{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:09:43Z","timestamp":1790240983058,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the stepwise, atraumatic dental management of a pediatric patient with severe recessive dystrophic epidermolysis bullosa (RDEB), emphasizing conservative caries arrest, the challenges of restorative care within a severely microstomia\u2010limited oral opening, and coordinated multidisciplinary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>A male patient with severe RDEB was followed at a university pediatric dental clinic from Age 13 to 14 years within a dental home maintained since infancy. Serial silver diamine fluoride applications arrested multiple occlusal carious lesions. Glass ionomer sealants were placed on seven teeth without retraction or mirror use. At Age 14, comprehensive restorative care under general anesthesia included stainless\u2010steel crown placement on a mandibular first molar and glass ionomer restorations on two additional teeth, all accomplished through a maximum interincisal opening of approximately 30\u00a0mm. Fiber\u2010optic nasal intubation required multiple attempts. Six\u2010month follow\u2010up confirmed caries\u2010free status and intact restorations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A guideline\u2010driven, stepwise protocol combining conservative caries arrest, glass ionomer sealants and restorations, and targeted general anesthesia care preserved oral function while minimizing mucosal trauma. Multidisciplinary coordination supported the care episode, with anesthesiology managing the difficult airway, dermatology advising on the treatment setting and mucosal protection, and hematology optimizing the patient's baseline iron\u2010deficiency anemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scd.70256","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:47:24Z","timestamp":1790239644000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimally Invasive Caries Arrest and Oral Rehabilitation for a Patient With Severe Recessive Dystrophic Epidermolysis Bullosa"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0986-7869","authenticated-orcid":false,"given":"David K.","family":"Langford","sequence":"first","affiliation":[{"name":"Department of Pediatric Dentistry University of Florida College of Dentistry  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan N.","family":"Sorsok","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry University of Florida College of Dentistry  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7331-4364","authenticated-orcid":false,"given":"Tung T.","family":"Wynn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hematology\u2010Oncology Department of Pediatrics University of Florida College of Medicine  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8274-465X","authenticated-orcid":false,"given":"Marcio","family":"Guelmann","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry University of Florida College of Dentistry  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3677-744X","authenticated-orcid":false,"given":"Sandra Natalia Gonzalez","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology University of Florida College of Medicine  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"1","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/scd.12511","article-title":"Clinical Practice Guidelines: Oral Health Care for Children and Adults Living With Epidermolysis Bullosa","volume":"40","author":"Kramer S. M.","year":"2020","journal-title":"Special Care in Dentistry"},{"issue":"4","key":"e_1_2_7_3_1","first-page":"242","article-title":"Hereditary Epidermolysis Bullosa: Oral Manifestations and Dental Management","volume":"15","author":"Wright J. T.","year":"1993","journal-title":"Pediatric Dentistry"},{"issue":"15","key":"e_1_2_7_4_1","first-page":"4567","article-title":"Treatment of Epidermolysis Bullosa and Future Directions","volume":"13","author":"Danescu S.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"issue":"4","key":"e_1_2_7_5_1","first-page":"187","article-title":"The Dental Management of Patients With Recessive Dystrophic Epidermolysis Bullosa: A Case Report of Two Siblings","volume":"78","author":"Fourie J.","year":"2023","journal-title":"South African Dental Journal"},{"issue":"4","key":"e_1_2_7_6_1","first-page":"211","article-title":"Epidermolysis Bullosa, Dental and Anesthetic Management: A Case Report","volume":"15","author":"Esfahanizade K.","year":"2014","journal-title":"Journal of Dentistry (Shiraz)"},{"issue":"9","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"998","DOI":"10.28982\/josam.872798","article-title":"Anesthesia Management in Dystrophic Epidermolysis Bullosa: A Case Report","volume":"5","author":"Tetiker S.","year":"2021","journal-title":"Journal of Surgery and Medicine"},{"issue":"1","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1186\/s12903-024-04861-y","article-title":"The Dental Needs of Children With Epidermolysis Bullosa and Service Delivery: A Scoping Review","volume":"24","author":"Smith Z.","year":"2024","journal-title":"BMC Oral Health"},{"issue":"4","key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/bjd.18921","article-title":"Consensus Reclassification of Inherited Epidermolysis Bullosa and Other Disorders With Skin Fragility","volume":"183","author":"Has C.","year":"2020","journal-title":"British Journal of Dermatology"},{"issue":"6","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/scd.12515","article-title":"Early Teeth Extraction in Patients With Generalized Recessive Dystrophic Epidermolysis Bullosa: A Case Series","volume":"40","author":"V\u00e9liz S.","year":"2020","journal-title":"Special Care in Dentistry"},{"issue":"24","key":"e_1_2_7_11_1","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1056\/NEJMoa2206663","article-title":"Trial of Beremagene Geperpavec (B\u2010VEC) for Dystrophic Epidermolysis Bullosa","volume":"387","author":"Guide S. V.","year":"2022","journal-title":"New England Journal of Medicine"},{"issue":"12","key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s40265-023-01921-5","article-title":"Beremagene Geperpavec: First Approval","volume":"83","author":"Heo A.","year":"2023","journal-title":"Drugs"},{"issue":"5","key":"e_1_2_7_13_1","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/0030-4220(90)90401-D","article-title":"Comprehensive Dental Care and General Anesthetic Management of Hereditary Epidermolysis Bullosa. A Review of Fourteen Cases","volume":"70","author":"Wright J. T.","year":"1990","journal-title":"Oral Surgery, Oral Medicine, and Oral Pathology"},{"issue":"4","key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1213\/ANE.0000000000005749","article-title":"Anesthetic Management and Outcomes of Patients With Epidermolysis Bullosa: Experience at a Tertiary Referral Center","volume":"134","author":"Brooks Peterson M.","year":"2022","journal-title":"Anesthesia and Analgesia"},{"issue":"1","key":"e_1_2_7_15_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-263X.2012.01247.x","article-title":"Oral Health Care for Patients With Epidermolysis Bullosa: Best Clinical Practice Guidelines","volume":"22","author":"Kramer S. M.","year":"2012","journal-title":"International Journal of Paediatric Dentistry"},{"key":"e_1_2_7_16_1","first-page":"364","volume-title":"The Reference Manual of Pediatric Dentistry","author":"American Academy of Pediatric Dentistry","year":"2025"},{"issue":"5","key":"e_1_2_7_17_1","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/scd.12808","article-title":"Impression Technique Modification and Oral Contracture Release Surgery for Orthodontic Treatment in a Patient With Severe Microstomia Due to Recessive Dystrophic Epidermolysis Bullosa","volume":"43","author":"V\u00e9liz M\u00e9ndez S.","year":"2023","journal-title":"Special Care in Dentistry"}],"container-title":["Special Care in Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scd.70256","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/scd.70256","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scd.70256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:47:27Z","timestamp":1790239647000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/scd.70256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1111\/scd.70256"],"URL":"https:\/\/doi.org\/10.1111\/scd.70256","archive":["Portico"],"relation":{},"ISSN":["0275-1879","1754-4505"],"issn-type":[{"value":"0275-1879","type":"print"},{"value":"1754-4505","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70256"}}