Osteogenesis imperfecta: minimizing complications in oral surgery/orthodontic treatment

Osteogenesis imperfecta (OI) is a rare genetic condition that affects connective tissue and is primarily characterized by bone fragility. Owing to the progressive nature of the disease, patients require life-long management of the adverse effects and the subsequent complications they can experience. Since the introduction of bisphosphonates as a treatment modality, complications and bone deformities associated with OI have been minimized. However, intravenous bisphosphonates in young patients could present a new era of difficulties for the dental profession. We report on a case of a patient with OI who presented with severe orthodontic crowding and describe the multidisciplinary treatment planning required to minimize potential complications. CPD/Clinical Relevance: General dental practitioners should be aware of the characteristics of osteogenesis imperfecta and the potential complications associated with dental treatment.

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A Dictionary of Dentistry

10.1093/acref/9780191828621.001.0001 ◽

2020 ◽

Author(s):

Robert Ireland

Keyword(s):

Oral Surgery ◽

Dental Students ◽

Reference Source ◽

Restorative Dentistry ◽

Oral Medicine ◽

General Reader ◽

Medical Practitioners ◽

Line Drawings ◽

Dental Practitioners ◽

Dental Profession

This dictionary covers thousands of important terms and concepts used in dentistry today. Entries are written in clear and concise English without the use of unnecessary dental or medical jargon, and many entries are supplemented by detailed line drawings or colour photographs. The dictionary defines terms in a broad range of dental specialist areas. In this edition expanded coverage has been given in particular to topics that include oral surgery, oral medicine, special care dentistry, anaesthesia, restorative dentistry, paediatric dentistry, anatomy, and orthodontics. An essential guide for dental practitioners and dental students, it is also an invaluable reference source for all members of the dental team, medical practitioners, lawyers involved with members of the dental profession, and the general reader.

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Complex spine deformities in young patients with severe osteogenesis imperfecta: current concepts review

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.13.180185 ◽

2019 ◽

Vol 13 (1) ◽

pp. 22-32 ◽

Cited By ~ 4

Author(s):

R. M. Castelein ◽

C. Hasler ◽

I. Helenius ◽

D. Ovadia ◽

M. Yazici ◽

...

Keyword(s):

Osteogenesis Imperfecta ◽

Young Patients ◽

Surgical Care ◽

Collagen Type I ◽

Bone Fragility ◽

Type I ◽

Vertebral Deformities ◽

Spine Deformities ◽

Paediatric Orthopaedic ◽

Chest Deformities

The severity of osteogenesis imperfecta (OI), the associated reduced quality and quantity of collagen type I, the degree of bone fragility, ligamentous laxity, vertebral fractures and multilevel vertebral deformities all impair the mechanical integrity of the whole spinal architecture and relate to the high prevalence of progressive kyphoscoliotic deformities during growth. Bisphosphonate therapy may at best slow down curve progression but does not seem to lower the prevalence of deformities or the incidence of surgery. Brace treatment is problematic due to pre-existing chest wall deformities, stiffness of the curve and the brittleness of the ribs which limit transfer of corrective forces from the brace shell to the spine. Progressive curves entail loss of balance, chest deformities, pain and compromise of pulmonary function and eventually require surgical stabilization, usually around puberty. Severe vertebral deformities including deformed, small pedicles, highly brittle bones and chest deformities, short deformed trunks and associated issues like C-spine and cranial base abnormalities (basilar impressions, cervical kyphosis) as well as deformed lower and upper extremities are posing multiple peri- and intraoperative challenges. Hence, an early multidisciplinary approach (anaesthetist, pulmonologist, paediatric orthopaedic spine surgeon) is mandatory.This paper was written under the guidance of the Spine Study Group of the European Paediatric Orthopaedic Society. It highlights the most pertinent information given in the current literature and various practical aspects on surgical care of spine deformities in young OI patients based on the personal experience of the contributing authors.

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P066 Orthopedic complications of osteogenesis imperfecta

Rheumatology ◽

10.1093/rheumatology/keab722.058 ◽

2021 ◽

Vol 60 (Supplement_5) ◽

Author(s):

Blel Ferdaous ◽

Hachfi Haifa ◽

Brahem Mouna ◽

Mouhamed Younes

Keyword(s):

