The Prevalence, Dental Complications, and Effects of Infant Oral Mutilation.

OBJECTIVE: The aim of this scoping review on infant oral mutilation (IOM) was to study the prevalence, dental complications, and immediate and long-term effects of this practice, in addition to providing a systematic overview on existing knowledge and analysis of identified knowledge gaps on IOM. METHODS: Five electronic bibliographic databases (OVID/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, SCOPUS, and Global Index Medicus) were searched for relevant studies. Data were entered in a bespoke data-charting form. The risk of bias was assessed by 2 independent reviewers. RESULTS: A total of 478 studies were identified from the search, out of which 42 studies were included in this review. Of the 42 studies, 19 were prevalence studies published between 1969 and 2019 which were additionally assessed for the risk of bias. We found the prevalence of IOM in Uganda was 2% to 30%; Ethiopia, 12% to 86%; Sudan, 10%; Kenya, 61% to 87%; and Tanzania 0% to 24%. Based on the prevalence studies, we observed that the most common factor motivating IOM was diarrhoea. The immediate effects of IOM were found to be infection, bleeding, anaemia, pneumonia, septicaemia, osteomyelitis, meningitis, tetanus, and blood-borne diseases, with some infants dying from these effects. Missing canines, enamel hypoplasia, malformations, abnormal eruption of permanent teeth, occlusal discrepancies, midline shift, chronic periapical infections, rotations, canine transposition, or odontomas were the long-term effects found in relation to IOM. CONCLUSIONS: IOM is a practice with serious immediate and long-term consequences that is mainly performed in East Africa (or by people originated from this region) in children aged 4 to 8 months. Most frequently affected are the deciduous canines and mostly the mandibular teeth. It is important to create professional and public awareness of the procedure in low- and high-income countries. Furthermore, there is a need for more research on the prevalence of IOM in Africa and other areas of the world to determine the long-term consequences of the practice.

Research on the Characteristics of Food Impaction with Tight Proximal Contacts Based on Deep Learning.

OBJECTIVE: Based on deep learning, the characteristics of food impaction with tight proximal contacts were studied to guide the subsequent clinical treatment of occlusal adjustment. At the same time, digital model building, software measurement, and statistical correlation analysis were used to explore the cause of tooth impaction and to provide evidence for clinical treatment. METHODS: Volunteers with (n = 250) and without (n = 250) tooth impaction were recruited, respectively, to conduct a questionnaire survey. Meanwhile, models were made and perfused by skilled clinical physicians for these patients, and characteristics such as adjacent line length, adjacent surface area, tongue abduction gap angle, buccal abduction gap angle, and occlusal abduction gap angle were measured. A normality test, differential analysis, correlation analysis of pathological characteristics of the impaction group, principal component analysis (PCA), and binary logistic regression analysis were performed. RESULTS: The adjacent line length, adjacent surface area, tongue abduction gap angle, buccal abduction gap angle, and occlusal abduction gap angle all met normal distribution. There were statistically significant differences in adjacent line length (p < 0.001), adjacent surface area (p < 0.001), and occlusal abduction gap angle (p < 0.001) between the two groups. After dimensionality reduction by PCA on characteristics, adjacent line length, adjacent surface area, buccal abduction gap angle, and occlusal abduction gap angle had a strong correlation with the principal components. Binary logistic regression analysis showed that adjacent line length and adjacent surface area had positive effects on impaction. The buccal abduction gap angle and occlusal abduction gap angle had a significant negative influence on impaction. CONCLUSION: Adjacent line length, adjacent surface area, buccal abduction gap angle, and occlusal abduction gap angle are independent factors influencing food impaction.

