A question of lineage.
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This report demonstrates a simple endodontic solution to an interdisciplinary case of a patient with multiple gene deficiencies. An adolescent patient presented with an impacted premolar that could not be extracted due to high-risk conditions. A suspicious degree of radiolucency around the crown was clinically diagnosed as dentigerous cyst. The treatment dilemma and implementation are discussed. This case report offers a different treatment option for impacted teeth when significant differential diagnosis of a pericoronal lesion dictates treatment.
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PATIENT: A 23-year-old female was seen with a major complaint involving problems of esthetic and masticatory function, since her posterior teeth had collapsed due to enamel hypocalcification. Radiographic examination suggested that many teeth were affected by periodontitis apicalis. DISCUSSION: Combined periodontal and prosthetic treatments including a crown lengthening procedure enabled us to fabricate esthetic and functional restorations. CONCLUSION: The crown lengthening procedure sometimes involves the loss of alveolar bone. In this case, however, the treatments were successful owing to the sufficient volume of bone available. As a result, the prosthesis achieved optimal plaque control. This clinical report describes the effectiveness of the periodontal and prosthetic treatments for enamel hypocalcification.
According to clinical studies, infants of diabetic mothers (IDM) seem to run a higher risk of mineralization disturbances in the enamel than normal healthy infants. In order to evaluate this observation at the histologic level, exfoliated primary incisors were collected from 74 IDM, representing two types of care during gestation and the perinatal period, and from 52 healthy children. The width of the neonatal line was evaluated in the enamel and the dentin by study of bucco-lingual undemineralized sections. Pre- and postnatal enamel was classified according to discolorations, deviations of prisms and hypoplasia. Microradiographic studies included measurements of the neonatal lines and classification of the degree of mineralization in the pre- and postnatal dental hard tissues. Irrespective of treatment, the IDM showed a significantly higher incidence of widened neonatal lines and also an increased frequency of postnatal disturbances compared to the controls. The observations are discussed against the background of the neonatal hypocalcemia reported in IDM.
The increased importance of congenital anomalies in childhood disease is stressed. It is suggested that treatment and research in congential craniofacial anomalies would benefit from centralized registration. Their clinical management should be delegated to centres with a multidisciplinary team. Some problems related to genetic counselling and identification of microforms are illustrated by cleft lip and palate. An account is given of some orofacial anomalies.
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Three members of a family present definite features of the oculodentodigital (ODD) dysplasia and one presents only a few features. The mother shows no clinical evidence of the syndrome but does have an isolated cleft of the palate. The syndrome is compatible with Mendelian autosomal dominant inheritance with father-to-son transmission. The variable expression of the gene in the three affected members is clearly demonstrable.
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Mapped phenotype of imperfect amelogenesis, type II imperfect dentinogenesis, hereditary opalescent dentin, Capdepont's dysplasia, and type II dentin dysplasia is described for the first time in Russia. Classification of hereditary disorders in dentin development is presented.
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Tuberous sclerosis complex (TSC) is an autosomal dominantly inherited disease. It is clinically a very variable disorder. Hamartomas can develop in many different organs, including the skin, kidneys, heart and brain. Diagnosis of patients with minimal expression of the disease can be very difficult. The dentist can contribute to the (early) diagnosis of the disease.
This article identifies certain syndromes of the head and neck, which a dentist may see in clinical practice, and relates these syndromes to their sites of mutation on involved genes. This paper is timely with the near completion of the Human Genome Project, the mapping of the entire human genetic material. Knowing the site of the genetic lesion is important in helping clinicians understand the genetic basis for these conditions, and may help in our future understanding of remedies and treatments.
Cancer is the second most common cause of mortality in childhood. Complex therapy decreases the rate of mortality, but chemotherapy and irradiation may, however, create acute and long-term side effects. Although immuno- and myelo-suppressive side effects of anti-neoplastic therapy are unavoidable, their detrimental impact on oral health can and should be avoided contributing to a better quality of life of these children.
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