Medically compromised patients in orthodontic practice: Review of evidence and recommendations

Background: The purpose of this cross-sectional study was to evaluate the prevalence of malocclusion in children with autism spectrum disorders (ASDs) and to determine the most common occlusal traits. Materials and Methods: The present cross-sectional study was conducted among 7-15 years old children with ASDs and randomly selected healthy children with the same demographic characteristics. Molar relationship, lip incompetence, overbite, overjet, midline deviation, crossbite, and crowding/spacing were recorded. A descriptive analysis was performed for all variables. A comparison of the presence or absence of malocclusion traits between children with and without ASDs was assessed using the chi-square test. Univariate and multivariate logistic regressions were used to calculate odds ratio (OR) and 95% confidence intervals (95% CI) to assay various parameters between autism and non-autism group. Results: A total of 96 patients were assessed, 47 patients in the ASD group, and 49 in the control (non-ASD) group. The results showed no significant difference between the ASD and control groups in terms of the overall prevalence of malocclusion (P>0.05). However, the prevalence of increased overjet and Class II molar relationship was significantly higher in the ASD group compared to the control group (P=0.03). Patients in the control group showed a higher prevalence of midline deviation (P=0.001). Conclusion: Despite a higher prevalence of overjet and Class II molar relationship in children with ASDs, the prevalence of malocclusion was not higher in this group of patients.

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“…These appliances should be as small as possible and reinforced by wires since hyperesthesia is common in autistic children. 29,30…”

Section: Discussionmentioning

confidence: 99%

<p>Prevalence of Malocclusion and Occlusal Traits in Children with Autism Spectrum Disorders</p>

Farmani¹,

Ajami²,

Babanouri³

2020

CCIDE

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“…I n recent years, the number of patients requiring orthodontic treatment has increased, some of them with systemic diseases that need medication [1]. Asthma is a chronic disease that affects around 300 million people worldwide, mainly to pediatric patients [2,3].…”

Section: Introductionmentioning

confidence: 99%

Effects of salbutamol, montelukast and prednisone on orthodontic tooth movement in rats

Chumpitaz-Cerrate

Chávez-Rimache

Franco-Quino

et al. 2021

BDS

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Objective: To evaluate the effect of salbutamol, montelukast, and prednisone on orthodontic tooth movement in rats. Material and Methods: In vivo experimental preclinical study. The sample consisted of 48 rats randomly distributed in four study groups. Group A was given saline solution; to group B, salbutamol 4 mg/Kg; to group C, montelukast 2.5 mg/Kg and to group D, prednisone 2.5 mg/Kg. All were fitted with orthodontic devices and the medications were administered intraperitoneally every 12 hours for 5 days. The clinical evaluation (variation in the interincisal distance) was performed at one, three, five, and seven days and the histopathological analysis (cell count) at five and seven days. Results: In the clinical evaluation of the variation in the interincisal distance, a significant difference was found in all the evaluations (p <0.05). It was found that the salbutamol group presented higher variation values in the interincisal distance on all the days evaluated. In the histopathological analysis at five and seven days, it was found that the osteoblast and osteocyte count was significantly higher in the salbutamol group compared to the other groups (p ><0.05). However, in the subgroup analysis, it was found that there was no significant difference in the osteoblast and osteocyte count between the prednisone, montelukast, and control group (p>0.05). Conclusion: The administration of salbutamol increased the magnitude of orthodontic tooth movement; nonetheless, the administration of montelukast and prednisone did not modify the magnitude of orthodontic tooth movement in rats. Keywords Albuterol; Montelukast; Prednisone; Rats; Tooth movement.

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“…They make their appearance more usually in adolescence, which is also the most common period during which orthodontic treatment (OT) is initiated [4,5,8,9,13]. There are a variety of oral symptoms in patients with EDs including enamel erosion, dental caries, dentinal hypersensitivity, enamel demineralization, malocclusion, and xerostomia; with tooth erosion being the most prevalent [6,[10][11][12][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…A mortality rate of up to 25% has been reported for patients with EDs [ 4 – 7 ]; and the prevalence of EDs is higher in females compared with males [ 4 , 5 , 8 , 9 ]. The most common forms of EDs are anorexia nervosa (AN) and bulimia nervosa (BN) [ 7 , 10 , 11 ]. The primary characteristic of AN includes restriction of food intake due to a persistent fear of becoming overweight, even though the affected individual is underweight [ 1 , 5 , 10 , 11 ]; whereas, BN is characterized by binge eating which, is often followed by self-induced vomiting in order to maintain a low body weight [ 1 , 5 , 6 , 10 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…The most common forms of EDs are anorexia nervosa (AN) and bulimia nervosa (BN) [ 7 , 10 , 11 ]. The primary characteristic of AN includes restriction of food intake due to a persistent fear of becoming overweight, even though the affected individual is underweight [ 1 , 5 , 10 , 11 ]; whereas, BN is characterized by binge eating which, is often followed by self-induced vomiting in order to maintain a low body weight [ 1 , 5 , 6 , 10 , 12 ]. It is well-established that AN and BN are serious conditions that jeopardize the general and psychological health status of patients [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Is There an Association Between Fixed Orthodontic Treatment and Initiation of Eating Disorders? A Review of Currently Available Evidence

Koukou

Javed

Michelogiannakis

2021

Front. Oral. Health

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Objectives: The aim was to review the available literature regarding the potential association between fixed orthodontic treatment (OT) and the onset of eating disorders (EDs).Method and Materials: Six indexed databases were searched until November 2020. The inclusion criteria were as follows: (a) patients undergoing fixed OT and (b) EDs in relation to fixed OT. Commentaries, letters to the Editor, reviews, and studies in patients with EDs not undergoing fixed OT were excluded. The pattern of the present review was customized to summarize the pertinent information.Results: Four out of 10,076 initially-identified studies were included, and all of them were case reports. All patients were females, and the EDs reported were either anorexia nervosa (AN) or bulimia nervosa (BN). In three case reports, patients developed EDs after the initiation of OT. Fixed OT was performed in all the studies, and a variety of oral complications such as sore mouth, gingivitis, tooth surface demineralization, and others were reported.Conclusion: Based upon the limited available evidence, the association between OT and the onset of EDs remains unclear. Further well-designed observational clinical studies are needed in this regard.

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Medically compromised patients in orthodontic practice: Review of evidence and recommendations

Cited by 12 publications

References 51 publications

<p>Prevalence of Malocclusion and Occlusal Traits in Children with Autism Spectrum Disorders</p>

<p>Prevalence of Malocclusion and Occlusal Traits in Children with Autism Spectrum Disorders</p>

Effects of salbutamol, montelukast and prednisone on orthodontic tooth movement in rats

Is There an Association Between Fixed Orthodontic Treatment and Initiation of Eating Disorders? A Review of Currently Available Evidence

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