Morphological evaluation of dental diseases in Parion chamber tomb (OM 5) Roman people / Evaluación morfológica de enfermedades dentales en la tumba de la cámara de Parion (OM 5) del pueblo romano

SUMMARY: Most of the dental diseases occur due to tooth or jaw morphology or nutritional habits. Anatomical differences in the teeth and jaws of men and women can cause different dental diseases between the sexes. In this study, 33 skeletons obtained from the excavation of the ancient city of Parion, which are dated to the late Roman period, were examined. Dental diseases and possible causes were investigated on a total of 33 skeletons. In the evaluations, it was evaluated that some diseases were caused by the difference between the sexes, while some were classified as nutritional diseases. The rates of tooth decay are different between men and women with Parion. It has been determined that the most important reason for this is the different morphological structure of the jaws and teeth, but the nutritional differences also cause this. Other dental and jaw diseases were also evaluated in the Parion population.

RESUMEN: La mayoría de las enfermedades dentales se deben a la morfología de los dientes o la mandíbula o a los hábitos nutricionales. Las diferencias anatómicas en los dientes y las mandíbulas de hombres y mujeres pueden causar diferentes enfermedades dentales entre los sexos. En este estudio, se examinaron 33 esqueletos obtenidos de la excavación de la antigua ciudad de Parion, que datan del período romano tardío. Se investigaron las enfermedades dentales y las posibles causas en un total de 33 esqueletos. En las evaluaciones, se determinó que algunas enfermedades fueron causadas por la diferencia entre los sexos, mientras que otras fueron clasificadas como enfermedades nutricionales. Además se encontraron diferentes estimaciones de caries entre hombres y mujeres. Se analizó que la razón más importante de esto es la diferencia de la estructura morfológica de los maxilares y los dientes, sin embargo las diferencias nutricionales también es un factor que se debe considerar. Se evaluaron además, otras enfermedades dentales y de la mandíbula en la población de Parion.

Dental enamel defects and oral cavity manifestations in Asian patients with celiac disease.

BACKGROUND: While the small intestine is the main site of disease, many other organs are affected by celiac disease (CeD). Dental enamel defects (DED) are common in patients with CeD, and these are one of the indicators of CeD, even when no other symptom of CeD is present. Data on dental and oral cavity manifestations in Asian patients with CeD are scanty. The purpose of the current study was to evaluate dental and oral manifestations in Asian patients with CeD. METHODS: We recruited 118 patients with biopsy-confirmed CeD (36 treatment naïve and 82 on follow-up for at least 1 year on gluten-free diet [GFD]) and 40 controls. Diagnosis was made as per the standard criteria. Oral and dental manifestations were evaluated by a dental surgeon. The DED were evaluated according to Aine's criteria. RESULTS: Overall higher number of patients with CeD (66.9%), both treatment naïve (69.4%) and those on GFD (65.8%) had DED in comparison to controls (20%) (odds ratio, 8.1, 95% confidence interval [CI] 3.4-19.2; p<0.001). Specific/bilaterally symmetrical DED were significantly higher in patients with CeD than controls. Recurrent aphthous ulcers were also significantly higher in patients with CeD. Approximately 80.6% and 63.4% treatment-naïve patients and those on GFD, respectively reported dry mouth sensation, which was significantly higher than the controls. CONCLUSION: Almost two-third of patients with CeD had DED. Physicians and dietitians caring for patients with CeD should be trained in identification of DED and other oral manifestations of CeD.

Rubinstein-Taybi syndrome: principal oral and dental disorders and literature update

Introduction: Oral and dental (OD) disorders in children with Rubinstein-Taybi syndrome (RTS) are frequent but not well-known by dentists and pediatricians due to the syndrome being extremely rare. Objective: To describe the OD findings observed in a 5-year-old girl with RTS and to update the literature. Clinical case: The patient presented the following OD manifestations: prominent lower lip, narrow mouth opening, narrow and arched palate, history of angular cheilitis, micrognathia, poor lingual motility, plaque and tartar, bleeding from gingival areas due to poor dental prophylaxis, and malocclusion in the form of an anterior open bite. These OD manifestations are seen in more than 40-60% of patients with RTS. Conclusions: Professionals who treat children with RTS should become aware of the advisability of referring them to the pediatric dentist from 1 year of age and performing check-ups every 6 months. Dental management is often difficult so collaboration with anesthesiologists is recommended in order to carry out a safe and effective treatment (AU)

Evaluation of oral health status and oral disorders of children with autism spectrum disorders by gender.