Osteogenesis Imperfecta ◽

Connective Tissue Disorder ◽

Bone Fragility ◽

Vitamin D Supplementation ◽

Lower Limbs ◽

Mineral Density ◽

Vertebral Disc ◽

Skeletal Complications ◽

Intravenous Bisphosphonates

Abstract Background Osteogenesis imperfecta (OI) is an inherited connective tissue disorder including various skeletal manifestations. Bone fragility, vertebral body malformation and length lower limbs inequality are often responsible for orthopedic complications. The aim of our study was to determine orthopedic complications of OI and to specify management modalities in rheumatology. Methods We conduct a retrospective study based on the files of children referred to the rheumatology departement over the last 15 years, for treatment of OI. The evaluation was clinical and radiological. Clinical examination included joint and spine assessment. An X-ray of the spine and painful joints associated with a quantitative densitometry were requested. Results Five patients were collected, their mean age was 9 years. All patients had peripheral fracture. Joint assessment revealed a flessum of the elbow and a reduction of the motion of hip in 40% of cases. Scoliosis was noted also in 40% of cases. The average of spine Z –score was -3, 4. All children had benefited from oral calcium and vitamin D supplementation associated with cyclic intravenous bisphosphonates and an adapted rehabilitation protocol. Surgical management was often needed in 2 cases. Discussion and Conclusion Orthopedic complications during OI are essentially the consequence of lower bone mineral density which would cause peripheral or vertebral fracture. Indeed, some other factors like length inequality, pelvic obliquity, ligamentous laxity and inter-vertebral disc abnormalities could be involved in scoliotic progression. The management of these skeletal complications must be early and multidisciplinary in order to improve the prognosis and the quality of life of the patient

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Oral rehabilitation in pediatric dentistry: a clinical case report

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720160001000131064 ◽

2016 ◽

Vol 64 (1) ◽

pp. 87-92

Author(s):

Natalino LOURENÇO NETO ◽

Cristiane Almeida Baldini CARDOSO ◽

Ruy César Camargo ABDO ◽

Salete Moura Bonifácio da SILVA

Keyword(s):

Case Report ◽

Behavior Management ◽

Dental Treatment ◽

Treatment Options ◽

Young Patients ◽

Well Being ◽

Clinical Situation ◽

Pediatric Dentistry ◽

Oral Rehabilitation ◽

Dental Practitioners

ABSTRACT Despite the emphasis and effort devoted to preventive dentistry, massive coronal destruction caused by dental caries or trauma is still seen in pediatric dentistry practice today. The technical difficulties related to dental treatment are compounded by problems related to the behavior of young patients in these circumstances, which brings the need for a broader understanding of behavior management techniques and certain skills in dealing with patients by dental practitioners, aimed at ensuring the well-being of both patient and dentist during treatment. This case report presents and discusses the scientific rationale for the treatment options adopted, considering the techniques and materials already established for aesthetic rehabilitation of adult patients (such as resins, glass-fiber posts, and glass ionomers), and now employed and adapted for pediatric dental care, that would best suit the clinical situation described. At the end of treatment, the patient achieved full rehabilitation and a restored smile, through the use of modern techniques and materials, while the dental practitioner gained a better understanding of the optimal treatment possibilities and strategies for similar cases.

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Restoration of Osteogenesis by CRISPR/Cas9 Genome Editing of the Mutated COL1A1 Gene in Osteogenesis Imperfecta

Journal of Clinical Medicine ◽

10.3390/jcm10143141 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3141

Author(s):

Hyerin Jung ◽

Yeri Alice Rim ◽

Narae Park ◽

Yoojun Nam ◽

Ji Hyeon Ju

Keyword(s):

Osteogenesis Imperfecta ◽

Type I Collagen ◽

Disease Modeling ◽

Bone Fragility ◽

Osteogenic Potential ◽

Type I ◽

Gene Correction ◽

Col1a1 Gene ◽

Collagen Formation

Osteogenesis imperfecta (OI) is a genetic disease characterized by bone fragility and repeated fractures. The bone fragility associated with OI is caused by a defect in collagen formation due to mutation of COL1A1 or COL1A2. Current strategies for treating OI are not curative. In this study, we generated induced pluripotent stem cells (iPSCs) from OI patient-derived blood cells harboring a mutation in the COL1A1 gene. Osteoblast (OB) differentiated from OI-iPSCs showed abnormally decreased levels of type I collagen and osteogenic differentiation ability. Gene correction of the COL1A1 gene using CRISPR/Cas9 recovered the decreased type I collagen expression in OBs differentiated from OI-iPSCs. The osteogenic potential of OI-iPSCs was also recovered by the gene correction. This study suggests a new possibility of treatment and in vitro disease modeling using patient-derived iPSCs and gene editing with CRISPR/Cas9.

