Maintenance Of Good Oral Hygiene Research Articles

Self-perceived need for dental care.

Aims:The aim of this study is to evaluate the self-perceived need for dental care among medical professionals and general public.Setting and Design:(1) To determine the perceived oral health status. (2) To evaluate the results in understanding the perception of oral health. (3) To determine the patients attitude toward dentist.Subjects and Methods:The study was carried out on 537 patients who came for their regular checkup and treatment.Statistical Analysis Used:The statistical analysis of this study was based on Chi-square test evaluation. The study was performed among in 537 participants. The participants included from age group of both <30 and >30. The study was made in the form of questionnaires enquiring how they would perceive their personal dental care and their attitude towards dentist.Results:Self-perceived questionnaires in evaluating general public in age group of <30 and >30 shows, that people in age group more than 30 has good oral hygiene maintenance, whereas attitude toward dentist and attending dental problems were more among group less than 30 of age.Conclusions:I conclude that there must be more awareness created by public health dentist among people about various dental problems, their complications and the treatment needs. Hence, that people be aware of their dental problem at the small stage and get cured. By conducting varies Public Health Programs and camp they became very free to contact their dentist for their varies dental problems and people attitude about dentist and toward dentist completely changes.

Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus.

This work provides a systematic review of the literature from January 2003 to April 2014 pertaining to the incidence, pathophysiology, diagnosis, and treatment of osteonecrosis of the jaw (ONJ), and offers recommendations for its management based on multidisciplinary international consensus. ONJ is associated with oncology-dose parenteral antiresorptive therapy of bisphosphonates (BP) and denosumab (Dmab). The incidence of ONJ is greatest in the oncology patient population (1% to 15%), where high doses of these medications are used at frequent intervals. In the osteoporosis patient population, the incidence of ONJ is estimated at 0.001% to 0.01%, marginally higher than the incidence in the general population (<0.001%). New insights into the pathophysiology of ONJ include antiresorptive effects of BPs and Dmab, effects of BPs on gamma delta T-cells and on monocyte and macrophage function, as well as the role of local bacterial infection, inflammation, and necrosis. Advances in imaging include the use of cone beam computerized tomography assessing cortical and cancellous architecture with lower radiation exposure, magnetic resonance imaging, bone scanning, and positron emission tomography, although plain films often suffice. Other risk factors for ONJ include glucocorticoid use, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, ill-fitting dentures, as well as other drugs, including antiangiogenic agents. Prevention strategies for ONJ include elimination or stabilization of oral disease prior to initiation of antiresorptive agents, as well as maintenance of good oral hygiene. In those patients at high risk for the development of ONJ, including cancer patients receiving high-dose BP or Dmab therapy, consideration should be given to withholding antiresorptive therapy following extensive oral surgery until the surgical site heals with mature mucosal coverage. Management of ONJ is based on the stage of the disease, size of the lesions, and the presence of contributing drug therapy and comorbidity. Conservative therapy includes topical antibiotic oral rinses and systemic antibiotic therapy. Localized surgical debridement is indicated in advanced nonresponsive disease and has been successful. Early data have suggested enhanced osseous wound healing with teriparatide in those without contraindications for its use. Experimental therapy includes bone marrow stem cell intralesional transplantation, low-level laser therapy, local platelet-derived growth factor application, hyperbaric oxygen, and tissue grafting.

Relationship between betel quid chewing and radiographic alveolar bone loss among Taiwanese aboriginals: a retrospective study.

BackgroundBetel quid chewing is associated with the periodontal status; however, results of epidemiological studies are inconsistent. To the best of our knowledge, no study has reported radiographic alveolar bone loss (RABL) associated with betel quid chewing.MethodsThis survey was conducted in an aboriginal community in Taiwan because almost all betel quid chewers were city-dwelling cigarette smokers. In total, 114 subjects, aged 30–60 years, were included. Full-mouth intraoral RABL was retrospectively measured and adjusted for age, gender, and plaque index (PI). Multiple regression analysis was used to assess the relationship between RABL and potential risk factors.ResultsAge-, gender-, and PI-adjusted mean RABL was significantly higher in chewers with or without cigarette smoking than in controls. Multiple regression analysis showed that the RABL for consumption of 100,000 pieces betel quid for the chewer group was 0.40 mm. Full-mouth plotted curves for adjusted mean RABL in the maxilla were similar between the chewer and control groups, suggesting that chemical effects were not the main factors affecting the association between betel quid chewing and the periodontal status.ConclusionBetel quid chewing significantly increases RABL. The main contributory factors are age and oral hygiene; however, the major mechanism underlying this process may not be a chemical mechanism. Regular dental visits, maintenance of good oral hygiene, and reduction in the consumption of betel quid, additives, and cigarettes are highly recommended to improve the periodontal status.