AIM: The aim of this study was to evaluate whether there is a relationship between gender and oral health status of children with autism spectrum disorders (CASD). MATERIAL-METHODS: The study was carried out with 348 children. The children were separated into two groups to evaluate the prevalence of caries and to assess oral disorders in terms of gender. The following factors were evaluated: mean dmft (decayed missed filled permanent tooth in primary dentition), mean DMFT (decayed missed filled permanent tooth in permanent dentition), plaque index, caries prevalence scores, dental crowding, open bite, deep palate, drooling of saliva, tongue thrusting habit, bruxism, dental and soft tissue trauma, tooth wear, delayed eruption, and hypodontia. RESULTS: The results showed that the mean dmft in boys with CASD (BCASD) was lower than the mean dmft in healthy boys. The mean dmft of the girls with CASD (GCASD) was also lower than that of the healthy girls. The prevalence of dental caries and mean DMFT in GCASD were higher than those of BCASD in permanent dentition. While the plaque index value of BCASD was higher than that of healthy boys, the plaque index value of GCASD was lower than that of healthy girls. The plaque index value of BCASD was higher than that of GCASD. GCASD were reported to have significantly more bruxism than their healthy counterparts. However, no statistically significant difference was found between BCASD and healthy boys regarding bruxism. Moreover, there was no significant difference between BCASD and GCASD in terms of bruxism. Drooling of saliva in BCASD was less than GCASD. CONCLUSION: There were significant gender differences between CASD and healthy children in terms of dental caries and oral disorders in this study. There were also significant differences regarding dental caries and oral disorders between GCASD and BCASD.

Oral manifestations of celiac disease in French children.

Celiac disease (CD) is an immune-mediated systemic disorder caused by ingestion of the gluten found in wheat, rye, and barley. The currently estimated prevalence in children is about 1%. CD is a chronic enteropathy with gastrointestinal manifestations including diarrhea, abdominal distension and weight loss, but extra-intestinal features are increasingly being reported. Dental and oral manifestations such as dental enamel defects (ED), delay in dental eruption, and recurrent aphthous stomatitis (RAS) are well-recognized manifestations of CD. The aim of this study was to compare the frequency of oral manifestations (ED, RAS and delay in dental eruption) on deciduous and permanent teeth between children with CD and a control population. An oral examination was performed on 28 CD children and 59 control children. All children were younger than 12 years old and had deciduous or mixed dentition. CD children had significantly more ED and RAS than the control group (67.9% vs. 33.9% P=0.004 and 50.0% vs. 21.8% P=0.011, respectively). No delay in dental eruption was observed in CD children. ED were mainly grade I and II of Aine's classification (color defects and slight structural defects). ED were more often seen on CD children's deciduous teeth than on permanent teeth (57.1% and 13.6%, respectively; P<0.001). The main teeth affected by ED are the second molar and canines of the deciduous teeth, and the first molar, central incisor, and lateral incisors of the permanent teeth. RAS and ED that were symmetrical in all quadrants and occurred firstly in teeth that mineralize during the first year of life both seem to be signs of CD. Thus, more information for dentists and pediatricians on these oral manifestations should help improve detection of CD.

Prevalence of oral manifestations of hypophosphatemic rickets in patients treated in a peruvian pediatric hospital / Prevalencia de manifestaciones bucales del raquitismo hipofosfatémico de pacientes atendidos en un hospital pediátrico peruano

Objective: To describe the prevalence of oral manifestations of hypophosphatemic rickets in patients treated in a Peruvian referral pediatric hospital during the years 2012-2016. Material and methods: An observational, descriptive, retrospective, cross-sectional study was carried out. The sample consisted of patients diagnosed with hypophosphatemic rickets who attended the outpatient clinic of the Stomatology Service and the Genetics Service of the National Institute of Child Health (INSN), Lima, Peru, between the years 2012-2016. The research project was assessed and approved by the Research Ethics Committee of the Health Service. Medical records stored in a database of the health institution with the Code CIE E83.3, which corresponds to the diagnosis of Hypophosphatemic Rickets, were requested for the study. Results: Fifteen children received health care, of which only 10 were treated at the Stomatology Service. The distribution of the data was obtained from these 10 patients according to the proposed objective. A higher frequency of gingival lesions was found at the soft tissue level (41.18%); at the bone tissue level, only one case of dentigerous cyst was observed; and at the dental level, 90% of the patients had dental caries. Conclusion: The most frequent oral manifestations of hypophosphatemic rickets in pediatric patients treated at the National Institute of Child Health (2012-2016) were gingivitis and dental caries.