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Early-Onset Osteoporosis

Calcified Tissue International ◽

10.1007/s00223-021-00885-6 ◽

2021 ◽

Author(s):

Outi Mäkitie ◽

M. Carola Zillikens

Keyword(s):

Young Adults ◽

Early Onset ◽

Type I Collagen ◽

Young Patients ◽

Fragility Fractures ◽

Underlying Disease ◽

Bone Fragility ◽

Sphingolipid Metabolism ◽

Type I ◽

Loss Of Function

AbstractOsteoporosis is a skeletal disorder with enhanced bone fragility, usually affecting the elderly. It is very rare in children and young adults and the definition is not only based on a low BMD (a Z-score < − 2.0 in growing children and a Z-score ≤ − 2.0 or a T-score ≤ − 2.5 in young adults) but also on the occurrence of fragility fractures and/or the existence of underlying chronic diseases or secondary factors such as use of glucocorticoids. In the absence of a known chronic disease, fragility fractures and low BMD should prompt extensive screening for secondary causes, which can be found in up to 90% of cases. When fragility fractures occur in childhood or young adulthood without an evident secondary cause, investigations should explore the possibility of an underlying monogenetic bone disease, where bone fragility is caused by a single variant in a gene that has a major role in the skeleton. Several monogenic forms relate to type I collagen, but other forms also exist. Loss-of-function variants in LRP5 and WNT1 may lead to early-onset osteoporosis. The X-chromosomal osteoporosis caused by PLS3 gene mutations affects especially males. Another recently discovered form relates to disturbed sphingolipid metabolism due to SGMS2 mutations, underscoring the complexity of molecular pathology in monogenic early-onset osteoporosis. Management of young patients consists of treatment of secondary factors, optimizing lifestyle factors including calcium and vitamin D and physical exercise. Treatment with bone-active medication should be discussed on a personalized basis, considering the severity of osteoporosis and underlying disease versus the absence of evidence on anti-fracture efficacy and potential harmful effects in pregnancy.

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Dental implant care and trouble among dependent patients based on the questionnaire survey among Japanese dental practitioners

BMC Oral Health ◽

10.1186/s12903-020-01279-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yuji Sato ◽

Shigeto Koyama ◽

Chikahiro Ohkubo ◽

Shin Ogura ◽

Ryutaro Kamijo ◽

...

Keyword(s):

Elderly People ◽

Dental Care ◽

Questionnaire Survey ◽

Japanese Society ◽

Dental Treatment ◽

Actual State ◽

Treatment Type ◽

Dental Practitioners ◽

Care Problems ◽

Implant Treatment

Abstract Background Self-care and professional care of implants may prove difficult for elderly people who require nursing care. However, the actual state of care and problems remains unknown. In this study, we investigated the actual state of implant problems in elderly people living in their own home or in a nursing home who received visiting dental treatment. Methods We mailed questionnaire survey forms to 2339 representatives or specialists who were members of the Japanese Society of Oral Implantology, the Japanese Society of Gerodontology or the Japan Prosthodontic Society. We narrowed down the respondents to those who provided visiting dental treatment, and analyzed the actual state of implants observed during visiting dental treatment (type, care, problems, countermeasures, etc.). Results Of the 924 dentists who responded to the questionnaire survey, 291 (22%) provided visiting dental treatment. While the majority of implant types encountered in the previous 12 months were root-form implants, there were still a certain number of blade and subperiosteal implants. Daily implant care involved mostly cleaning with a toothbrush + auxiliary tools. The most frequent implant problems encountered in the past were difficulty in cleaning and peri-implantitis. Medication and antiphlogistic treatment were most frequently adopted as countermeasures to implant problems, followed by observation. When we classified the results into those for the dentists who provided implant treatment and those for the dentists who did not, we found that many of the dentists who did not provide implant treatment opted for observation or medication, while those who provided implant treatment also implemented removal of superstructure, retightening of screws, repair and so forth. Conclusions We found that many of the implant troubles encountered by dentists who provided visiting dental care were difficulty in cleaning or peri-implantitis, and that the actions taken against these troubles varied depending on the experience of the dentist performing the implant treatment. Our study also revealed that dentists who provide visiting dental care need to acquire knowledge and skills of implant treatment, to have actions prepared in case they encounter such cases, or to closely coordinate with dentists who specialize in implants.

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Assessment of Knowledge and Practice of Fresh Dental Graduates, Dental Surgeons and Specialists of Multan about Different LA Techniques for Mandibular Teeth: A cross-sectional survey

10.53350/pjmhs211571745 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1745-1748

Author(s):

Zaid Bin Sohail ◽

Muhammad Salman Chishty ◽

M. Shairaz Sadiq ◽

Farhan Riaz ◽

Mehwish Munawar ◽

...

