Oral health-related quality of life after dental treatment in patients with intellectual disability.

BACKGROUND: The influence of dental treatment on oral health-related quality of life (OHRQOL) has rarely been evaluated in patients with intellectual disability (ID) through validated questionnaires. The aim of this study was to estimate the changes on OHRQOL in patients with ID after the implementation of an institutional dental treatment program under general anesthesia using the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHCOHRQOL-Q). MATERIAL AND METHODS: A prospective longitudinal study was conducted on 85 patients (mean age=24.85 years) classified according to DSM-V whose parents/caregivers completed the FHC-OHRQOL-Q. We analyzed the changes in the questionnaire's overall score and its dimensions from pre-treatment to 12-months of follow-up, considering effect sizes and minimal important differences estimated by the standard measurement error. The impact of clinical and therapeutic factors was evaluated using univariate and multiple linear regression analysis (p<0.05). RESULTS: Significant improvement of OHRQOL was found after dental treatment in oral symptoms (p0.001), daily life problems (p=0.018), parent's perceptions (p=0.013) and FHCOHRQOL-Q´s overall score (p=0.001). OHRQOL changes exhibited an intermediate magnitude (0.38-0.21) as estimated by effect sizes. Changes in oral symptoms showed positive correlation with DMFT index (r=0.375, p=0.002), decayed teeth (r=0.244, p=0.036), dental extractions (r=0.424, p<0.001) and number of treatments (r=0.255, p=0.019). The improvement was greater in patients with 4 decayed teeth (p=0.049) and undergoing 2 dental extractions (p=0.002). Multiple regression analysis demonstrated that dental extractions (p<0.001) and DMFT index (p=0.028) were significantly related to oral symptom improvement. CONCLUSIONS: Dental treatment under general anesthesia showed a positive effect on the overall FHC-OHRQOL-Q score and most of its dimensions. At 12-months of follow-up, the improvement of oral symptoms was significantly associated with DMFT index, decayed teeth, dental extractions and number of treatments. In our clinical setting, the implementation of a dental treatment program enhanced the OHRQOL of patients with ID.

Preventive dental management of osteonecrosis of the jaws related to zoledronic acid treatment.

OBJECTIVE: To evaluate the effect of preventive dental management on reducing the incidence and delaying the onset of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in patients treated with intravenous zoledronic acid (ZA). MATERIALS AND METHODS: This single-center clinical study included 255 patients with cancer monitored over a 6-year period. Patients received dental treatment prior to (group A) or after (group B) the initiation of ZA therapy. Dental treatments performed, incidence proportion (IP), and incidence rate (IR) in both groups were analyzed using significance tests. BRONJ onset was estimated using the Kaplan-Meier estimator and log-rank test. Independent risk factors to develop BRONJ were evaluated using Cox regression analysis models. RESULTS: Thirty-seven patients suffered from BRONJ (IP = 14.5%), 7.3% in group A and 36.5% in group B (p = .000). The IR was 0.007 patients/month in group B and 0.004 in group A. BRONJ-free survival at 3 years was 97% in group A and 66% in group B. Survival curves were significant (p = .056) according to log-rank test. Multivariate Cox models showed that dental extractions (p = .000) were significant. CONCLUSIONS: BRONJ occurred significantly in patients who underwent dental extractions after the initiation of ZA and did not accomplish a preventive dental program.

Assessment of quality of life of oral cancer survivors compared with Spanish population norms.

This study evaluated the quality of life (QL) of patients who survived oral cancer more than 5 years after treatment, using the Short-Form 36 questionnaire (SF-36), and assessed the impact of factors influencing QL compared with the Spanish population norms. 60 oral cancer patients (65.41 years; 49 males) with cancer-free survival after surgery of >5 years were enrolled. The outcomes of every dimension of the SF-36 questionnaire in every patient were compared with those of a reference Spanish population. Females had statistically significant negative differences in the dimensions of role-emotional, social functioning and vitality. Patients under 65 years had statistically significant negative differences in the dimensions of physical functioning and general health. In the other variables analysed the differences between groups were only clinically relevant. The QL of patients with oral cancer who survive more than 5 years, when assessed with the SF-36 questionnaire, presented similar values to those of the general population, even exceeding these reference values in some dimensions. It is necessary to evaluate QL in the long-term since patients may need a long time to recover from the disease, and to complement QL assessment with other specific questionnaires.

Telemedicina en cirugía maxilofacial / Telemedicine in maxillofacial surgery

En nuestra especialidad el cáncer oral, debido a su elevada mortalidad,así como otras patologías de menor gravedad pero de gran morbilidady presión asistencial como la cirugía oral y la patología de la articulacióntemporomandibular, nos obligan a minimizar las demoras optimizandolos recursos de que disponemos. Dentro de estos recursos, la aplicaciónde las nuevas tecnologías a la medicina se está imponiendo en todaslas especialidades. Entre estas nuevas tecnologías, está adquiriendo un papelprotagonista la telemedicina. Creemos que ésta nos puede servir como sistemaóptimo y eficaz de cribado y derivación de pacientes desde atenciónprimaria (AP) hasta el nivel hospitalario. En el presente artículo describimostodos los detalles relacionados con el desarrollo, la utilización y las ventajasde una teleconsulta como herramienta integrante de una unidad degestión clínica para el proceso diagnóstico y terapéutico de la patología dela articulación temporomandibular valorando de esta forma su aplicabilidaden otros ámbitos de la cirugía oral y maxilofacial(AU)

There is a group of pathologies that tolerate little delayand require optimal use of the resources available to us in our dailywork as oral and maxillofacial surgeons. For instance, oral cancerhas a high mortality and other pathologies, which otherwise arenot serious, have a high morbidity and care burden, e.g., oral surgeryand temporomandibular joint dysfunction.Among these resources, the use of new technologies in medicinehas become routine practice in every specialty. Among thesetechnologies, telemedicine is becoming prominent. We believe thattelemedicine could be an optimal system for screening patientsfor referral from primary care to hospitals. The development, use,and advantages of teleconsultation as a tool used in a clinicalmanagement unit for the diagnosis and treatment oftemporomandibular joint disorders is described. The potential useof teleconsultation in other fields of oral and maxillofacial surgeryis evaluated(AU)

Metástasis lingual de carcinoma renal / Lingual metastasis from renal carcinoma

No disponible

No disponible

Adenoma pleomorfo intraoral / Intraoral Pleomorphic Adenoma

No disponible

No disponible