Objetivo:Describir la prevalencia de las manifestaciones bucales del raquitismo hipofosfatémico de pacientes atendidos en un hospital pediátrico de referencia peruano durante los años 2012-2016. Material y Métodos:Se realizó un estudio tipo observacional, descriptivo, retrospectivo, transversal. Para la selección de la muestra se consideró a los pacientes que acudieron a la consulta externa del Servicio de Odontoestomatología y el Servicio de Genética del Instituto Nacional de Salud del Niño, Lima, Perú; en el periodo comprendido entre los años 2012-2016 y que presentaron como diagnóstico Raquitismo Hipofosfatémico. El proyecto de investigación fue evaluado por un Comité de Ética en Investigación del servicio de salud. Se solicitaron las historias clínicas consignadas en una base de datos de la institución de salud con el Código CIE E83.3, que corresponde a este diagnóstico. Resultados: Fueron atendidos 15 niños, de los cuales solo 10 fueron tratados en el Servicio Odontoestomatología; siendo de estos 10 pacientes la distribución de los datos obtenidos según el objetivo propuesto. Se encontró mayor frecuencia de lesiones a nivel de tejido blando de gingivitis con 41.18%, a nivel de tejido óseo solo se presentó un caso de quiste dentígero; y a nivel de tejido dental el 90% de los pacientes presentó caries dental. Conclusión: Las manifestaciones bucales más frecuentes del raquitismo hipofosfatémico de pacientes pediátricos atendidos en el Instituto Nacional de Salud del Niño (2012-2016), fueron la gingivitis y caries dental.

Clinical dental finding in Iranian horses.

BACKGROUND: A horse's well-being is directly related to the management of its dental health. A good knowledge of the epidemiology and aetiology of dental disorders could help the owners and clinicians to prevent not only dental problems but also severe gastrointestinal diseases. OBJECTIVES: In this study we report the prevalence of dental disorders in horses in Iran. METHODS: We examined 317 horses randomly in eight provinces in Iran and 21 diseases were characterized in the examined horses. The observed diseases were compared among different breeds, genders and ages of the examined horses. RESULTS: The factor of age among the other three factors was more important in the incidence of diseases because most of the diseases found were significantly different among age groups. Between different breeds examined, only cheek teeth cemental caries in Kurdish and Arabian horses was significantly different (p = .022). Enamel point with an occurrence of 34.4% was the most common disease. Broken cheek teeth were more prevalent in male horses in comparison with female horses (p = .035). CONCLUSION: Our study showed a moderate prevalence of dental disorders in Iranian horse clubs, which could be reduced with better management.

Vitamin D Deficiency and Oral Health: A Comprehensive Review.

Vitamin D (VD) levels have been gaining growing attention in Oral Health. During growth and adulthood, VD deficiency (VDD) is associated with a wide variety of oral health disorders, and impaired VD synthesis may expedite some of these conditions. In children, severe VDD can induce defective tooth mineralization, resulting in dentin and enamel defects. As a consequence, these defects may increase the risk of the onset and progression of dental caries. Further, VDD has been associated with higher prevalence of periodontitis and gingival inflammation, and several recent preclinical and clinical studies have unveiled potential pathways through which Vitamin D may interact with the periodontium. VDD correction through supplementation may contribute to a successful treatment of periodontitis; however, alveolar bone regeneration procedures performed in baseline VDD patients seem more prone to failure. Vitamin D may also be linked with some oral pathology entities such as certain oral cancers and events of osteonecrosis of the jaw. This review aims to provide comprehensive evidence of how VD levels should be considered to promote good oral health, and to summarize how VDD may hamper oral development and its role in certain oral conditions.

