1/7. Acute porphyric disorders.Acute porphyrias are classified into 3 distinct groups of rare genetic disorders of metabolic enzyme biosynthesis. Acute porphyrias can significantly impact multiple organ systems, which often provides a challenge to the dentist presented with such a patient. A case of hereditary coproporphyria is reported in a patient with many of the classical signs and symptoms. The patient also had complex dental needs that required special medical and pharmacotherapeutic modifications. The acute porphyrias are reviewed by the authors with presentation of this challenging case. Recommendations for other dental health care professionals encountering these patients are then presented.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/7. focal dermal hypoplasia: management of complex dental features.A 17 year-old female who presented for treatment of grossly carious lower first molar teeth had multiple features of focal dermal hypoplasia (FDH). These included enamel pitting and hypoplasia, anomalies of shape, size and positioning of teeth, as well as soft tissue papillomas and telangiectasis of tongue. A case report and a synopsis of the syndrome (FDH) are presented, the oral aspects of the condition are reviewed and the management of the complex dental anomalies is discussed.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
3/7. Oral rehabilitation of young adults with amelogenesis imperfecta.PURPOSE: This article describes the restorative management of two patients in whom the diagnosis of amelogenesis imperfecta was not made until young adulthood. MATERIALS AND methods: amelogenesis imperfecta is a variable developmental abnormality of the tooth enamel that affects relatively few persons. Previous case reports have focused largely on the early management of children and young adolescents. However, some patients may not be diagnosed correctly or may not request dental treatment until they are older, as with the two cases presented. In some instances, parents fail to appreciate the importance of early intervention. RESULTS: Both patients required intensive preventive therapy and extensive restorative treatment over several years. The correct sequencing of treatment phases was required to achieve relief of pain and provide satisfactory function and esthetics. CONCLUSION: The two cases presented illustrate the degree of complexity that extended restorative treatments can involve, especially following severe tooth wear and poor bonding of restorations to the affected enamel.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
4/7. dyskeratosis congenita: dental management of a medically complex child.dyskeratosis congenita (DKC) is a rare syndrome characterized by cutaneous hyperpigmentation, nail dystrophy, leukoplakia, and pancytopenia. The purpose of this case study was to describe the management of a 7-year-old girl diagnosed with DKC who urgently needed dental treatment under general anesthesia before bone marrow transplantation (BMT). The patient presented normal skin, nails, and hair, but oral examination revealed a number of ulcers, leukoplakia, gingival recessions, alveolar bone loss, and dental caries. Hematologic preparation included raising blood parameters, and the anesthesiologist to had consider pulmonary infection. The alveolar bone loss and the gingival recessions required the consultation of a periodontist. Avoiding stainless steel crowns was necessary due to potential plaque accumulation in the crown margins. The goal of this dental treatment was eliminating potential sources of infection before transplantation was conducted. It is important for the pediatric dentist to recognize the medical aspects associated with dental management prior to BMT, and to incorporate them into the treatment plan.- - - - - - - - - - ranking = 4keywords = complex (Clic here for more details about this article) |
5/7. Prader-Labhart-Willi syndrome.Prader-Labhart-Willi syndrome is a complex, multisystem sporadic disorder which presents during childhood and proceeds into adulthood. The major features include infantile hypotonia, developmental delay, hypogonadism with abnormal sexual maturation, mental retardation and behavior abnormalities, short stature with small hands and feet, massive obesity with diabetes mellitus, dysmorphic facial features, and marked dental caries and enamel hypoplasia. Recently, a deletion of chromosome 15 has been found in a large percentage of these patients, but the exact cause and genetic transmission has not yet been determined. Two cases of Prader-Labhart-Willi syndrome are presented with emphasis on the differential diagnosis of enamel hypoplasia associated with sexual maturation.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
6/7. Anticipating failure in extensive restorative treatment of the periodontally compromised patient.If even one supporting tooth fails, a complex restorative treatment may have to be redone. Improved design of a restoration can anticipate failure and offer alterations to existing appliances.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
7/7. Periodontal, implant, and prosthetic treatment for advanced periodontal disease.This article reports a case that involved a challenge in multidisciplinary decision making. A patient presented with severe periodontal disease and the need for prosthetic rehabilitation for purposes of tooth replacement and the stabilization of periodontally compromised teeth. The initial diagnosis revealed that the treatment regimen would require periodontic, endodontic, and orthodontic treatment, as well as dental implants. This case report demonstrates teamwork and a sequential approach to a complex case in a postgraduate clinical setting.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |