RESUMEN
OBJECTIVES: Juvenile idiopathic arthritis (JIA) frequently causes temporomandibular joint (TMJ) inflammation. The aim of this study was to evaluate the presence of orofacial pain and temporomandibular dysfunction in patients with JIA and controls. METHODS. Forty-one patients with JIA and 41 age- and sex-matched healthy controls participated. Subjects were asked about facial pain variables and their influence on daily life. A clinical examination was performed. Panoramic radiograph and medical data were extracted from the records. RESULTS: Thirty-three of the JIA patients reported TMJ or facial pain compared to four of the controls (p < 0.001). Nine of the JIA patients, compared to none of the controls, reported that their orofacial symptoms influenced daily life severely (p < 0.001). Clinical findings were more prevalent in JIA (p < 0.001). The assessments of disease activity correlated to palpation pain of jaw muscles (p < 0.001) whereas the presence of structural TMJ changes correlated to reduced jaw opening (p < 0.001). CONCLUSIONS: TMJ pain was prevalent in patients with JIA and influenced daily life severely for nearly a quarter of them. Collaboration between medical and dental care is therefore important.
Asunto(s)
Artritis Juvenil/fisiopatología , Dolor Facial/fisiopatología , Calidad de Vida , Adolescente , Artritis Juvenil/complicaciones , Artritis Juvenil/diagnóstico por imagen , Estudios de Casos y Controles , Niño , Preescolar , Dolor Facial/complicaciones , Dolor Facial/diagnóstico por imagen , Femenino , Humanos , Masculino , Dimensión del Dolor , Radiografía , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/fisiopatologíaRESUMEN
Self-injurious behaviour (SIB) is deliberate harm to the body without suicidal intent, and the condition occurs in a number of psychiatric, behavioural and developmental disorders. This case report describes a 4-year-old female with SIB who presented to a paediatric dentist after the self-extraction of teeth as a result of oral motor tics. The girl repetitively ground her teeth in a monophasic lateral motion that resulted in luxation of her maxillary right primary canine, and produced generalized oral and facial pain. The parents consulted the dentist about their child's complaint of toothache. The oral findings were unexcephonable except for a mobile primary canine, but there was a history of unusual behaviour including hyperactivity, and after multidisciplinary consultation and exclusion of other systemic diseases, the subject was diagnosed as suffering from Tourette syndrome (TS). Preventive treatment using a dental splint was provided. Noncontingent reinforcement therapy was successfully used to diminish the subject's SIB.
Asunto(s)
Conducta Autodestructiva/etiología , Avulsión de Diente/etiología , Movilidad Dentaria/etiología , Síndrome de Tourette/complicaciones , Terapia Conductista , Bruxismo/complicaciones , Bruxismo/etiología , Preescolar , Femenino , Humanos , Ferulas Oclusales , Conducta Autodestructiva/terapia , Tics/etiologíaRESUMEN
The aim was to assess the prevalence of pulp exposure after stepwise versus direct complete excavation of permanent posterior teeth with deep carious lesions. The material, representing 116 patients aged 6-16 yrs (mean = 10.2 yrs), consisted of 127 teeth with radiographs revealing carious lesions to such a depth that pulp exposure could be expected if direct complete excavation was performed. Teeth with clinical symptoms, other than transient pain shortly before treatment, were not accepted. The teeth were randomly selected for either treatment procedure. Stepwise excavation implied removal of the bulk of carious tissue and application of calcium hydroxide, followed by sealing of the cavity with zinc-oxide eugenol cement. After a period of 8-24 weeks the rest of the carious dentin was removed and the cavity sealed with calcium hydroxide, zinc-oxide-eugenol (ZOE) and a restorative material. Direct complete excavation entailed removal of all carious dentin followed by sealing as mentioned above. In case of pulp exposure, pulp treatment was performed. The pulp was exposed in 40 of the teeth treated by direct complete excavation. The corresponding figure for those treated by stepwise excavation was 17.5%. The difference was statistically significant. The teeth with no pulp exposure after direct or stepwise excavation showed normal clinical and radiographic conditions at the last check-up (mean = 43 months).
Asunto(s)
Caries Dental/terapia , Preparación de la Cavidad Dental/efectos adversos , Preparación de la Cavidad Dental/métodos , Exposición de la Pulpa Dental/etiología , Adolescente , Diente Premolar , Hidróxido de Calcio , Distribución de Chi-Cuadrado , Niño , Caries Dental/patología , Restauración Dental Permanente/efectos adversos , Restauración Dental Permanente/métodos , Restauración Dental Provisional/métodos , Dentina , Femenino , Humanos , Masculino , Diente Molar , Planificación de Atención al Paciente , Cemento de Óxido de Zinc-EugenolRESUMEN
The aim was to investigate how 3, 4 and 5-year-old children would handle a placebo lozenge in the oral cavity when given instructions on how to use it. The material consisted of sixty-five healthy pre-school children at three day-care centres in the city of Stockholm. Two lozenge sizes were tested: 400 mg (10 mm in diameter) and 800 mg (13.5 mm in diameter). The children were told to try to keep the lozenge in the mouth without sucking or biting on it until asked to spit out. Any tablet remains were collected and weighed after 5, 10 and 15 minutes, respectively. The results showed that the larger lozenge gave the longest dissolution time. This lozenge was also well tolerated by the children. It was noteworthy that 62% of the children could keep parts of the lozenge in the mouth for at least 10 minutes. The possible benefits of using a lozenge compared with a conventional tablet for preventing caries has to be further investigated.