ines kapferer -seebacher dental complications in eds...schubart et al. j dent anesthpainmed...
TRANSCRIPT
Ines Kapferer-Seebacher
Dental Complications in EDS
Austria
Innsbruck
I have no personal commercial interests!
I lose my teeth!
Symbolic picture
Healthy condition
WHAT IS PERIODONTITIS?
Symbioticbacteria
Periodontitis
Dysbioticbacteria
Mild immune reaction Inflammatory bone loss
Tooth-supporting
bone
Periodontal EDS (formerly EDS VIII)
Pretibial discolorations Specific gumsEarly severe periodontitisAge of diagnosis (mean): 12 years
Complete tooth loss (mean): 20 yearswithout periodontal treatment
Healthy siblings
Children with periodontal EDS
Kapferer-Seebacher et al. (submitted)
„Periodontal disease has also been suggested to arise in classical and vascular EDS.“
British EDS Society
Ehlers-Danlos Syndrome„Early-onset generalized periodontitis is one of the most
significant oral manifestations of the syndrome.“Letourneau et al. 2011
„Periodontitis also may occur in EDS type IV and to a lesser extent, in EDS Type I.“
Classification of periodontal diseases 2018
Increased Risk of Periodontitis with other EDS types ?
Early severe periodontitisis a feature of
periodontal EDSbut
not of other EDS types!
Shortened roots with classical EDS
Hakki et al. J Dent Oral Biol. 2017; 2(15): 1090.
Described in 9 individuals up to now
Pulp stones
classicalEDS
hypermobileEDS
dermatosparacticEDS
periodontalEDS
7 3 1 4
Supernumerary teeth Rotated teeth Tooth transposition
Single cases with hypermobile EDS and classical EDS
Are these manifestations of EDS?
Schubart et al. J Dent Anesth Pain Med 2019;19(5):261-270
MethodQuestionnaire: 980 EDS + 249 non EDS respondents
"Have you ever had a problem with a local anesthetic injectionnot working adequately or properly?"
ResultsEDS: 88% recalled inadequate pain preventionnon EDS: 33% recalled inadequate pain prevention
The agent with the highest success rate was articaine (30%), followed by bupivacaine(25%), and mepivacaine (22%).
Healthy condition
DENTAL IMPLANTS
Peri-Implantitis
There seems to be no increased risk for implant loss with other EDS typesone study on five individuals with hypermobile or classical EDS
Jensen et al. 2012
Three individuals included
All typesResistance to local anesthetics
periodontal EDSEarly severe periodontitisSpecific gumsPulp stonesIncreased risk of peri-implantitis
classical EDSPulp stonesShortened roots
vascular EDSExceeding roots
Conclusions
Striking lack of scientificevidence!
Clinical studies on oral manifestations of various EDS types
Periodontaldisease
Temporomandibularjoint
Enamel defectsRoot
deformities
Dental anaesthetics
Implantsuccess
Practical advice from a dentist!
