Sedacja w stomatologii – aktualne wytyczne anestezjologiczne

Introduction. Dental treatment remains a constant concern of children as well as adult patients. Adequate choice of sedation enables dentists to safely carry out medical procedures. Aim. To review current literature concerning anesthetic guidelines for sedation in a dental office. Material and methods. Articles from 3 databases were analyzed: PubMed/Medline, EMBASE and Cochrane Library, for current guidelines on sedation in dentistry. Results. The most current guidelines show that sedation can be applied to any patient in the event in which anxiety or pain prevents practitioners from safely performing medical procedures. In order for the patient to be qualified for treatment under sedation, he must undergo thorough health assessment and physical examination as well as evolution of the possibility of performing the procedure using minimal, moderate or deep sedation. The most common form of sedation applied in dentistry is oral or inhalation minimal sedation, which does not require the presence of an anesthesiologist during the procedure. Patients suffering from severe odontophobia can be successfully sedated with the use of intravenous drug infusions. However, such procedure requires assistance of a trained Anesthesia Care team specialized in life support. Conclusions. Current guidelines enable treating patients with various health conditions and with fear of dental treatment, using varying degrees of sedation. Thanks to trained medical personnel, the application of specific, procedures and an appropriately equipped dental office, sedation of adults as well as children is safe.

Profilaktyka stomatologiczna – zalecenia dla osób starszych, rezydentów domów opieki i ich opiekunów. Stanowisko grupy roboczej Polskiego Oddziału Sojuszu dla Przyszłości Wolnej od Próchnicy (ACFF) ds. zapobiegania próchnicy w populacji osób dorosłych

Introduction. Oral health is an integral part of general health. In the population of elderly people with multiple chronic diseases, the prevention of oral diseases should be an integral part of medical care. Older people are often dependent, have limited manual skills and require help or assistance in performing hygiene procedures, including brushing teeth. Aim. Development of standards for the prevention of oral diseases dedicated to the elderly, residents of nursing homes and their carers. Material and methods. Analysis of the medical databases (Pubmed, EMBASE, MEDLINE), using the following search phrases: “oral health”, “prophylactic procedures”, “oral care”, “elderly”, “residents of nursing home” and manual search of recommendations of dental societies and the World Health Organization. Results. The available literature indicates the need to develop standards of dental prophylaxis for the elderly, including those living in nursing homes. Pro-health education of the elderly and their caregivers is a key element of dental prophylaxis and an important element of medical care. Conclusions. Regular oral hygiene and nutrition in accordance with the recommendations aimed at reducing the risk of caries improves general health and improves the quality of life of seniors.

Skuteczność działania ozonoterapii w leczeniu mucositis jamy ustnej indukowanej chemioterapią u onkologicznego pacjenta w wieku rozwojowym – opis przypadku

Oral mucositis (OMBI) is a common side effect of chemo- and radiotherapy, which are use to cancer treatment. The clinical symptoms are: erythematous, ulcers that appear over time, which may be painful and cause difficulty in food intake, secondary fungal and bacterial infections. Among the methods of treatment, we distinguish laser therapy, ozone therapy, cryotherapy and local treatment. The paper presents the case of a 12-year-old patient with B-cell lymphoblastic leukemia, treated according to the AIEOP-BFM-ALL 2017 protocol, who developed oral mucositis IV°. Bleeding from wounds after laser therapy were noticed. Ozone therapy was applied. After 6 treatments significant lesion healing was observed. The use of ozone therapy in the case of necrotic-ulcerative lesions in the course of oral mucositis in a patient in the developmental age may lead to the healing of the lesions, which allows the continuation of antitumor therapy.