Keyword(s):

Nerve Block ◽

Dental Treatment ◽

Inferior Alveolar Nerve ◽

Mandibular Nerve ◽

Survey Study ◽

Cross Sectional Survey ◽

Chi Square ◽

Cross Sectional ◽

Dental Procedures ◽

Dental Practitioners

Objective: To assess the knowledge about different mandibular nerve block techniques of fresh dental graduates, dental surgeons and specialists to attain mandibular nerve block for dental treatment in Multan. Design of the Study: It was a cross-sectional survey. Study Settings: This study was carried out at Department of Dentistry at Multan Medical & Dental College, Nishtar Institute of dentistry (Nishtar Medical University) and Bakhtawer Amin Dental College from August 2019 to August 2020. Material and Methods: The study involved 220 respondents. The questionnaire was administered to fresh dental graduates (house officers) and dental surgeons in 3 dental colleges of Multan, and was collected on the same day. House officers who did not return the forms were reminded personally and contacted on the phone thrice over the following week. Results of the Study: The frequency of respondants who could administer Gow-Gates without supervison was 20.9% (n=46). Participants from NID, Multan had the highest frequency (35.3%) with the lowest in BIMDC (16.6%)and MMDC(20.6%). The differences were non-significant (p=0.19). Significantly higher frequency of male respondants (10%, n=22) claimed they could administer Gow-Gates without supervison compared to female respondants (5.4%, n=12, p=0.012, Chi-Square). Training for Gow-Gates had been received by 12.7% (n=28) of the House Officers and dental surgeons. The Highest frequency of training was in NID, Multan (5.4%, n= 12, p= 0.016, chi-square). Conclusion: The majority of the dental practitioners of Multan used IANB as their primary LA technique and intraligamental injections as a supplemental LA technique in their clinics to attain mandibular molars anesthesia for general dental procedures like fillings, root canals and extractions. Keywords: Mandibular local anesthesia, Inferior alveolar nerve block, Gow-Gates technique

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Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma

Case Reports in Dentistry ◽

10.1155/2014/918461 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5

Author(s):

Atacan Yavuz ◽

Ömer Birkan Ağralı ◽

Zeynep Lale Çalışkan ◽

Dilek Türkaydın ◽

Atilla Sertgöz ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Multidisciplinary Approach ◽

Dental Treatment ◽

Treatment Approach ◽

Multidisciplinary Treatment ◽

Preventative Care ◽

Self Confidence ◽

Dental Hospital ◽

History Of

Radiotherapy in NPC patients has side effects on the dentition, which affects quality of life dramatically. This case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. The adolescent patient applied to dental hospital 4 years after the radiotherapy with aesthetic and functional problems on dentition affecting psychological, social, and physical aspects of his life. The dentition of the patient demonstrated the severe destruction as a devastating side effect of radiotherapy. With a successful multidisciplinary approach, our patient’s aesthetics, function, and self-confidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy.

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CIRURGIAS ORAIS EM PACIENTES EM USO DE VARFARINA: REVISÃO DE LITERATURA

Journal of Dentistry & Public Health ◽

10.17267/2596-3368dentistry.v7i2.907 ◽

2016 ◽

Vol 7 (2) ◽

Author(s):

Marlus Da Silva Pedrosa ◽

Jézlia Chris Da Silva Galdino ◽

Flávia Ennes Dourado Ferro ◽

José Guilherme Férrer Pompeu ◽

Marcia Socorro da Costa Borba

Keyword(s):

Drug Therapy ◽

Anticoagulant Therapy ◽

Dental Treatment ◽

Oral Surgery ◽

Thromboembolic Events ◽

Risk Of Bleeding ◽

Dental Procedures ◽

Therapy Interruption ◽

Anticoagulant Drug ◽

Dental Offices

Introduction: Dental treatment performed in patients on anticoagulant drug therapy is becoming increasingly common in dental offices. Thus, questions concerning thromboembolic and bleeding risks relative to invasive dental procedures, are frequently raised. Aim: To review the scientific evidences regarding anticoagulant therapy interruption in patients taking warfarin undergoing oral surgeries. Methods: It was carried out a literature review in the electronic SciELO, PubMed, Lilacs and Oviatt Library databases from January to March of 2016, using as descriptors: Anticoagulants, Warfarin, Oral Surgery, and Oral Hemorrhage. Results and Discussion: Anticoagulant therapy is extremely important in patients at high risk for development of thromboembolic events. Most studies show that the risk of bleeding oral surgery in patients taking warfarin is relatively insignificant and it can be controlled by simple measures such as hemostasis. Conclusion: It is highly recommended to not interrupt anticoagulant in minor oral surgeries.

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