Prevalence of Bruxism in Children and Adolescents with Cerebral Palsy: Systematic Review and Meta-analysis.

AIMS: To perform a systematic review and meta-analysis compiling data on the prevalence of bruxism in children and adolescents with cerebral palsy. METHODS AND RESULTS: Searches were carried out in PubMed/Medline, Web of Science, and Scopus databases to identify the articles published by February 2023. Two independent reviewers, and in duplicate, employed a two-stage process to select publications. The same two reviewers performed the data extraction. Studies were included when the following eligibility criteria were met: performed in children and/or adolescents with cerebral palsy and reporting bruxism. Potentially eligible studies were read in full and excluded that: not presented numerical data on the prevalence of bruxism; not reported how the bruxism was assessed; not reported data about the cerebral palsy; and not an observational study. The risk assessment of bias was assessed by the Newcastle- Ottawa Scale. After reading the titles and abstracts of the 358 identified articles, eight articles from 1966 to 2020 were included. The main reason for not including the studies was not to report data about bruxism (59.3%), and 44.5% were excluded for not reporting data from patients with cerebral palsy. The studies were carried out in schools, university hospitals, or centers for patients with special needs (Brazil, the United States, and Egypt). The pooled prevalence of bruxism in children and adolescents with cerebral palsy was 46% (95%CI: 0.38-0.55) after removing one study. CONCLUSION: The pooled prevalence of bruxism in children with cerebral palsy can be considered high since almost half of the studied population is affected by this condition. PROSPERO #CRD42021225781.

Associated factors and treatment options for sleep bruxism in children: an umbrella review.

Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Associated factors and treatment options for sleep bruxism in children: an umbrella review

Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.

Indicadores salivares e o risco de cárie na Síndrome de Down utilizando o software Cariogram® / Salivary indicators and the caries risk in Down Syndrome using Cariogram software

O objetivo deste estudo foi analisar o risco de cárie em indivíduos com Síndrome de Down (SD) utilizando o Software Cariogram®, associando aos indicadores salivares. Participaram do estudo 124 pacientes, entre 6-52 anos, 62 indivíduos SD e 62 indivíduos controles sem a síndrome. Foram recolhidos dados sobre dieta, uso de flúor, pH salivar, capacidade tampão e contagem de Streptococcus mutans. Os resultados mostraram que os indivíduos SD apresentaram maior índice de placa, capacidade tampão e fluxo salivar reduzidos. A hipossalivação mostrou uma associação moderada com índice CPOD e índice de placa. Na análise Cariogram® verificou-se alto risco de cárie nestes pacientes, e dada a importância e facilidade deste método de diagnóstico, sugerimos que seu uso seja ampliado como uma ferramenta importante para facilitar o controle da cárie em indivíduos SD.

The aim of this study was to analyze the caries risk in Down Syndrome individuals (SD) using the Cariogram® software and salivary parameters. We considered a sample of 124 patients aged 6-52 years, 62 with SD and 62 without the syndrome (controls). Data were also collected on diet, use of fluoride, saliva pH, buffer capacity and Streptococcus mutans count. The results were that the SD patients had a higher plaque index, lower buffering capacity and reduced salivary flow. A higher prevalence of hyposalivation, showing a moderate association with DMFT and plaque index. In the Cariogram® analysis we found a high risk of caries in these patients, and given the importance and ease of this method of diagnosis, we suggest that its use be established as an important tool in facilitating the control of caries in Down syndrome individuals.

