Therapeutic solutions for anterior restorations in disabled patients: Systematic review and case report.

INTRODUCTION: Treating anterior restorations is a real challenge for a dentist and conventional protocols are not always applicable. The aim of this study is to determine different therapeutic to conducting anterior restorations in disabled people. CASE REPORT: We begin by presenting the case of a 23-year-old, handicapped man, who was brought in consultation to compensate for the loss of the left upper central incisor (#21). MATERIALS AND METHODS: We then performed a systematic literature review in December 2022, in accordance with the PRISMA guidelines. The publications, on three databases, dealing with dental treatments on disabled people were selected whether they were clinical studies or case reports. RESULTS: In the end, 14 publications were included. Most of the treatments described in the studies (n = 10; 71.43%) concern people aged under 19. The patients present different types of handicaps with various degrees of severity and the oral diseases described are as heterogeneous as the handicaps retrieved. DISCUSSION: It is therefore difficult to make common treatment recommendations for all these variable profiles and situations. Most of patients in this study are very young, so there is a need for preventive and therapeutic care as earlier as possible, to preserve the vitality of their teeth and dental occlusion.

Morbidity and Mortality Review in a University Dental Hospital: A Necessary Tool to Improve Quality of Care.

OBJECTIVE: The study aimed to describe and to analyze the first morbidity and mortality review (MMRs) set up within a Dental University Hospital using detailed case reports to highlight the benefits of MMRs for patients, practitioners, teachers and to implement appropriate protocols to prevent recurrence. MATERIALS AND METHODS: The MMRs were performed within the dentistry departments of the hospital over the 1-year study period. Each case was reviewed according to a protocol based on a tool defined by the Clinical Risk Unit and the Association of Litigation and Risk Management (ALARM). RESULTS: Four cases were selected based on an oral report by a doctor from the dental service, a downstream service, or by the attending physician. The first case report related to a patient who suffered a breathing shock. The second concerned a tooth inhalation by a young disabled boy. The third was a therapeutic failure instigated by a student during a tooth preparation, and the fourth case involved an unexpected face-to-face meeting between a prisoner accompanied by police guards and an ancient victim at the dental hospital. DISCUSSION: Clinical incidents were investigated with the ALARM protocol. This process is also less focused on the individual who makes the error and more on contributing systemic factors. The systematic analysis of cases associated with bibliographic reviews improves learning and performance outcomes. Clear answers were given in response to the problems raised during these MMRs. CONCLUSION: In dental hospitals, the culture of MMRs needs to be integrated into resident training like in medical hospitals.

Sealer penetration and adaptation in the dentinal tubules: a scanning electron microscopic study.

INTRODUCTION: Tubular penetration and adaptation of the sealer can determine the sealability of the root filling. The aim of this study was to assess, in vitro, the tubular adaptation and penetration depth and the adaptation to the root canal walls in the apical, middle, and coronal third of the root canal of 5 different sealers used in combination with softened gutta-percha cones. METHODS: Fifty-two single-rooted teeth were prepared and filled with 5 different sealers and softened gutta-percha cones. Thereafter, the roots were cross-sectioned and prepared for scanning electron microscopic evaluation. Adaptation of the sealer to the root canal and tubular walls and tubular penetration were assessed. RESULTS: AH Plus (Dentsply De Trey, Konstanz, Germany), an epoxy resin sealer, showed the best tubular adaptation and penetration. CONCLUSIONS: The tubular penetration and adaptation varies with the different physical and chemical properties of the sealers used. AH Plus showed the most optimal tubular penetration and adaptation to the root canal wall of the sealers tested.