Oral hygiene practices among paramedical staff of a private dental institution in India

Health promotion in dentistry is targeted at the two most common oral diseases – dental caries and periodontal disease. The maintenance of good oral hygiene is considered to be a central issue in oral health promotion. Objective: To assess the oral hygiene practices among paramedical staff of a private dental institution in India. Material and methods: A cross sectional questionnaire survey was undertaken among 100 paramedical staff of a private dental institution in Mangalore, India. Data was collected by using self designed questionnaire. Results: About 49% of the subjects brushed thrice with soft toothbrush and 55% changed their tooth brush once in 3 months. About 77% of them cleaned their tongue either by tongue cleaner, toothbrush or finger and 82% of the subjects used tooth paste. About 56% of the subjects had never used dental floss. Majority of the subjects (56%) visited the dentist only when required. Conclusion: Oral hygiene practices among the paramedical staff were poor.

Oral manifestation of leukemic children under chemotherapy

Background: The term leukemia refers to cancers of the white blood cells (also called leukocytes or WBCs). When a child has leukemia, large numbers of abnormal white blood cells are produced in the bone marrow. These abnormal white cells crowd the bone marrow and flood the bloodstream, but they cannot perform their proper role of protecting the body against disease because they are defective. Most of the children with cancer will be at risk for significant pain at some time during the course of illness. Objective: To assess the oral manifestation in children with leukemia under chemotherapy treatment and itsrelation to the duration of patient's hospitalization. Methodology: One hundred twenty seven patients diagnosed Acute Lymphocytic Leukemia (ALL), collected of Children Welfare Teaching Hospital /Medical City, Central Child Teaching Hospital/Baghdad (hematology &amp; oncology unit) in 25th January 2009 to 25th January 2010, the questionnaire including demographic &amp; clinical information, main oral manifestations. Results: Patients samples ranged in age between (5-16) years, only 55 patients (43%) were aged between (8-10)years; 75patients (58.5%) were males; 40 patients (31%) were living in south of Iraq. Swollen &amp; palpable lymph node were the main chief complaints in 40 patients (31%); duration of disease is Less than 6 months, in 65 patients (51%); patients who stay in hospital more than 15 days were 90(70.8%); patients who their diagnosis were based on core biopsy &amp; bone marrow biopsy were the most diagnostic methods in 40 (31%); in about half of the patients hematological tests showed that Thrombocytopenia &amp; leukocytosis, elevated in erythrocytes sedimentation rate and anemia. Main oral manifestations presented were: ulceration gentle pressure, spontaneous bleeding, dry mouth, ulcerated/with or without bleeding of lips, laryngeal pain, unable to swallow and difficult/painful speech and mucositis. Conclusions: In this study we can conclude that the main oral manifestations in patient with leukemia were ulceration after gentle pressure; spontaneous bleeding; dry mouth; ulcerated/with or without bleeding of lips,laryngeal pain; unable to swallow and difficult/painful speech, and the duration of hospitalizations were related to the manifestations of patients and their chief complaints; diagnostic procedure and their therapy. Recommendation: the oral manifestations of patient with leukemia are focusing on them through a palliativemeasures such as the treatment of pain, and nutritional support and maintenance of good oral hygiene.

Preventing aspiration pneumonia in older people: do we have the 'know-how'?

