{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T15:41:16Z","timestamp":1769269276796,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T00:00:00Z","timestamp":1752796800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This retrospective cross\u2010sectional study aims to elucidate the challenging oral and maxillofacial management associated with congenital insensitivity to pain with anhidrosis (CIPA), emphasizing the need for early intervention and specialized treatment approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Conducted at the Soroka University Medical Center, this study spans from 2005 to 2024, examining a significant cohort within a high\u2010prevalence Bedouin community. We analyzed clinical outcomes focusing on dental extractions, incidence of osteomyelitis (OM), and subsequent mandibular fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 36 patients diagnosed with CIPA, highlighting a high incidence of early\u2010onset dental extractions and OM leading to various complications, including pathological mandibular fractures. Specifically, 63.9% of the patients underwent tooth extractions, primarily due to self\u2010mutilation and infection. The average age at first tooth extraction was remarkably young at 2.23 years. Pathological fractures were observed in several cases, emphasizing the progressive and destructive nature of the disorder's impact on oral structures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Given the escalating nature of oral and maxillofacial manifestations in CIPA, there is a critical need for early dental intervention and the adoption of preventive strategies. This study advocates for a multidisciplinary approach to enhance long\u2010term outcomes, integrating oral and maxillofacial surgeons, pediatricians, geneticists, and rehabilitation specialists in the care of these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/scd.70073","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:38:26Z","timestamp":1752835106000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oral and Maxillofacial Management in Patients With Congenital Insensitivity to Pain and Anhidrosis (CIPA)"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0338-6888","authenticated-orcid":false,"given":"Evyatar","family":"Yefet","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery the Soroka University Medical Center  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2307-1370","authenticated-orcid":false,"given":"Moshe","family":"Shmueli","sequence":"additional","affiliation":[{"name":"Clinical Research Center the Soroka University Medical Center  Beer\u2010Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Navot","family":"Givol","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery the Soroka University Medical Center  Beer\u2010Sheva Israel"},{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Pikovsky","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery the Soroka University Medical Center  Beer\u2010Sheva Israel"},{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer Sheva Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","first-page":"125","article-title":"Congenital Insensitivity to Pain and Anhidrosis: A Report of Two Cases","volume":"21","author":"Karthikeyan M.","year":"2013","journal-title":"Indian Journal of Orthopaedics"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5413.80047"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/humu.1224"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2350-12-86"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2005.08.002"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(02)00482-7"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.1992.tb00091.x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/1096-8628(20000619)92:5<353::AID-AJMG12>3.0.CO;2-C"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1079-2104(98)90368-7"},{"key":"e_1_2_11_11_1","first-page":"293","article-title":"Orofacial Manifestations of Congenital Insensitivity to Pain With Anhidrosis: A Report of 24 Cases","volume":"69","author":"Bodner L.","year":"2002","journal-title":"ASDC Journal of Dentistry for Children"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10006-015-0486-5"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.01.011"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2012.07.008"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002470100506"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-017-1387-z"},{"issue":"2","key":"e_1_2_11_17_1","first-page":"83","article-title":"Hereditary Sensory and Autonomic Neuropathy Type IV in a 9\u2010Year\u2010Old Boy: A Case Report","volume":"10","author":"Azadvari M.","year":"2016","journal-title":"Iranian Journal of Child Neurology"},{"issue":"2","key":"e_1_2_11_18_1","first-page":"80","article-title":"Congenital Insensitivity to Pain With Anhidrosis in Sudanese Children","volume":"16","author":"Othman S. 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