The use of botulinum toxin for grinding in patients with Rett syndrome-Case report.

AIMS: Rett syndrome (RTT) is a neurodevelopmental disorder caused by a mutation in the methyl-CpG-binding protein 2 (MECP2) gene. It is characterized by profound and severe motor disability. Patients with RTT grind their teeth, causing damage to their permanent teeth. This article aims to describe the case of an 8-year-old child with RTT and the methods of botulinum toxin-based treatment for teeth grinding. METHODS AND RESULTS: Surface electromyography (sEMG) was used to monitor the effects of treatment. The masseter and temporal muscles, responsible for the elevation of the mandible, were injected with botulinum toxin. The results of the sEMG examination performed 1 week, 1 month and 4 months after toxin administration were compared to the sEMG conducted before treatment. The research demonstrates a significant reduction in both grinding frequency and tension of the masseter and temporal muscles. CONCLUSION: Possible adverse effects after chronic use of botulinum toxin were discussed. The article also emphasizes the need for masticatory muscle rehabilitation during botulinum toxin therapy. However, it is necessary to repeat this procedure on a larger group of children with RTT to establish our efforts' efficacy.

Chemotherapy-Induced Oral Complications and Prophylaxis Strategies.

Cancer is currently a significant therapeutic challenge and is frequently connected with numerous adverse effects. Despite many improvements in chemotherapy, oral complications are common, leading to poor quality of life and chemotherapeutic dose reduction, which impair survival. This review summarizes the most common dental complications in patients receiving chemotherapy. We mainly focus on oral mucositis as it is a major cause of dose-limiting toxicity. Furthermore, oral candidiasis, viral infections, and xerostomia will be discussed. Conclusions: preventing complications is significantly more important than treating them. All patients beginning systemic anticancer treatment should undergo a thorough oral examination and get appropriate prophylaxis.

Maxillary transverse deficiency, with closed intermaxillary suture, does bone-anchored appliance during SARPE cause predictable, and stable maxillary expansion compared to the tooth-borne appliance during SARPE - Systematic review.

INTRODUCTION: Managing maxillary transverse deficiency (MTD) with closed intermaxillary suture is a challenge in orthodontic treatment plans; over the years, clinicians have developed many approaches to treat this significant dentofacial deformity. Therefore, it is crucial to understand the underlying causes of MTD and to establish an effective treatment method for restoring the ideal aesthetics and functions for patients. A current and effective SARPE technique for expanding the maxillary arch involves performing 2-piece Le Fort I osteotomy to surgically apply horizontal force to the maxilla along the midpalatal suture in conjunction with either a tooth-borne or bone-borne appliance. MATERIAL AND METHODS: A systemic review was conducted in order to investigate the differences between the two treatment methods for MTD with matured and closed intermaxillary suture: bone-anchored and tooth-borne appliance during SARPE (surgically-assisted rapid palatal expansion). The review was conducted in the English language through PubMed and Google Scholar electronic databases. The protocol is being reported in accordance with the PRISMA Statement. RESULTS: This research, however, is subject to several limitations, including minimal randomization, limited sample size, indefinite measurement methods, and a short follow-up period. Each method of maxillary transverse deficiency therapy has been proven to be effective in expanding the maxillary arch. CONCLUSION: From the analysis of the articles, it was concluded that bone-anchored appliances have a more predictable and stable expansion compared to the tooth-borne appliance during SARPE. Nevertheless, further studies are needed to confirm its long-term effectiveness.

Orbital Abscess-Two Case Reports with Review.

Periorbital infections lead to severe condition of the orbital abscess, and eventually to sight loss, and even death. Current study aims in reviewing the literature regarding orbital abscess in adult patients and presenting 2 original cases. A surgical intervention to drain the abscess and a revision of the orbital was required. A review of literature is also reported focusing on aetiology and treatment options dealing with an orbital abscess.

The Management of Foreign Body Displacement into the Maxillary Sinus as a Complication of Maxillofacial Interventions: Systematic Review.

Displacement of foreign bodies into the maxillary sinus shows an increasing tendency, especially in regard to raising amount of dental implant installation procedures. The purpose of our study was to compare the efficiency and the rate of late complications among the methods of removal of foreign bodies from maxillary sinus. We performed a systematic review following PRISMA Checklist, searching Pubmed and Google Scholar databases for studies investigating the methods of removal of foreign bodies from maxillary sinus. The inclusion criteria embraced the examined group of at least 10 cases and the follow up period of minimum 3 months. We qualified 7 papers from 531 identified in primary search. Among qualified studies functional endoscopic sinus surgery used in order to remove foreign body from maxillary sinus had no late complications, whereas they occurred in 0-5% cases of using replaceable or pedicled bone approaches and in 15-18% cases of Caldwell-Luc approach. FESS probably should become a gold standard in retrieving foreign bodies from maxillary sinus, however poor evidence requires further investigation, especially in prospective, randomized trials.

The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants.

BACKGROUND: It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems. METHODS: Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography). RESULTS: We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles. CONCLUSIONS: sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible.

The Importance of Monitoring Neurodevelopmental Outcomes for Preterm Infants: A Comparison of the AIMS, GMA, Pull to Sit Maneuver and ASQ-3.