Dental Manifestations of Ehlers-Danlos Syndromes: A Systematic Review.

Ehlers-Danlos syndromes (EDS) are a group of inherited connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and variable tissue fragility. However, there are limited published data on the dental manifestations of EDS. This review systematically assessed the spectrum of published dental anomalies in various types of EDS. Twenty-four individual case reports/series and 3 longer case-control studies, reporting on a total of 84 individuals with a clinical diagnosis of EDS, were included in the data analysis. The main dental features listed in classical EDS were pulp calcification and localized root hypoplasia. Common dental abnormalities observed in vascular EDS were pulp shape modifications (52.2%), exceeding root length (34.8%), and molar root fusion (47.8%). Dentinogenesis imperfecta is a consistent finding in osteogenesis imperfecta/EDS overlap syndrome. Data on dental manifestations in other types of EDS are both rare and generally inconclusive.

Knowledge and Awareness of Oral Manifestations of Diabetes Mellitus and Oral Health Assessment among Diabetes Mellitus Patients- A Cross Sectional Study.

BACKGROUND AND OBJECTIVES: Diabetes mellitus has increased rapidly throughout the world. The objectives of our study were to assess the knowledge and awareness about oral manifestations of diabetes, among type 2 diabetes mellitus patients, their risk for developing oral diseases due to complications associated with diabetes mellitus, and at same time, to perform an oral examination to detect these oral symptoms, if present any, along with the recording of Decayed Missing Filled Teeth Index (DMFT) and Community Periodontal Index (CPI) index. METHODOLOGY: Structured questionnaires consisting of 12 different statements on the knowledge base of oral manifestations of diabetes mellitus were distributed to 447 Type 2 diabetes mellitus patients. Following this oral examination, brushing and dental visit history were noted, and CPI index and DMFT indices were recorded in all the patients. RESULTS: Results showed that the knowledge about oral manifestations of diabetes mellitus was poor with a mean value of 4.92 out of a possible score of 12. Among the study subjects, the average score of men was 4.42 while that of females, was 5.41. These scores, when subjected to statistical analysis, were highly significant. (P value- 0.005) Subjects also showed significantly high DMFT (P value <0.001) and CPI scores (P value- 0.270). CONCLUSION: Our study concluded that there is a significant lack of knowledge about oral manifestations of diabetes mellitus among patients and hence steps have to be taken to increase their awareness through various outreach programs. All health professionals need to work together for promoting better oral health so that oral complications of diabetes can be brought under control.

Temporomandibular and Odontological Abnormalities in Patients with Rheumatoid Arthritis. / Alteraciones temporomandibulares y odontológicas en pacientes con artritis reumatoide.

OBJECTIVE: To characterize the orofacial abnormalities in patients with rheumatoid arthritis (RA) and compare them with those in a reference population. METHODS: The study included 30 RA patients and 30 consecutive patients in an odontology clinic in whom RA was ruled out. Patients underwent a clinical dental examination which included: 1) clinical and radiographic abnormalities of the temporomandibular joint; 2) biomechanical craniocervical analysis; 3) state of dentition and treatment needs; 4) periodontal status; 5) oral hygiene status; and 6) facial pain, which was compared among study groups. In addition, the association between the variables studied was determined through correlation tests. RESULTS: Patients with RA showed a higher prevalence of temporomandibular abnormalities, both clinical (100.0% vs. 60.0%, P<.001) and radiographic, including erosions (50.0% vs. 16.0%, P=.010), compared with individuals in the control group. Likewise, patients with RA had a greater number of missing teeth (6.9±5.7 vs. 3.0±2.0, P=.001), more caries (13.4±5.4 vs. 4.9±6.5, P=.001), periodontitis (1.3±0.9 vs. 0.8±0.8, P=.015), poorer oral hygiene (43.3% vs. 13.3%, P=.005) and greater facial pain (66.7% vs. 20.0%, P <.001). The cephalometric analysis of Rocabado showed differences in the craniocervical angle and hyoid triangle between RA and controls. Significant correlations were obtained between oral and temporomandibular abnormalities. CONCLUSIONS: Patients with RA showed a greater orofacial deterioration, which reflects the importance of multidisciplinary care, including periodic dental examination.