Aspiration pneumonia is common in older people. To reduce the risk of aspiration pneumonia, maintenance of good oral hygiene is important and medications affecting salivary flow or causing sedation are best avoided, if possible. The use of H2 blockers and proton-pump inhibitors should be minimised. Different compensatory and facilitation techniques can be applied during oral feeding. Hand feeding should be tried before consideration of tube feeding. The use of tube feeding is the last resort and is mainly for improving nutrition and hydration. Prevention of aspiration pneumonia and increasing survival rates should not be the rationales for tube feeding. Feeding via both gastrostomy and nasogastric tube has similar risks for aspiration pneumonia, and continuous pump feeding is not better than intermittent feeding. Jejunal feeding might decrease the chance of aspiration pneumonia in selected high-risk patients. If older patients are on angiotensin-converting enzyme inhibitors without intolerable cough, continuing the drug may be beneficial. Folate deficiency, if present, needs to be promptly corrected. Further better-designed studies are warranted to find the best ways for prevention of aspiration pneumonia.

Assessment of postoperative pain of oral mucosal biopsy: A health initiative prospective study.

The aim of the present study was to evaluate post-biopsy pain using a questionnaire supported by a visual analog scale (VAS), and the role of pharmacological agents in pain relief. Three hundred patients undergoing oral biopsy were included in the study and divided into three groups. Group A: Patients received no analgesic post biopsy, except when required (SOS). Group B: Patients received anesthetic mouthwash along with oral analgesic post biopsy. Group C: Patients received anesthetic mouthwash alone. The statistical analysis was done using statistical analysis software SPSS version 11.0. ANOVA was used to compare the VAS scores and hygiene status of the three groups, while Pearson's chi-square test was used for determining association between age, sex, educational status, and association of pain with biopsy site. A highly significant difference was found between the VAS scores of patients in Groups A, B, and C, and significant correlation was observed between hygiene status and degree of pain. Oral biopsy is definitely associated with pain, if proper medications are not deployed. Anesthetic mouthwash alone is sufficient to relieve the pain produced by oral biopsy. Direct correlation exists between hygiene status and the level of discomfort, thereby indicating that pain control is essential for good oral hygiene maintenance.

Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures

The Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures evidence-based clinical practice guideline was codeveloped by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association. This guideline replaces the previous AAOS Information Statement, "Antibiotic Prophylaxis in Bacteremia in Patients With Joint Replacement," published in 2009. Based on the best current evidence and a systematic review of published studies, three recommendations have been created to guide clinical practice in the prevention of orthopaedic implant infections in patients undergoing dental procedures. The first recommendation is graded as Limited; this recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The second, graded as Inconclusive, addresses the use of oral topical antimicrobials in the prevention of periprosthetic joint infections. The third recommendation, a Consensus statement, addresses the maintenance of good oral hygiene.

Awareness and attitude towards maintenance of oral health during pregnancy among patients and clinicians attending obstetrics and gynecology ward

Aim : To assess the oral health status and pH of saliva in pregnant women in comparison to non-pregnant women and to appraise the awareness and attitude towards regular dental checkups and oral health maintenance among patients and clinicians attending a hospital gynecology ward. Study Design: The oral health status and extra-oral manifestations of 220 healthy women,including 110 pregnant women, attending the government hospital, Bhimavaram were considered. The findings were recorded along with a questionnaire and documented in a specially designed proforma. The response to another set of questions answered by 60 clinicians attending the gynecology ward was recorded in a separate proforma. Results: The clinical manifestations showed statistical significance (P = <0.001) values with 91% patients positive for gingivitis and 85% patients with ptyalism during their pregnancy. There were only 14.5% of pregnant women who consulted a dentist for their oral health problems during pregnancy, and only 35% of the clinicians have advised their patients regarding maintenance of good oral hygiene and routine dental checkups during pregnancy. Conclusion: Results show that certain oral manifestations were more prevalent among the pregnant women, and very few expecting mothers know about these changes related to pregnancy and follow maintenance of good oral hygiene and routine dental checkups. Hardly any gynecologists advised these women regarding the maintenance of good oral hygiene during pregnancy. Hence, oral health intervention programs should be targeted to the risk groups.

