Oral health needs in individuals with trisomy 18 and trisomy 13: Implications for dental professionals

Bruns, Deborah A.; Martinez, Alyssa; Campbell, Emily

doi:10.1111/scd.12146

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…8 Although patients with T13 and T18 often have limited oral feeding ability, over half of these patients are able to take some amount of food orally. 12,13 Cleft lip and palate repair therefore provides functional improvement to T13 and T18 patients. Furthermore, early intervention for cleft lip and palate has been shown to positively influence the caregiver-child relationship in children without T13/T18.…”

Section: Arguments In Favor Of Surgerymentioning

confidence: 99%

Ethical Implications of Cleft Lip and Palate Repair in Patients with Trisomy 13 and Trisomy 18

Appel

Grush

Upadhyaya

et al. 2023

The Cleft Palate Craniofacial Journal

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Background Children born with Trisomy 13 or 18 (T13/18) often have multiple congenital anomalies, many of which drastically shorten their lifespan. Among these defects are cleft lip and palate, the repair of which presents an ethical dilemma to the surgeon given the underlying comorbidities associated with T13/18. The authors present an ethical discussion and institutional experience in navigating this dilemma. Methods The authors analyzed existing literature on T13 and T18 surgery and mortality. A retrospective study over ten years was also conducted to identify pediatric patients who underwent surgical correction of cleft lip and/or palate secondary to a confirmed diagnosis of T13/18. The authors identified two patients and examined their treatment course. Results The authors’ review of literature coupled with their institution's experience builds on the published successes of correcting cleft lip and palate in the setting of T13/18. It was found that both patients identified in the case series underwent successful correction with no surgical complications. Conclusion A careful balance must be struck between improved quality of life, benefits of treatment, and risks of surgery in children with T13/T18. Careful consideration should be given to the medical status of these complex patients. If the remaining medical comorbidities are well managed and under control, there is an ethical precedent for performing cleft lip and palate surgeries on these children. A diagnosis of T13/T18 alone is not enough to disqualify patients from cleft lip/palate surgery.

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Section: Arguments In Favor Of Surgerymentioning

confidence: 99%

Ethical Implications of Cleft Lip and Palate Repair in Patients with Trisomy 13 and Trisomy 18

Appel

Grush

Upadhyaya

et al. 2023

The Cleft Palate Craniofacial Journal

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show abstract

“…Historically, trisomies 13 and 18 were not compatible with life, however there is a percentage of survivors due to a variation of genotype, phenotype and medical handling. Their orofacial features are micrognathia, cleft lip and palate 55,56 .…”

Section: Trisomy 21 (Down Syndrome)mentioning

confidence: 99%

“…Malocclusion appears in many conditions when patients have crowded teeth, frontal open bite, posterior crossbite, and dental Class II or III malocclusion 24,35,39,41 . Changes of dental crown shape, for instance peg shaped, bulbous shaped or taurodontism can be observed 23,31,32,[37][38][39]54,55,64,68 .…”

Section: Major Dental Symptomsmentioning

confidence: 99%

“…Calcium enriched root canal or pulp stones, an early apoptosis of deciduous or permanent teeth were also found 17,28,30 . Supernumerous teeth and dental caries appear sometimes 1,26,27,31,32,39,[53][54][55]57,64,67 . However, wrong position of erupted teeth, root absorption and discolored teeth present rarely 5,34,35,63,65,66 .…”

Section: Secondary Dental Featuresmentioning

confidence: 99%

“…hypoplastic mandibula presents rarely 5,26,27,31,32,34,40,[53][54][55] . A prognathism of mandibular appears at a same frequency with prognathic maxilla 16,37,39,41,47,65,67,[71][72][73][74][75] .…”

Section: Jrpmsmentioning

confidence: 99%

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A dental approach to hereditary and congenial metabolic bone diseases

Rallatou¹,

Sakka²,

Zafeiris³

2023

JRPMS

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Bone growth requires a balance of minerals such as calcium, phosphorus, and factors of bone biomineralization. The difference between jaws' bones and the rest of the bones is the existence of teeth. Although the development of teeth has no similarities with bones, the biomineralization of both is happening at the same time. Consequently, the disturbances in the metabolism of minerals and peptides which participate in osteogenesis, have an impact on teeth, jaws, periodontal tissues, and oral mucosa. The hereditary and congenial metabolic bone diseases are being analysed and classified based on their genetic profile and oral manifestations. Regarding the categories, there are metabolic bone diseases caused by genetic mutations, like hereditary rickets, and others caused by chromosomal abnormalities, such as Down syndrome. In addition, many disorders are provoked by enzymatic dysfunction, disturbances of creation of polypeptide chain, while others have an unknown explanation. Many oral manifestations are related with problems in the dentition, oral mucosa, periodontal tissues, and jaws. Especially some syndromes present with cleft lip and palate. To conclude, there is a big variety of dental symptoms of these disorders, while the most frequent are the delayed eruption of teeth, oligodontia, a dysplastic enamel and dentine.

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Liveborn children with trisomy 18: A scoping review

Schlosser,

MacPherson,

Castro-Codesal

et al. 2024

Journal of Neonatal-Perinatal Medicine

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Background There have been an increasing number of publications related to trisomy 18 associated with a shift in the philosophy of care. The objective of this review is to understand the scope of contemporary literature informing the care of children born alive with trisomy 18. Methods Included was peer-reviewed, primary literature in MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Cochrane Library from 2012 to 2023 reporting outcomes of children born alive with trisomy 18. Data extraction involved descriptive statistics of the types of studies, and an inductive thematic analysis of the questions addressed by the studies. Results Of 4628 records identified, 229 met inclusion criteria. Key themes were organized around the domains: What is trisomy 18? What are the chances of survival with trisomy 18? What can be done to improve the chances of survival with trisomy 18? How do children with trisomy 18 die? Do surgical interventions provide a benefit? Are there non-surgical options? What knowledge is informing medical management? How is life described for children with trisomy 18? What are children with trisomy 18 like as babies and as they get older? What is life like for families caring for children with trisomy 18? Conclusions A sizeable number of publications grouped trisomy 18 with other syndromes. Relatively few showed the longitudinal evolution of medical issues associated with trisomy 18, nor did they unfold the clinical heterogeneity of this population. This review shows the limited knowledge base guiding decision-making and care for children born alive with trisomy 18.

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Oral health needs in individuals with trisomy 18 and trisomy 13: Implications for dental professionals

Cited by 3 publications

References 16 publications

Ethical Implications of Cleft Lip and Palate Repair in Patients with Trisomy 13 and Trisomy 18

Ethical Implications of Cleft Lip and Palate Repair in Patients with Trisomy 13 and Trisomy 18

A dental approach to hereditary and congenial metabolic bone diseases

Liveborn children with trisomy 18: A scoping review

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