An overview of radiological manifestations of acquired dental developmental disturbances in paediatric head and neck cancer survivors.

OBJECTIVES: In paediatric cancer survivors treated with chemotherapy and radiotherapy therapy, late effects on dental development are quite common. Oral radiologists are not familiar with the radiographic images of these specific dental consequences of chemotherapy and radiotherapy. With the goal of educating colleagues, to raise awareness of the needs of survivors, and to identify directions for future research, we present dental radiographs of survivors treated for head and neck rhabdomyosarcoma with chemotherapy and radiotherapy. Also, based on the survivors reviewed, a radiographic inventory of commonly found late dental developmental effects seen in conjunction with treatment is presented. METHODS: Panoramic radiographic findings of five illustrative cases are presented, from a group of 42 survivors of head and neck rhabdomyosarcoma treated at the Academic Medical Center Amsterdam, The Netherlands over the past 25 years. RESULTS: Five cases showing dental developmental disorders are presented. These cases show an association of the location of the radiation field and the developmental stage of the teeth with the severity of the effect on dental development. We also report an inventory of severe and moderate effects of chemotherapy and radiotherapy on the development of molars and anterior teeth. CONCLUSIONS: This paper presents five cases and a radiographic inventory to illustrate disturbances of dental development associated with chemotherapy and radiotherapy in children. Medical and dental professionals involved in the treatment of cancer survivors are relatively unaware of the dental consequences of radiation therapy and the age dependency of specific regional effects. These effects can be severe, with great impact on quality of life. Further research in this area could help improve planning of radiation therapy for children, potentially preventing or limiting dental or maxillofacial sequelae.

Deep neck infection of dental origin. A case report / Infección cervical profunda de origen dental. Descripción de un caso

INTRODUCCIÓN Y OBJETIVO: Al menos el 36% de las infecciones cervicales profundas pueden tener un origen dental. Descripción del caso: Mujer de 44 años que consultó por disfonía de una semana de evolución. La rinofibrolaringoscopia reveló edema aritenoideo izquierdo y parálisis de la hemilaringe izquierda y cuello normal. Se realizó una tomografía axial computarizada, encontrando absceso parafaríngeo izquierdo. Se realizó tratamiento antibiótico sistémico y quirúrgico con cervicotomía y drenaje del absceso en cuyo cultivo se aisló Prevotella buccae. Comentarios: El resultado del cultivo ayudó a establecer el origen dental de la infección. En la historia dental, se encontró una historia de pericoronitis asociada con 3.8. CONCLUSIONES: el diagnóstico del origen dental de una infección cervical profunda se establece mediante la historia dental, el examen oral, la radiología oral y el cultivo microbiológico

INTRODUCTION AND OBJECTIVE: At least 36% of deep cervical infections may have a dental origin. CASE DESCRIPTION: A 44-year-old woman who consulted for dysphonia of a week of evolution. Rhinofibrolaryngoscopy revealed left arytenoid edema and paralysis of the left hemilarynx and normal neck. A computerized axial tomography was performed, finding left parapharyngeal abscess. Systemic and surgical antibiotic treatment was performed with cervicotomy and drainage of the abscess in whose culture Prevotella buccae was isolated. COMMENTS: The result of the culture helped establish the dental origin of the infection. In the dental history, a history of pericoronitis associated with 3.8 was found. CONCLUSIONS: The diagnosis of the dental origin of a deep cervical infection is established by dental history, oral examination, oral radiology and microbiological culture

Treatment of dental complications in sickle cell disease.