Influence of personality traits on gingival health

Background:The maintenance of good oral hygiene is considered a salient issue in dental health promotion. Personality is the combination of characteristics or qualities that form an individual's distinctive character. Various personality traits have been proposed to influence the oral health. The purpose of the present study was to assess the influence of personality characteristics using questionnaire on oral hygiene performance and gingival health.Materials and Methods:In total, 155 patients were subjected to personality questionnaire using Eysenck Personality Questionnaire. Clinical parameters such as Patient oral hygiene performance index and gingival index were recorded. Based on Eysenck Personality Questionnaire, the subjects were divided into three groups: Psychoticism, extroversion, and neuroticism.Results:Data analysis showed that subjects in psychoticism and neuroticism groups displayed moderate gingivitis, whereas subjects in extroversion group had severe gingivitis. Subjects in all the three groups demonstrated poor oral hygiene status. No statistically significant relation was found.Conclusions:A considerable clinical correlation was observed between the different personality traits and gingival health status of the subjects. It was not statistically significant. Further trials need to be conducted so as to ascertain this association so that psychological interventions may be undertaken to improve the oral hygiene condition of the population.

Prevalence of dentofacial abnormalities in children and adolescents with β-thalassaemia major

β-thalassaemia major is a hereditary hemolytic anemia and the patients often experience growth retardation, protrusive maxilla, and depressed nasal bride leading to various degrees of malocclusion. The purpose of this investigation is to find the prevalence of dentofacial abnormalities in β-thalassaemia major patients. Seventy-two patients between 6 and 18 years of age diagnosed with β-thalassaemia major were examined for extraoral abnormalities, malocclusion, oral hygiene, and dental caries. Data obtained were tabulated and statistically analyzed using Chi-square and paired t-test. Thirty-nine (54.2%) were males and 33 (45.8%) were females. Prominent extraoral abnormalities were found in 41 (56.9%) of the individuals. Study population predominantly had class I occlusion (59.7%) followed by class II occlusion (23.6%) and no class III occlusion. Mean oral hygiene index-simplified score was 2.43 ± 1.24, mean decayed missing filled teeth (DMFT) score was 7.10 ± 3.92, and deft was 5.68 ± 3.12. Despite starting regular blood transfusion at an early age, β-thalassaemia major patients showed marked facial abnormalities. When compared with individuals with no systemic disease, oral hygiene status was similar, but the caries experience was higher in β-thalassaemia major patients. Therefore, emphasis to educate these patients in the prevention and control of dental caries and maintenance of good oral hygiene should be considered.

A Case of Severe Gingival Overgrowth Caused by Long-Term Amlodipine Treatment

Amlodipine is one of the most commonly used calcium-channel blockers for the management of hypertension in Korea. Gingival overgrowth is an infrequent complication in patients receiving amlodipine treatment. A 52-year-old man on an amlodipine regimen of 10 mg/day for 25 months sought medical attention because of gradually progressive gingival enlargement. Examination of the oral cavity revealed severe gingival overgrowth. We stopped the amlodipine treatment and recommended the maintenance of good oral hygiene and a gingivectomy. Histological findings of the gingivectomy were typical of drug-induced gingival overgrowth, including epithelial thickening with proliferation, acanthosis with elongated rete ridges, and focal parakeratosis. A marked reduction in gingival overgrowth was evident 1 month after the gingivectomy and cessation of amlodipine. This report describes the case of a 52-year-old man who developed severe and histologically confirmed amlodipine-induced gingival overgrowth. (Korean J Med 2012;82:623-627)

Effect of Oral Care on Oral Hygiene among Children in Kancheepuram District, Tamil Nadu

Oral debris is most commonly seen in children with poor oral hygiene. Thorough brushing of the teeth at least twice a day is basic to an effective oral hygiene programme. Around a million new cases of poor oral hygiene (i.e. one child every minute) are diagnosed each year. Hence the investigator ended up using a simple procedure brushing technique to prevent poor oral hygiene. The objectives of this study were to assess the effectiveness of oral care with a view to improve oral hygiene among children between five to eight years of age. Demonstration of brushing procedure was done among school children with poor oral hygiene, knowledge regarding oral care, attitude and practice were assessed. The pre and post-test assessment was done by using debris index simplified assessment scale. After analysis the results showed that health education and proper brushing technique are very effective among children in improving the knowledge and awareness about maintenance of good oral hygiene.