Podwójne zęby środkowe szczęki w uzębieniu mlecznym – opis przypadku i przegląd piśmiennictwa

Mesiodens is the most common form of supernumerary teeth, usually located in maxilla, in the region of medial line. The overall prevalence of mesiodens in primary, mixed and young permanent dentition varies between 0.09 and 2.05%. However, occurrence of double mesiodentes in patient without any associated systemic conditions or syndromes is a rare phenomenon. This paper presents a report of nonsyndromic double mesiodentes in 3.5-year-old girl with positive family history of supernumerary teeth. Both of mesiodentes had conical shape. One of supernumerary tooth was partially erupted and caused mesial displacement of deciduous maxillary right incisor, root resorption of that tooth found on intraoral radiograph, as well as rotation of the germ of permanent incisor. While the other was impacted and inverted. Mesiodentes were surgically removed under general anaesthesia. The healing was uneventful. As the mesiodens is a single or multiple anomaly that a dental practitioner may come across, the paper discusses signs, complications and management of mesiodentes. It also emphasizes the importance of early detection and adequate management of single or double mesiodentes to minimize the future dental complication or malocclusion caused by this anomaly.

Leczenie zachowawcze torbieli korzeniowej – opis przypadku

Radicular cyst is the most common odontogenic cyst. This condition can be asomptymatic, it may be accidentally detected on radiographs. Among the treatment methods we distinct conservative, surgical and conservative-surgical procedures. This article presents the case of a 15-year old male patient. He was reported to endodontic treatment of tooth 22 with extensive periapical lesion. Intraoral examination showed a change in the colour of the tooth crown, negative reaction to ethyl chloride, palpable slight excessive growth around the root of the tooth 22 and positive Smreker’s test. The radiographic examination showed the presence of a large 11 x 10 mm diameter radiolucent lesion covering 2/3 of the root lenght of tooth 22. Antiseptic root canal treatment was used. Complete healing of the periapical lesion was observed after 9-months treatment. Conservative treatment of root cysts, especially in young patients, may lead to complete healing of the lesion, which will allow to avoid the need for surgery intervention or at least reduce its extent.

Pacjent z astmą oskrzelową w gabinecie stomatologicznym – przegląd piśmiennictwa dotyczącego postępowania leczniczego

Introduction. Asthma is the most common chronic condition of childhood. Patients with bronchial asthma are a high-risk group requiring constant and intensive dental prophylaxis and treatment as well as regular dental check-ups. They also require certain modifications of the management in order to minimize the risk of a disease exacerbation during dental treatment. Aim. The purpose of the article is to discuss dental therapeutic management in asthma patients in light of the latest research. Material and methods. Three databases PUBmed/Medline, EMBASE and Cochrane Library were searched through in terms of contemporary methods of dental treatment of an asthmatic patient. Results. In order to provide the best dental care and to avoid exacerbations during dental procedures to a patient with asthma, a dentist should cooperate with the patient’s attending physician. The elimination of pre-procedural stress using inhaled or oral sedation and knowledge of allergenic agents within dental anaesthetic substances and materials are crucial for successful treatment of the patient. Additionally, a professional fluoride prophylactic is recommended as a standard of care in patients at a high risk of caries. Conclusions. In light of recent research, intensive treatment and dental prevention is necessary in asthma patients as it may reduce symptoms and lead to the stabilization of the disease.

Otyłość jako czynnik ryzyka chorób przyzębia – opis przypadku

Over the past years, the significance of obesity as the global health problem has grown. By 2016, there were 1.1 billion obese people, and by 2025 a quarter of the world’s population will be overweight. It is mainly adults who are suffering from it, but we observe an increasing number of children and adolescents are affected as well. One of the main root causes of overweight and obesity is a sedentary lifestyle, excessive food consumption and the highly processed carbohydrates intake. Obesity may modulate the host’s immunity and lead to negative systemic changes in the body, including the oral cavity. Excess weight is considered to be a major risk factor with the patients suffering from ischemic heart disease, high blood pressure, diabetes, as well as periodontitis. The relation between obesity and periodontal changes is already noticeable in children. The presented case shows the influence of systemic factors such as obesity, vitamin D deficiency on the course of periodontal disease. It depicts the importance of introducing periodontal prevention with obese children. It includes the control of risk factors and the teaching of proper hygiene habits. Therefore, taking preventive and curative measures at the early stage can prevent extreme, irreversible changes in periodontal tissues.

