses a nighttime extraoral device, and the treatment continues for dental alignment and prevention of tooth decay. The presence of cleft palate could be coincidental with AAS and may aggravate the prognosis, requiring careful patient monitoring by a multiprofessional team. Key words:Aarskog-Scott syndrome, cleft lip, cleft palate, multidisciplinary treatment.

Periodontal Findings in Children and Adolescents with Cleft Lip and/or Palate: A Case-Control Study.

Purpose: The purpose of this study was to evaluate periodontal disease and oral biofilm in children and adolescents with cleft lip and/or palate (CLP). Methods: A total of 118 individuals aged six to 18 years, with CLP (n equals 60) and without CLP (n equals 58), were evaluated according to plaque index (PI), gingival bleeding index (BI), clinical attachment level (CAL), and probing pocket depth (PPD). Gingivitis and periodontitis were also diagnosed. Samples of subgingival oral biofilm were collected, and genomic DNA was extracted for oral microbial analysis. Aggregatibacter actinomycetemcomitans, Tannerela forsythia, Porphyromonas gingivalis, and Streptococcus oralis were identified and quantified by qPCR using Taqman primers and probes. Results: PI, BI, CAL, and PPD were statistically higher in the CLP group. Gingivitis was observed in 52 percent and 29 percent (P<0.001) and mild periodontitis was observed in 48 percent and 22 percent (P<0.001) of the CLP and control groups, respectively. When the permanent dentition group was evaluated, a greater occurrence of mild periodontitis was observed in the CLP group (P<0.001). The level of A. actinomycetemcomitans (P<0.001), P. gingivalis (P<0.001), and T. forsythia (P<0.001) was statistically higher in the subgingival biofilm of the CLP group. Conclusions: The presence of cleft lip and/or palate negatively affects oral hygiene and levels of periodontopathogens in oral biofilm. In addition, clinical and microbiological results highlight the importance of early assessment of young people with cleft lip and/or palate and the permanent dentition to prevent periodontal disease.

Can different stages of leprosy treatment influence the profile of oral health? Oral status in leprosy

BACKGROUND: The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects. MATERIAL AND METHODS: A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA). RESULTS: The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment). CONCLUSIONS: It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals

Caries Experience and Periodontal Status in Children and Adolescents with Cleft Lip and Palate.

PURPOSE: The purpose of this study was to examine the rate of dental caries and the periodontal status of children and adolescents with cleft lip and palate (CLP) and to compare them with gender- and age-matched control subjects. METHODS: A total of 156 five- to 18-year-olds, with or without CLP, were examined for dental caries (decayed, missing and filled permanent teeth and primary surfaces [DMFT and dmfs, respectively] indices), plaque index (PI), the gingival bleeding index (BI), clinical attachment level (CAL), and probing pocket depth (PPD). Diagnoses of gingivitis (localized and generalized) and periodontitis (mild, moderate, and advanced) were performed. Characteristics such as gender, age group, cleft type, socioeconomic status, dental occlusion, and the use of orthodontic appliance were analyzed. RESULTS: DMFT and dmfs scores were significantly higher in the control group. The PI, BI, and PPD indices were higher in the CLP group. Respectively, in individuals with and without CLP, 49 percent and 75 percent, had good gingival health, 22 percent and 24 percent had localized gingivitis, and 29 percent and one percent had generalized gingivitis. CONCLUSIONS: The results demonstrate that caries experience in both dentitions was higher for CLP patients, and the presence of CLP is a determining factor for higher risk of gingival inflammation.