Journal of Disability and Oral Health
- Cover Date:
- September 2012
- Print ISSN:
- 1470-855
- Vol:
- 13
- Issue:
- 3
Poster Abstracts
Poster Abstracts
The mechanism of phenytoin-induced gingival overgrowth
Takeuchi R, Matsumoto H, Akimoto Y, FujiiA Nihon University School of Dentistry at Matsudo, Chiba, Japan takeuchi.reiri@nihon-u.ac.jp
Possibilities of dental implants in paediatric patients
Kumar G Associate professor, Department of Paediatric Dentistry, Maulana Azad institute of Dental Sciences New Delhi, India Aims: To explore the possibilities of dental implants in paediatric patients. Methodology: Various literature and clinic trials were reviewed. Results: It is recommended to wait for completion of skeletal and dental growth before planning an implant; however, many physiologic and psychological factors create pressure to commence earlier treatment. Discussion: Traumatic tooth loss or congenital partial anodontia, mainly in patients with ectodermal dysplasia, is frequently encountered in children. In those cases, oral rehabilitation is required before skeletal and dental maturation, and removable prostheses is often treatment of choice. However, this may lead to increase in caries rate, increased residual alveolar resorption, and other periodontal complications. Use of implants in children has been discussed lately. From a physiologic standpoint, the conservation of bone may be the most important reason for the use of dental implants in growing patients, and it even may be beneficial in some cases to stimulate alveolar bone development. Other factors that favour implant placement in children are their excellent local blood supply, positive immunobiologic resistance, and uncomplicated osseous healing. Conclusion: Implant retained prostheses create additional concerns not created by adult patients, and dental and skeletal growth is a major confounding variable when implants are used in children. Most dentists prefer to place implants after growth is completed, upon sexual maturity, the appropriate age for installation of implants.
Objective: Hyperplastic change in gingiva occurs in response to phenytoin (PHT). It is evident that an increased number of fibroblasts are found in overgrown gingival tissue. The population balance amongst fibroblasts in a tissue is maintained by cell cycle regulation that leads to proliferation and division. In the study, the cell cycle phase distribution of gingival fibroblasts in the presence of PHT was examined to investigate the mechanism of PHT-induced gingival overgrowth. Methodology: Cultured human gingival fibroblasts were purchased from Primary Cell Co., Ltd. Semi-confluent cells were stimulated by DMEM with 0% FBS (DMEM-0) ± 0.25 µM PHT or 10% FBS. Cell cycle analysis at 24 h, cell proliferation assay at 24, 48, 72 h, western blotting with antibodies to p21, p27, p57, pCdk2, pCkd4, and pRb (Ser780 and 807/811) at 24 h were then performed. Results: Cells were significantly transited into G0/G1 phase from S and G2/M phases in DMEM-0. However, this transition did not occur in the cells exposed to PHT. Number of cells was constant in DMEM-0 at all periods after stimulation; however, it was significantly increased in DMEM-0 with PHT. Protein levels of pCdk2 and pRb (ser807/811) were enhanced and those of p21 and p27 were decreased in the PHT-treated cultures compared with the control, significantly. Conclusion: The cause of PHT-induced gingival overgrowth could be that PHT hinders to arrest at G1 phase by inhibitions of down-regulation of pCdk2 and pRb (ser807/811) and up-regulation of p21 and p27.
Oral care of the liver failure patient – pre-transplant
Hicks JL, Seagren KL University of Texas Health Science Centre at San Antonio, San Antonio, USA hicksj@uthscsa.edu Objective: The Hospital Dentistry Department provides consulting and treatment services for liver failure patients seeking liver transplant. A treatment algorithm for the oral care of patients was constructed and guided care of patients in the pre-transplant period. Methodology: Retrospective analysis of 500 patient medical and dental charts was performed and specific data analysed. Data collected included: medical diagnosis/aetiology of liver disease, laboratory test results, dental disease present, dental care necessary to clear patient for transplant (treatment plan), and cost of dental care necessary pre-transplant. The medical and dental charts yielded data that were subjected to statistical analyses. Analyses computed the cost of care necessary for transplant clearance and to examine correlations among laboratory tests. Results and Conclusions: Patients who had invasive procedures healed without unexpected incident or fatality. The care algorithm devised for liver failure patients guided care to safe, successful completion. Platelet transfusion was required by 15% of patients. Even with precautions, some patients experienced recurrent bleeding but none required re-transfusion of platelets or red cells. Elevation of International Normalized Ratio and Partial Thromboplastin Time were commonly seen, but were less elevated than expected. Average cost of care to dental clearance was $1,169. Low red, white cell or platelet counts were not associated with excessively elevated INR or prolonged PTT times.
Working together: people with disabilities helping oral and general health professionals to reach across professional boundaries and provide better healthcare
Tracy J Centre for Developmental Disability Health Victoria, Monash University, Melbourne, Victoria, Australia jane.tracy@monash.edu
People with intellectual and associated developmental disabilities have complex health and social needs and challenge healthcare providers to work as members of multidisciplinary healthcare teams. Traditionally, oral, general and mental health providers have worked within their own professional spheres of expertise and comfort. Currently, healthcare for people who have simultaneous issues and needs in several of these domains tends to be fragmented and poorly coordinated. When those people also have communication and/or cognitive impairments, then care provision is even more challenging. If we respect the expertise of each professional discipline, and each member of the healthcare team, and together search for ways to improve the care we provide, then the health of those with the most complex needs will be enhanced. Such changes in our approach and understanding will also advance the care we provide to all our patients. The paper will explore the importance of working across professional boundaries to improve the ease and effectiveness of providing care to people with developmental disabilities, and discuss some potential strategies for doing so.
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