Dental treatment under general anesthesia in patients with severe intellectual disability at the Gregorio Marañón General University Hospital: a 10-year retrospective study.

OBJECTIVES: There is a high demand for dental treatment in a hospital setting for patients with severe intellectual disability (ID), due to their inability to cooperate. The objective was to determine the types of dental treatment carried out on patients with severe ID, as well as the possibility of performing clinical and radiographic examinations prior to treatment and to identify their characteristics. METHOD AND MATERIALS: A retrospective observational study was performed, based on the medical histories of patients with severe ID or a disability included in the portfolio of dental services of Community of Madrid, who underwent dental treatment at the Stomatology Service of the Gregorio Marañón General University Hospital from the year 2009 to 2019. Data on age, sex, etiology of disability, and dental treatment were obtained. RESULTS: A total of 1,845 patients were included. The type of disability in the majority of cases was unknown, followed by encephalopathy, cerebral paralysis, and Down syndrome. In total, 8,439 dental extractions were performed on 1,548 patients (83.9%). Clinical and radiographic exploration were carried out on 874 patients (47.4%). CONCLUSIONS: Ultrasonic scaling was the most frequently performed treatment in patients. Dental extractions were the next most common treatment. An increase in age showed a higher demand for surgical procedures and extractions. Over half of the patients (52.6%) did not tolerate clinical or radiographic examinations.

Acute traumatic lumbosacral dislocation treated by open reduction internal fixation and fusion.

STUDY DESIGN: Case report of a patient with acute traumatic lumbosacral dislocation. OBJECTIVE: To report a case of traumatic lumbosacral dislocation treated with open reduction internal fixation and fusion. SUMMARY OF BACKGROUND DATA: To our knowledge, there are only 49 cases reported in the literature of this exceptional lesion. Complete lumbosacral dislocation is a three-column lesion, and therefore, open reduction internal fixation and fusion is recommended. METHOD: We report the case of a 42-year-old man who had a vehicle accident. In addition to other fractures, he suffered an anterior lumbosacral dislocation. The displacement of L5 on S1 was 35%. The patient was surgically treated with open posterior reduction fixation and fusion with good result. RESULTS: Complete fusion was achieved, and at 5 years follow-up, the patient was asymptomatic, and no further slippage has been observed. CONCLUSIONS: A rare case of acute anterior lumbosacral dislocation treated surgically is reported. We consider the surgical treatment for reduction, decompression, stabilization, and fusion as the method of choice in acute cases of this exceptional condition.