New guidelines and the development of an international consensus on recommendations for the antibiotic prophylaxis of infective endocarditis

During the last five years there has been a considerable change in attitude towards antibiotic prophylaxis of endocarditis in many countries so that far fewer cardiac patients are advised to receive prophylaxis in comparison with previous years. Much greater emphasis is now given to the maintenance of good oral hygiene as the main method of preventing endocarditis and prophylaxis is only recommended for patients with the highest risk cardiac conditions undergoing dental procedures. Most countries have now abandoned prophylaxis for urological and gastrointestinal procedures. The UK National Institute for Health and Clinical Excellence guidance, which does not recommend prophylaxis for any group of patients undergoing dental procedures, is regarded as too extreme by many experts in other countries. The assertion that more patients would die from fatal anaphylaxis after oral amoxicillin, the main prophylactic agent, than would die from endocarditis because prophylaxis is withheld, may not be correct since the risks of dying after oral amoxicillin have probably been overestimated. There is a lack of clinical evidence either for or against the efficacy of antibiotic prophylaxis. Unless convincing data is obtained from future research any new international consensus guidelines will continue to be based mainly on expert opinion rather than on good evidence.

The antimicrobial efficacy of siwak (Salvadora persica) extract towards Streptococcus sanguis

Introduction: Siwak (Salvadora persica) has been used for good oral hygiene maintenance purposes by the Babylonians since 7000 years ago and also by the Greek, Roman, Egyptian, and Arabian. The aim of this study is to assess the antimicrobial efficacy of siwak extract towards Streptococcus sanguis as the oral-plaque-inducer, by determining the Minimum Inhibitory Concentration (MIC) and exposure time, to determine whether siwak extract could be chosen as an alternative ingredient for plaque control. Methods: Type of research is experimental laboratory. The MIC test were conducted based on a serial dilution of 64%, 32%, 16%, 8%, 4%, 2%, 1%, 0.5%, 0.25%, and 0.125% concentration of siwak extract respectively, against 5 samples of Streptococcus sanguis within three repetitions. The exposure time test has been performed within 30 seconds, 1’, 2’, 3’, and 4’ with 0.25%, 0.5%, and 1.0% concentration of siwak extract. Results: The siwak extract can inhibit Streptococcus sanguis at the concentration of 0.25% to 0.125%. There is no antimicrobial effect towards Streptococcus sanguis until 4 minutes of exposure time. Conclusion: Siwak extract had the antimicrobial effect towards Streptococcus sanguis in minimum concentration between 0.25% - 0.125% with the exposure time more than 4 minutes.

In vivo efficacy of alkaline peroxide tablets and mouthwashes on Candida albicans in patients with denture stomatitis

ObjectiveEffective cleaning of dentures is important for the maintenance of good oral hygiene for denture stomatitis patients. The in vivo efficacy of three different brands of alkaline peroxide tablets (Polident, Efferdent, and Fittydent) and two mouthwashes (CloSYS II and Corsodyl) to eliminate Candida albicans on dentures was evaluated in this in vivo study.Material and methodsNinety denture wearers with clinical evidence of denture stomatitis were randomly divided into 5 test groups and 1 control group. Each group was further divided into three subgroups in which the dentures were subjected to 15-, 30-, and 60-min disinfection procedures. The dentures of each test group were treated with one of the cleaners, while those of the control group were treated with distilled water. Swab samples from the palatal surfaces (2 cm x 2 cm template delimited area) of the upper dentures were obtained before and after 15, 30, and 60 min periods of cleaner use and examined mycologically.ResultsThe reduction in the number of colony-forming units (CFU) of C. albicans before, and after 15, 30, and 60 min of use of CloSYS II and Corsodyl was significantly greater than that of the control group (p<0.05). Moreover, there was no statistically significant difference (p>0.05) among Polident, Efferdent and the control group in any of the treatment periods. Dentures treated with Fittydent appeared to have a significantly greater reduction in the number of Candida spp. only after 60 min of treatment.ConclusionsThe results of this study showed that the use of mouthwashes significantly reduced the number of microorganisms on dentures.

Dynamic commissural splint

Microstomia, an abnormally small oral orifice, can manifest as a sequela of burns involving the oral and perioral tissues due to contraction of the tissues and hypotonia of the circumoral musculature. Regardless of the etiology, scar contracture results in deformities that produce esthetic and functional impairment. Changes in the circumoral anatomy prevent optimal dental care and maintenance of good oral hygiene. The anatomic changes may detrimentally alter eating, speech, and mandibular motion. Prosthetic treatment involves providing physical resistance to scar contracture by maintaining the oral commissures in their normal relationship by means of a splint. This article describes a method to fabricate a dynamic commissural splint and describes its use in two cases.

