Dental implants placement in paranoid squizofrenic patient with obsessive-compulsive disorder: A case report

Abstract

BackgroundParanoid schizophrenia is a mental illness that involves no observable anatomical alteration. Main characteristic affects the personality of the individual, as well as areas of his own psychology.Case ReportA 33-year-old man with paranoid schizophrenia and obsessive-compulsive disorder in treatment with Haloperidol, Oxcarbazepine, Olanzapine and Seroquel is presented. Dental exploration showed widespread decay mostly cervical with numerous root fragments, agenesis of lateral incisors, impacted wisdom teeth, missing teeth and malocclusion. Treatment plan included restoration of teeth decay, extractions of root fragments and implant-supported prostheses in bilateral upper lateral incisors for aesthetics reason. A previous consultation with a psychiatric specialist was performed and no contraindication were observed. A preliminary radiological examination was performed previous dental treatment and implant placement. Due to patient refusal to replace dental abscenses with implants, inform consent was signed up from his parents. After local anesthesia, first implant was placed at upper right lateral positions (Straumann Bone Level Ø 3.3 mm, length 10 mm). Two weeks later a second implant was placed at upper left lateral position (Straumann Bone Level Ø 3.3 mm, length 12 mm). The patient showed no postoperative complications. After implant placement, the patient attended scheduled review appointments. The prosthesis was placed after a 3-month period of osseointegration.ConclusionsImplant placement can be considered a suitable option for people with mental disorders. A previous consultation with psychiatric specialists for conducting a good patient management is necessaire. Key words:Paranoid schizophrenia, obsessive-compulsive disorder, dental implants.

The Behavior of Patients with Obsessive-Compulsive Disorder in Dental Clinics

“…Multiple dental symptoms were documented in these 8 case reports including tooth pain, dental caries, agenesis of lateral incisor, root fragment, impacted wisdom, missing teeth, complex vocal tics, severe lip biting, tooth wear, prolonged tooth brushing, gingival bleeding, painful palatal lesion, halitosis, and bruxism. All patients accepted the dental treatment except for one patient, where dental treatment was conducted after taking parent consent [ 7 ]. All cases (except two cases [ 7 , 13 ]) reported at least one obsessions or compulsions symptom according to the NIMH.…”

“…All patients accepted the dental treatment except for one patient, where dental treatment was conducted after taking parent consent [ 7 ]. All cases (except two cases [ 7 , 13 ]) reported at least one obsessions or compulsions symptom according to the NIMH. Fear of germs and contamination was reported in the works of Ahuja et al [ 6 ], Chandna et al [ 8 ], Michael [ 11 ], and Vieira et al [ 12 ].…”

“…Ordering and arranging things in a particular way, repeatedly checking things, and compulsive counting were reported in the works of Ahuja et al [ 6 ] and Chandna et al [ 8 ]. All patients had OCD with no other psychological disorder except for one patient who was schizophrenic [ 7 ]. Table 5 shows the study population and inclusion criteria for all selected clinical investigations.…”

“…Out of the eight evaluated case reports, seven showed low risk of bias, while one case report [ 10 ] showed moderate risk of bias. The overall scores for case reports were as follows: 75% for studies of Ahuja et al [ 6 ], Castellanos-Cosano et al [ 7 ], and Chandna et al [ 8 ]; 87.5% for studies of Fontenelle and Leite [ 9 ], Michael [ 11 ], Vieira et al [ 12 ], and Oulis et al [ 13 ]; and 62.5% for the study of Herren and Lindroth [ 10 ]. Of the five analyzed cross-sectional studies, four articles were scored as low risk of bias, while one article [ 17 ] showed moderate risk of bias.…”

“…They also used to count in a specific pattern during the treatment. Castellanos-Cosano et al [ 7 ] showed that there was no contraindication in placing a dental implant in a patient with OCD after consulting the patient's psychologist. They also pointed that their patient may refuse the dental treatment but, with the guardian consent, treatment can be conducted safely.…”