Estudo do metaboloma salivar e sua associação com a doença periodontal em pacientes com síndrome de Down / Saliva metabolome in patients with Down syndrome and its association with periodontal disease

Os pacientes com Síndrome de Down (SD) possuem grande incidência de doença periodontal (DP), caracterizada por um curso precoce e com maior severidade. O estudo de metaboloma pode contribuir para o entendimento deste curso da doença, identificando possíveis metabólitos como biomarcadores nestes indivíduos. Para entender o perfil metabolômico dos indivíduos com síndrome de Down e a sua relação com a doença periodontal, realizamos a identificação de metabólitos salivares de adolescentes e adultos jovens, entre 12 e 21 anos, ambos os gêneros. Foram coletados dados sobre o estado geral de saúde e realizados exames clínicos bucais, como índice de higiene oral simplificado, sangramento e profundidade de sondagem. Para a análise do metaboloma foi coletada amostra de saliva não estimulada, analisadas por meio de cromatografia gasosa acoplada á espectrometria de massas. Saliva e fluido crevicular gengival também foram coletados para identificação microbiana através do MALDI-TOF. Os dados encontrados foram submetidos a análise estátisca por meio da Análise dos Componentes Principais (PCA) e quantificação relativa dos metabólitos foi avaliada por testes não paramétricos, Mann-Whitney

e Kruskal-Wallis. Foi possível observar através dos modelos de PCA separação dos indivíduos com SD e controles, independente da doença periodontal. A quantificação relativa revelou maiores níveis de glicina, lprolina, l-leucina, l-serina, ácido palmítico, ácido pentanóico, ácido tetradecanóico, tirosina e l-fenilalanina nos grupos SD quando comparados aos controles. Controles com DP também apresentaram níveis elevados de glicina, l-alanina, l-serina e manopiranose quando comparados com controles saudáveis. A microbiota de indivíduos com SD apresentous diferenças siginificantes em relação aos individuos controles, principalmente para Rothia dentocariosa, Staphylococcus epidermidis, Tannerella forsythia quando avaliado a saliva e A. Actinomycetemcomitans, Micrococcus luteus, Rothia aeria, Treponema denticola no fluido crevicular gengival. Em conclusão, o perfil metabolômico impresso nos indivíduos com SD difere significativamente dos indivíduos controles, independente da doença periodontal. Entretanto, os metabólitos que diferenciam indivíduos controles com e sem DP, apresentam-se elevados em todos indivíduos com SD, promovendo novos "insights" para o perfil metabólico relacionado a DP na SD.

Down Syndrome (DS) patients have a high incidence of periodontal disease (PD), characterized by an early course and greater severity. The metabolome study may contribute to the understanding of the disease course, identifying possible metabolites as biomarkers in these individuals. To understand the metabolomic profile of the DS and their relationship with PD, we conducted the identification of salivary metabolites of adolescents and young adults between 12 and 21 years, both genders. Data were collected on general health and was performed oral clinical examination, as the IHOS, bleeding index and probing depth. For metabolome analysis was collected unstimulated saliva sample, analyzed by gas chromatography coupled to mass spectrometry. Saliva and gingival crevicular fluid were also collected for microbial identification by MALDI-TOF. Data were submitted to analysis-statistic by PCA and relative quantification

of metabolites was evaluated by Mann-Whitney and Kruskal-Wallis tests. It can be observed through the PCA models separation of DS groups and controls groups, regardless of periodontal disease. Relative quantification showed higher levels of glycine, L-proline, L-leucine, L-serine, palmitic acid, pentanoic acid, tetradecanoic acid, tyrosine and L-phenylalanine in the SD groups when compared to controls groups. Controls with PD also showed high levels of glycine, L-alanine, L-serine and mannopyranose compared with healthy controls. The microbiota of individuals with DS groups show significant differences compared to control groups, especially for Rothia dentocariosa, Staphylococcus epidermidis, Tannerella forsythia when evaluated saliva and A. actinomycetemcomitans, Micrococcus luteus, Rothia aeria, Treponema denticola in gingival crevicular fluid. In conclusion, the printed metabolomic profile in individuals with Down syndrome differs significantly from control subjects, regardless of periodontal disease. However, the metabolites that distinguish controls group with and without PD, show up high in all DS individuals, promoting new "insights" to the metabolic profile related to PD in DS.