BACKGROUND: Clinicians and parents should closely monitor the neurodevelopment of very preterm infants. The aim of our study was to compare whether neurodevelopmental assessments completed by parents and those done by specialists yielded similar outcomes. We wanted to check whether the assessments completed by specialists and parents were comparable in outcomes to emphasize the important roles of early assessment of a child and of the parents in their child's treatment and medical care. Another aim was to check whether or not the pull to sit maneuver from the Neonatal Behavioral Assessment Scale (NBAS) is still a parable item in well-known scales of neurodevelopment. METHODS: We assessed 18 preterm neonates in the fourth month of corrected age with scales such as the General Movement Assessment (GMA), the Alberta Infant Motor Scale (AIMS), and the pull to sit maneuver from the NBAS. Finally, we asked parents to complete the Ages and Stages Questionnaire, Third Edition (ASQ-3). RESULTS: We found that the respective assessments completed by specialists and parents are comparable in outcomes. We also found that the pull to sit item from the NBAS was still a valid test since it showed similar findings to those from the AIMS, the GMA, and the ASQ-3. CONCLUSIONS: The pull to sit item from the NBAS is an important item for assessment of very preterm infants. Specialists should also take into consideration the input and concerns of parents when planning for treatment and intervention.

The Influence of Parent Education on the Neurobehavior and Sucking Reflexes of Very Preterm Infants.

The diagnosis of neurobehavioral problems in very preterm neonates helps with planning and applying proper and direct therapeutic interventions. (1) Background: The aim of this study was to determine the direct impact of neurobehavior on the sucking reflex and eating abilities of neonates. (2) Methods: We assessed 18 preterm neonates twice hospitalized at the Gynecology and Obstetrics Clinical Hospital through the use of the Neonatal Behavioral Assessment Scale (NBAS). (3) Results: We found that that a neonate's sucking ability positively correlated with the activity level item from the motor system cluster of the NBAS. (4) Conclusions: Neurobehavior should be closely assessed in very preterm neonates. Firstly, because assessments can detect fundamental problems and help a practitioner plan for early intervention. Secondly, the education of parents regarding the neurobehavior of their child can help in the facilitation of feeding skills and the planning of early rehabilitation.

Botulinum toxin type A as a novel method of preventing cleft lip scar hypertrophy-A literature review.

BACKGROUND: Cleft lip is a congenital development defect. Primary cleft lip repair leads to cleft scar formation. The resulting scar often undergoes hypertrophy, which negatively affects the facial esthetics, function, and patient's mental health. One of the methods used in scar therapy described in recent years is botulinum toxin injections The aim of this work is to present current knowledge about the impact of botulinum toxin A on cleft lip scar appearance and its effect on scar hypertrophy. METHODS: The literature search was conducted in the English language via the PubMed and Google Scholar databases. RESULTS: The results show injections seem to be a promising method in cleft lip scar management. However, future studies, especially randomized controlled trials, are necessary to assess the effect of BoNT-A compared with placebo and to determine the optimal dosages and injection schemes for BoNT-A treatment in cleft lip patients.

Scar management in patients after cleft lip repair-Systematic review Cleft lip scar management.

BACKGROUND: Cleft lip is a commonly occurring congenital development defect. Primary cleft lip repair leads to cleft scar formation. The resulting scar often undergoes hypertrophy, which negatively affects facial esthetics, function, and the patient's mental health. AIMS: The systematic review presented here was carried out to answer the following question: What cleft lip scar management options exist and how effective are they? METHODS: The systematic review of the articles on scar management methods in cleft lip patients was done in accordance with the PRISMA checklist. The literature search was conducted via the PubMed and Google Scholar databases. RESULTS: A total of 95 items were obtained. Finally, nine works have been included in the systematic review. Among the obtained works, there is a variety of cleft lip scar management methods. All the presented methods of cleft lip scar management proved to be effective in cleft scar therapy. CONCLUSIONS: Cleft lip scar management should be considered as a constant and mandatory element of the treatment plan in cleft patients. It is also worth considering creating detailed protocols of conduct for cases of cleft lip scaring which pay attention to existing needs, prevention/correction and problems of superficiality and depth.

Botulinum toxin type A as an alternative way to treat trigeminal neuralgia: a systematic review.

INTRODUCTION: Trigeminal neuralgia (TN) is one of the most common neurological diseases involving the orofacial region. It affects mainly the older population, usually after the age of 60, and more commonlywomen. It involves the fifth cranial nerve and manifests as paroxysmal, unilateral, severe, shock-like or knife-like pain of from a second to two minutes' duration. Usually pain attacks arise spontaneously, but they can also be precipitated by triggers such as cold weather, brushing teeth or shaving. The ICHD-3 classification divides TN into classical, secondary and idiopathic. Current treatment includes pharmacological and surgical methods. Anticonvulsants, such as carbamazepine and oxcarbazepine, are the first line therapy. Microvascular decompression is the most common and most effective way to treat TN surgically. However, none of these methods is free from complications. Moreover, 25-50% of patients became refractory to drug therapy. Some studies have shown that a new therapy that uses a Botulinum toxin type A can be a safe and effective way to treat trigeminal neuralgia. METHODS: Literature from the PubMed base and the Main Medical Library from the last 18 years was analysed. Forty-three items were obtained; after verification, seven articles were included. AIM OF THE STUDY: To look at current guidelines about treating trigeminal neuralgia with Botulinum Toxin type A in patients who are refractory to drug therapy or who do not want to undergo surgical treatment. CONCLUSION: BoNT-A therapy is a safe and effective method of treating trigeminal neuralgia.