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2002 BSPD Clinical Case Presentations, sponsored by South Yorkshire branch of BSPD

Identifieur interne : 002961 ( Istex/Corpus ); précédent : 002960; suivant : 002962

2002 BSPD Clinical Case Presentations, sponsored by South Yorkshire branch of BSPD

Auteurs :

Source :

RBID : ISTEX:546E71656C088DE86EFBE9F00475CBB75FF9A67B

English descriptors

Abstract

Presenting problem. The parents requested that we improve the appearance of their 10‐year‐old child's teeth. She had lost occlusal vertical dimension and had cold sores at right and left commissures of her lips. She had gross caries involving her primary and permanent dentitions, hypodontia, microdontia and very poor oral hygiene. She was missing 18, 17, 15, 12, 22, 25, 27, 28, 38, 37, 35, 31, 41, 45, 47 and 48. The unerupted 14 had arrested root development associated with a periradicular infection in 54. Clinical management. Preventive advice was given. 54 was extracted and the development of 14 was monitored. The first permanent molars were restored with stainless steel crowns. 21 was root filled. 53, 52, 21, 62 and 63 were restored with composite. Composite veneers were placed on 11, 81 and 71. 55 and 65 were restored with glass ionomer cement. An orthodontic consultation was obtained. Discussion. The occlusal vertical dimension, function and aesthetics were restored. Space for missing units was retained by maintaining their primary predecessors. Tooth 14 erupted and root development is now complete. This case illustrates that even in the case of a long‐standing chronic infection in a primary molar arrest of root development in the successor may be transient. Extraction of the primary predecessor and monitoring the successor should be considered before enucleation of the permanent tooth germ. In this case a vital unit remains in a quadrant that is already missing three units.