Prevalência de cárie em grupos distintos de pacientes com necessidades especiais / Prevalence af dental caries in differents graups af patients with special needs

A prevenção da cárie para pessoas com deficiência é um problema desafiador na Odon¬tologia, verificando-se altas taxas de prevalência para a doença, falta de tratamento con¬servador e higiene bucal precária. O objetivo deste estudo foi avaliar a prevalência de cárie através do CPO-D e ceo-d em pacientes com distintas deficiências. Participaram 130 pa¬cientes, de ambos os gêneros, na faixa etária de 6 a 52 anos, divididos em grupos segundo a patologia de base, constituindo o grupo 1: 45 individuos com Síndrome de Down; grupo 2: 43 indivíduos com Paralisia Cerebral; grupo 3: 42 indivíduos com Deficiência Mental. O grupo com deficiência mental mostrou maior prevalência de CPO-D, quando comparados aos outros grupos, os pacientes com síndrome de Down demonstraram menor prevalência de cárie, dentes obturados e perdidos em relação às outras síndromes.

The caries prevention for people with disabilities is a challenging problem in dentistry, ve¬rifying high prevalence rates for this disease, the lack of conserva tive treatment and poor oral hygiene. The aim of this study was to evaluate the prevalence of caries through the DMFr and dmft in patients with different disabilities. The sample consisted of 130 patients of both gen¬ders, aged 6 to 52 years, divided into groups according to underlying pathology, constituting the SD group: 45 individuais with Down syndrome; CP group: 43 individuais with Cerebral Palsy ; DM group: 42 individuais with mental retardation. The group with mental retardation had a higher prevalence of DMFT, compared to other groups, patients with Down syndrome showed a lower prevalence of caries, fillings and missing teeth in relation to other syndromes.

Use of photodynamic therapy as an adjuvant to periodontal treatment in patients with Down syndrome: case report / Uso da terapia fotodinâmica como coadjuvante ao tratamento periodontal no paciente com síndrome de Down: relato de caso

Periodontitis is an inflammatory disease induced by bacteria in plaque biofilm on the surface subgingival. The inflammation leads to pocket formation in the gingival tissue, attachment loss, bone destruction and ultimately possible tooth loss. The prevalence of periodontal disease in adolescents with Down syndrome (DS) is 30% to 40%, and individuals in the next 30-40 years the percentage is about 100%. Authors suggest that periodontal disease in DS is consistent with the pattern of aggressive periodontitis, and is correlated with changes in the immune system of the same. In view of these changes, many researchers seek methods to supporting basic periodontal therapy such as combination with antibiotics, but their indiscriminate use can lead to resistant bacteria strains. Photodynamic therapy, a combination of photosensitizing agent or dye to a light source, and has been extensively studied with promising results. The present report deals with photodynamic therapy in the treatment of periodontal disease in an individual with Down syndrome.

A periodontite é uma doença inflamatória induzida por bactérias do biofilme da placa bacteriana localizadas na superfície subgengival. A inflamação conduz a formação de bolsa no tecido gengival, perda de inserção, destruição óssea e ultimamente uma possível perda dentária. A prevalência de doença periodontal em adolescentes com síndrome de Down (SD) é de 30% a 40%, sendo que em indivíduos próximos aos 30 ao 40 anos a porcentagem é de cerca de 100%. Autores sugerem que a doença periodontal na SD é compatível com o padrão de periodontite agressiva, e tem relação com as alterações no sistema imunes dos mesmos. Em vista destas alterações, muitos pesquisadores buscam métodos coadjuvantes à terapia periodontal básica, como associação com antibióticos, porém seu uso indiscriminado pode levar à resistência das cepas bacterianas. A terapia fotodinâmica, associação agente fotossensibilizador a uma fonte de luz, vem sendo muito estudado e com resultados promissores. O presente relato aborda a terapia fotodinâmica no tratamento da doença periodontal em um individuo com síndrome de Down.