Periodontal disease in a patient with Prader-Willi syndrome: a case report

<p>Abstract</p> <p>Introduction</p> <p>Prader-Willi syndrome is a complex genetic disease caused by lack of expression of paternally inherited genes on chromosome 15q11-q13. The prevalence of Prader-Willi syndrome is estimated to be one in 10,000 to 25,000. However, descriptions of the oral and dental phenotype are rare.</p> <p>Case presentation</p> <p>We describe the clinical presentation and periodontal findings in a 20-year-old Japanese man with previously diagnosed Prader-Willi syndrome. Clinical and radiographic findings confirmed the diagnosis of periodontitis. The most striking oral findings were anterior open bite, and crowding and attrition of the lower first molars. Periodontal treatment consisted of tooth-brushing instruction and scaling. Home care involved recommended use of adjunctive chlorhexidine gel for tooth brushing twice a week and chlorhexidine mouthwash twice daily. Gingival swelling improved, but further treatment will be required and our patient's oral hygiene remains poor. The present treatment of tooth-brushing instruction and scaling every three weeks therefore only represents a temporary solution.</p> <p>Conclusions</p> <p>Rather than being a direct result of genetic defects, periodontal diseases in Prader-Willi syndrome may largely result from a loss of cuspid guidance leading to traumatic occlusion, which in turn leads to the development of periodontal diseases and dental plaque because of poor oral hygiene. These could be avoided by early interventions to improve occlusion and regular follow-up to monitor oral hygiene. This report emphasizes the importance of long-term follow-up of oral health care by dental practitioners, especially pediatric dentists, to prevent periodontal disease and dental caries in patients with Prader-Willi syndrome, who appear to have problems maintaining their own oral health.</p

日本語版Dickman Impulsivity Inventory の作成

Dickman（ 1990） proposed that there were two types of impulsivity, the Functional impulsivity（ FI） and the Dysfunctional impulsivity （DI）. He made the measure for the FI and the DI, and named it the Dickman Impulsivity Inventory （DII）. In our previous study, we tried to make the Japanese version of the DII, but the result of its reliability and validity showed that factor structure was slightly low. Therefore this study aimed at the making the Japanese Version of the DII, and was investigated the reliability and validity. 546 participants （male: 205, female: 341） took part in this research. By exploratory factor analysis, we found two factors: FI（ 8 items）, DI（ 8 items）. By confirmatory factor analysis, the goodness- of-fit supported this model（ RMSEA=.076, 90％CI=.068-.083; GFI=.902; AGFI＝.871）. We obtained high coefficient by the test-retest reliability. In order to check construct validity, we examined relationship between these two factors and other personality measurements related to impulsiveness. We confirmed the construct validity. These results showed that the Japanese Version of the DII was good model and can be used as a measure for the FI and DI in Japan

Respiratory disease in workers handling cross-linked water-soluble acrylic acid polymer.

Eight workers involved in packing cross-linked water-soluble acrylic acid polymer, an organic substance, developed pulmonary fibrosis, and the upper lobe was the most affected. The dust concentration in the polymer packing workstation was measured. Chest computed tomography (CT) was obtained for 82 individuals, including the 8 workers mentioned above. Three workers were histopathologically examined. In six of these eight workers, central pulmonary fibrosis and secondary bulla formation caused pneumothorax. Histopathologically, multiple centrilobular fibrotic foci were observed. Chest CT revealed centrilobular nodular opacity and interlobular septal thickening, suggesting early lesions in the workers because the dust concentration was remarkably high. Although the pathogenesis of the disease is unclear, we reported the occurrence of pulmonary fibrosis caused by the exposure to cross-linked water-soluble acrylic acid polymers in humans as it has not been reported earlier