Opiekun dziecka jako sprawca urazu nieprzypadkowego. Część II. Badanie podmiotowe i przedmiotowe w ujęciu wiktymologicznym

Introduction. Post-traumatic injuries are significant problems of paedodontic dentistry that parents with children urgently report to dental practice. Aim. The aim of the study is to indicate the necessity of maintaining the victimological awareness of the dental team in assessing injuries of deciduous and permanent teeth in terms of differentiating accidental and non-accidental injuries. Material and methods. The publications in the PubMed scientific database were reviewed by applying the search criteria for the following keywords in Polish and English: “non-accidental injury”, “children and youth”, “perpetrator of abuse”, “phenomenon identification”, “interview and clinical examination”. Results. Interview and clinical examination are among the basic diagnostic tools for correct diagnosis, which results in the implementation of proper therapeutic management in a child after an injury. This also an opportunity to observe disturbing behavior of children that may indicate abuse. Regardless of the provided information, the subject examination is verifying the compliance of an interview with post-traumatic injuries arising in a simple physical mechanism – the greater the energy, the greater destruction. This will provide relevant information that verifies the compliance of the interview with the clinical examination, thanks to the reliable victimological knowledge of the dentist, results in the correct diagnosis, implementation of appropriate treatment, and child abuse intervention. Conclusions. The likelihood of a child’s non-accidental injury requires medical professionals to take decisive action to protect the child from the effects of physical violence in particular during the COVID-19 pandemic, in which minors forced by the external situation spend more time with perpetrators of abuse, they are more exposed to harm. Victimology education and an appropriate response to child abuse will allow for effective intervention regarding both the therapeutic process and measures to prevent further harm to children.

Opiekun dziecka jako sprawca urazu nieprzypadkowego w obrębie uzębienia. Część I. Identyfikacja zjawiska w aspekcie środowiskowym

Introduction. The problem of non-accidental injury has long been analyzed as a public health problem generating high social and economic costs. Aim. The aim of the study is to present views on the etiology of occurrence of the phenomenon of child abuse and its identification in order to take effective interventions interrupting the phenomenon of improper handling of a child. Material and methods. The publications in the PubMed scientific database were reviewed by applying the search criteria for the following keywords in Polish and English: “non-accidental injuries”, “children and adolescents”, “child abuse”, “identification of the phenomenon”, “perpetrator’s psychological profile”, “improper handling of the child”, “social and economic costs”, “public health”. Results. Medical community plays an important role in diagnosing non-accidental injuries. For a dental team, that may be dealing with physical violence injuries, correctly taken medical history and compliance of information provided by the child’s caregiver with visible head and neck post-traumatic injuries is the key factor to differentiate the origins of the trauma. By recognising the multifaceted risk factors in regards to child abuse (resulting due to the environment, the structure of the family, the life situation of the parent or directly related to the child), medical team will be required to intervene to stop child abuse. Conclusions. The authors of studies from various countries agree that despite many publications on the occurrence of the phenomenon of improper handling of a child, there is a need to constantly work on the competences of professionals in the child’s environment – including the dental environment, which can and should effectively respond to violence against children.

Wpływ ultradźwięków pulsacyjnych o niskim natężeniu na przebieg leczenia ortodontycznego

Acceptable speed of tooth movement in orthodontics is main limiting factor in treatment time. Although there are many devices and accessories which helps to move teeth – big forces in small period can cause complications like tooth resorption. The paper aimed to verify low-intensity pulsed ultrasound as method to accelerate orthodontic movement. A literature review from 2002-2020 using data bases like PubMed and Medline was performed. LIPUS orthodontics, LIPUS in dentistry, low-intensity pulsed ultrasound. 35 articles associated with the aim of this review were chosen and analyzed. Low-intensity pulsed ultrasounds start biological sequence on molecular level. Reactions on cellular structures accelerate bone healing and reduce negative effects and complications during treatment. Low-intensity pulsed ultrasounds have positive impact on bone wounds healing, treating developmental bone defects, cartilage and soft tissues reactions, tooth resorption, teeth tissue and periodontal regeneration and on orthodontic treatment acceleration.