Url:
DOI: 10.1046/j.1365-263X.2002.00005.x

Links to Exploration step

ISTEX:546E71656C088DE86EFBE9F00475CBB75FF9A67B

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<div type="abstract" xml:lang="en">Presenting problem. The parents requested that we improve the appearance of their 10‐year‐old child's teeth. She had lost occlusal vertical dimension and had cold sores at right and left commissures of her lips. She had gross caries involving her primary and permanent dentitions, hypodontia, microdontia and very poor oral hygiene. She was missing 18, 17, 15, 12, 22, 25, 27, 28, 38, 37, 35, 31, 41, 45, 47 and 48. The unerupted 14 had arrested root development associated with a periradicular infection in 54. Clinical management. Preventive advice was given. 54 was extracted and the development of 14 was monitored. The first permanent molars were restored with stainless steel crowns. 21 was root filled. 53, 52, 21, 62 and 63 were restored with composite. Composite veneers were placed on 11, 81 and 71. 55 and 65 were restored with glass ionomer cement. An orthodontic consultation was obtained. Discussion. The occlusal vertical dimension, function and aesthetics were restored. Space for missing units was retained by maintaining their primary predecessors. Tooth 14 erupted and root development is now complete. This case illustrates that even in the case of a long‐standing chronic infection in a primary molar arrest of root development in the successor may be transient. Extraction of the primary predecessor and monitoring the successor should be considered before enucleation of the permanent tooth germ. In this case a vital unit remains in a quadrant that is already missing three units.</div>
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<abstract>Presenting problem. The parents requested that we improve the appearance of their 10‐year‐old child's teeth. She had lost occlusal vertical dimension and had cold sores at right and left commissures of her lips. She had gross caries involving her primary and permanent dentitions, hypodontia, microdontia and very poor oral hygiene. She was missing 18, 17, 15, 12, 22, 25, 27, 28, 38, 37, 35, 31, 41, 45, 47 and 48. The unerupted 14 had arrested root development associated with a periradicular infection in 54. Clinical management. Preventive advice was given. 54 was extracted and the development of 14 was monitored. The first permanent molars were restored with stainless steel crowns. 21 was root filled. 53, 52, 21, 62 and 63 were restored with composite. Composite veneers were placed on 11, 81 and 71. 55 and 65 were restored with glass ionomer cement. An orthodontic consultation was obtained. Discussion. The occlusal vertical dimension, function and aesthetics were restored. Space for missing units was retained by maintaining their primary predecessors. Tooth 14 erupted and root development is now complete. This case illustrates that even in the case of a long‐standing chronic infection in a primary molar arrest of root development in the successor may be transient. Extraction of the primary predecessor and monitoring the successor should be considered before enucleation of the permanent tooth germ. In this case a vital unit remains in a quadrant that is already missing three units.</abstract>
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<abstract lang="en">Presenting problem. The parents requested that we improve the appearance of their 10‐year‐old child's teeth. She had lost occlusal vertical dimension and had cold sores at right and left commissures of her lips. She had gross caries involving her primary and permanent dentitions, hypodontia, microdontia and very poor oral hygiene. She was missing 18, 17, 15, 12, 22, 25, 27, 28, 38, 37, 35, 31, 41, 45, 47 and 48. The unerupted 14 had arrested root development associated with a periradicular infection in 54. Clinical management. Preventive advice was given. 54 was extracted and the development of 14 was monitored. The first permanent molars were restored with stainless steel crowns. 21 was root filled. 53, 52, 21, 62 and 63 were restored with composite. Composite veneers were placed on 11, 81 and 71. 55 and 65 were restored with glass ionomer cement. An orthodontic consultation was obtained. Discussion. The occlusal vertical dimension, function and aesthetics were restored. Space for missing units was retained by maintaining their primary predecessors. Tooth 14 erupted and root development is now complete. This case illustrates that even in the case of a long‐standing chronic infection in a primary molar arrest of root development in the successor may be transient. Extraction of the primary predecessor and monitoring the successor should be considered before enucleation of the permanent tooth germ. In this case a vital unit remains in a quadrant that is already missing three units.</abstract>
<abstract lang="en">Presenting problem. This report describes an 8‐year‐old girl who was referred due to abnormal mobility of newly erupted lower permanent incisors. Clinical management. Clinical examination revealed that the patient was small for her age. There was marked frontal bossing, depressed nasal bridge, high anterior hairline and temporal balding. Her hair were fine and scanty. Intra‐oral examination revealed that she was in the early mixed dentition. The lower permanent central incisors had grade 2–3 mobility. Radiographic examination revealed the absence of root development of all the anterior teeth. The primary molar roots were taurodont and the follicles of the developing permanent premolars were displaced. An initial diagnosis of tricho‐dento‐osseous syndrome or ectodermal dysplasia was made. This initial diagnosis was revised following screening by the clinical genetics department. The teeth were initially splinted and about 6 months later; the signs of root development became obvious. Since then, the lower lateral incisors and the upper permanent incisors have erupted and also shown similar problems as the lower teeth. These have now been splinted with the hope of encouraging root development. A diagnosis is still being awaited.</abstract>
<abstract lang="en">Presenting problem. The link of Noonan syndrome with cherubism derives from the presence of multiple giant cell lesions within the mandible and maxilla. The following is of one such case. A 9‐year‐old girl was referred to the Oral and Maxillofacial Unit at the Royal Liverpool Children's Hospital by her general dental practitioner for an opinion concerning a 2‐month history of swelling and tenderness affecting the left side of her mandible. The patient's medical history included Noonan syndrome. Clinical management. Radiographic and subsequent CT scanning of the mandible confirmed the presence of bilateral expansile cystic lesions occupying both angles and rami. Subsequently, the patient underwent a general anaesthetic for the surgical exploration and biopsy of the left side. The histopathological features were considered to be indistinguishable from a central giant cell lesion, and given the lateral position and symmetry of the lesions, a diagnosis of cherubism could be reached. Discussion. Noonan syndrome is characterized by short stature, various congenital heart defects, webbed neck, chest deformity, hypertelorism, ptosis, low set ears and mild mental deficiency. Cherubism manifests itself in early childhood and affects the mandible and maxilla almost exclusively. The patient exhibits a progressive, painless, symmetrical swelling of the jaws, producing the typical chubby face suggestive of a cherub. Noonan syndrome and cherubism are so essentially different that a common link is difficult to foresee. It may be possible that they are independent diseases transmitted by genes that are closely linked on the same chromosome. To date, this rare syndrome still requires considerable investigation.</abstract>
<abstract lang="en">Presenting problem. A 2‐year‐old child was referred to the Department of Child Dental Health for specialist care. From early infancy he presented with problems in feeding, limited mouth opening, a hypoplastic mandible, a tendency to grind his teeth and later on speech difficulties and restricted movements, mainly of the head and neck. At the age of 6 years, a diagnosis of Worster‐Drought Syndrome (WDS) was made. Clinical management. A multidisciplinary approach was used, involving the paediatrician, neurologist, speech therapist, physiotherapist, osteopath and paediatric dentist. Dental management consisted mainly of a vigorous preventive regime, i.e. oral hygiene instruction, diet advice and fluoride therapy. A mouth exerciser based on a Swedish design was provided and an improvement in jaw movement was reported. Discussion. Named after Dr Worster‐Drought who first described it in 1956, WDS is a form of cerebral palsy mainly affecting muscles involving lips, jaws, tongue, palate, pharynx and upper oesophagus, which can be affected to variable degrees. Children may have problems with eating, drinking, swallowing, dribbling and speech. This complex condition can be associated with learning difficulties and epilepsy but the presentation may be very different in each case. Involvement by the dental specialist should begin in early infancy in order to prevent disease, the treatment of which would be extremely difficult in view of limited opening. This case highlights the unusual orofacial features of patients with WDS and a coordinated approach to its management from a team of medical and dental specialists.</abstract>
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