BACKGROUND: Sickle cell disease is the most common single gene disorder and the commonest haemoglobinopathy found with high prevalence in many populations across the world. Management of dental complications in people with sickle cell disease requires special consideration for three main reasons. Firstly, dental and oral tissues are affected by the blood disorder resulting in several oro-facial abnormalities. Secondly, living with a haemoglobinopathy and coping with its associated serious consequences may result in individuals neglecting their oral health care. Finally, the treatment of these oral complications must be adapted to the systemic condition and special needs of these individuals, in order not to exacerbate or deteriorate their general health. Guidelines for the treatment of dental complications in this population who require special care are unclear and even unavailable in many aspects. Hence this review was undertaken to provide a basis for clinical care by investigating and analysing the existing evidence in the literature for the treatment of dental complications in people with sickle cell disease. This is an update of a previously published review. OBJECTIVES: To assess methods of treating dental complications in people with sickle cell disease. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Review Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. Date of last search: 01 August 2019. Additionally, we searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We also searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field. Date of last search: 07 November 2019. SELECTION CRITERIA: We searched for published or unpublished randomised controlled studies of treatments for dental complications in people with sickle cell disease. DATA COLLECTION AND ANALYSIS: Two review authors intended to independently extract data and assess the risk of bias of the included studies using standard Cochrane methodologies; however, no studies were identified for inclusion in the review. MAIN RESULTS: No randomised controlled studies were identified. AUTHORS' CONCLUSIONS: This Cochrane Review did not identify any randomised controlled studies assessing interventions for the treatment of dental complications in people with sickle cell disease. There is an important need for randomised controlled studies in this area, so as to identify the most effective and safe method for treating dental complications in people with sickle cell disease.

Treatment of dental and orthodontic complications in thalassaemia.

BACKGROUND: Thalassaemia is a quantitative abnormality of haemoglobin caused by mutations in genes controlling production of alpha or beta globins. Abnormally unpaired globin chains cause haemolytic anaemia by causing membrane damage and cell death within organ systems and destruction of erythroid precursors in the bone marrow. The life-long management of the general health effects of thalassaemia in affected individuals is a highly challenging issue in and of itself; and failure to deal with dental and orthodontic complications in people with thalassaemia exacerbates the public health, financial and personal burden posed by the condition. There exists a lack of evidence-based guidelines for care-seekers and providers to best deal with such dental and orthodontic complications in thalassaemia, which this review seeks to address. OBJECTIVES: The main objective of this review was to assess different methods to treat dental and orthodontic complications in people with thalassaemia. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register, compiled from electronic database searches and handsearching of journals and conference abstract books. We searched the reference lists of relevant articles and reviews.Date of last search: 01 August 2019.We also searched nine online databases (PubMed, Google Scholar, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Literature in the Health Sciences in Latin America and the Caribbean database, African Index Medicus, Index Medicus for South East Asia Region, Index Medicus for the Eastern Mediterranean Region, Indexing of Indian Medical Journals). We searched the reference lists of relevant articles and reviews and contacted haematologists, experts in fields of dentistry, organizations, pharmaceutical companies and researchers working in this field.Date of last search: 22 July 2019. SELECTION CRITERIA: We searched for published or unpublished randomised controlled trials for treatment of dental and orthodontic complications in individuals diagnosed with thalassaemia, irrespective of phenotype, severity, age, gender and ethnic origin. DATA COLLECTION AND ANALYSIS: Two review authors independently screened 35,202 titles from search results. We identified four unique randomised controlled trials, of which one seemed potentially relevant. Based on closer inspection, the trial was found not to be eligible for inclusion. MAIN RESULTS: We did not find any relevant trials for inclusion in the review. AUTHORS' CONCLUSIONS: We were unable to draw any conclusions due to the lack of available data and trials. This review highlights the need for conducting and appropriate reporting, of high-quality randomised controlled trials investigating the effectiveness of various treatment modalities for dental and orthodontic complications in people with thalassaemia.

Dental Infection Cause of Flap Loss in Cleft Palate Repair.

Flap necrosis is a very common complication encountered after cleft palate repair, especially in uni-pedicled flaps. Many causes have been attributed to this complication but very limited data is available in the literature on dental infection as the cause of flap necrosis. This report of a case describes loss of flap caused due to a periapical granuloma of dental origin impinging on the pedicle causing suspected thrombosis of the pedicle resulting in flap necrosis. Since this is an important cause that can be easily prevented, it is reported.