Radiographic evaluation of infra-bony defects treated by bone graft procedures

Purpose: A number of techniques and materials have been used for periodontal regeneration and bone graft procedures with guided tissue regeneration(GTR) have been suggested as alternatives to osseous surgery in the management of local infra-bony defects. However, the long-term stability and treatment outcome following bone graft procedure of infra-bony defects is poorly documented. The purpose of this study was to assess radiographic change in infra-bony defects over 2 years after bone graft procedures with various graft materials. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients showed clinical and radiographic evidence of infra-bony defect(s). 44 sites of 34 patients aged 31 to 69 (mean age 48.3) were treated by bone graft procedure with a bone graft material. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. Result: We observed 1.15±1.95 mm of bone fill, 0.40±1.19 mm of crestal resorption, 1.55±1.77 mm of defect resolution, and 40±44% of percentage of defect resolution. Deeper initial defect depth, narrower initial defect angle showed significantly greater bone fill, defect resolution, and % of defect resolution. But no significant difference was observed in graft sites and graft materials. Conclusion: If good oral hygiene maintenance and periodic recall check of patients is assured, bone graft procedure using various graft materials is one of the appropriate treatment modality for regenerative therapy of infra-bony defects. (J Korean Acad Periodontol 2008;38:437-444)

Long-term radiographic evaluation of GTR treatment in intrabony defect

【Periodontal surgery as part of the treatment of periodontal disease is mainly performed 1) to gain access to diseased areas for adequate cleaning; 2) to achieve pocket reduction or elimination; and 3) to restore the periodontal tissues lost through the disease; i.e., a new attachment formation of periodontal regeneration. To accomplish the latter, often referred to as the ultimate goal of periodontal therapy, a number of surgical procedures have been advocated throughout the years. Clinical studies have demonstrated that considerable gain of clinical attachment and bone can be achieved following guided tissue regeneration (GTR) therapy of intrabony defects. The aim of this study was to analyse the radiographic bone changes 2-year after GTR using a bone graft material and nonresorbable membrane. Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of intrabony defect(s), 33 sites of 30 patients aged 32 to 56 (mean age 45.6) were treated by GTR with a bone graft material and nonresorbable membrane. Baseline and 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, defect depth, defect angle, bone graft materials) using the paired t-test were examined. We observed $2.86{\pm}1,87mm$ of bone fill, $065{\pm}0.79mm$ of crestal resorption, $3.49{\pm}2.11mm$ of defect resolution, and $44.42{\pm}19.51%$ of percentage of defect resolution. Mandible, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. But no difference was observed between xenograft and allograft. Outcome of GTR as a therapy of intrabony defect was better than other therapy, but herein, good oral hygiene maintenance as a anti-infective treatment and periodic recall check of patients are essential.】

Early experience of implant-supported prostheses in patients with neurologic disabilities

The purpose of this prospective study was to provide a preliminary report of implant treatment in patients with neurologic disabilities.Patients had been referred to the National Orofacial Resource Centre with different disabilities, specifically neurologic disorders causing various orofacial dysfunction problems, and were suitable for prosthodontic treatment with implants. Patients were treated with single implant-supported crowns, fixed partial dentures, or complete implant-supported dentures. Implants used were threaded titanium cylinders placed under general or local anesthesia. All surgical complications in the healing period or at second-stage surgery were noted, as were all prosthodontic complications.Fourteen patients were treated with 35 implants. Three implants were lost before or at second-stage surgery, and two implants were lost after loading. These complications were observed in two patients. Implant failures and other complications were observed in two patients in the mandible because of dehiscence of the mucoperiosteal flap and infection. Some patients had developed finger or oral habits, such as excessive tongue movements, that were probably responsible for these complications. One of the patients with Down syndrome possibly had reduced resistance to infections. No major complications were observed for the other 12 patients treated.Strict adherence to a surgical protocol is needed for the management of patients with neurologic disabilities. It is important to inform the patient's caregiver about maintenance of good oral hygiene and the increased risk of complications caused by finger or oral habits.