Management of subluxation injury in a thumb-sucking child: a case report

Abstract –  This case report presents use of a custom trauma splint that was fabricated to prevent excessive thumb-sucking trauma to a previously-subluxated permanent incisor. A 10-year-old boy was referred to the clinic 10 days after falling in the schoolyard that resulted in a trauma to his maxillary left central incisor. The extent of clinical mobility stipulated fabrication of a custom trauma splint that would prevent further trauma to the incisor caused by excessive pressure of the thumb. A light-cured resin composite splint, covering the incisal edges of the central incisors and labial surfaces of the lateral incisors was made, and approximately 1-mm composite within the impressions of central incisors were trimmed off. The splint was bonded to the neighboring lateral incisors with flowable resin composite and root canal therapy was initiated on the subluxated incisor. After one week, the patient stopped his sucking habit completely. The treatment not only allowed for complete healing of the subluxated incisor without being exposed to further trauma, but also for spontaneous eruption of the tooth and closure of the existing open-bite.     

The use of a neoprene thumb-sock to prevent trauma in a thumb-sucking child with intractable epilepsy

A nine-year-old girl with spastic quadripiegia, mental retardation, poor vision, a gastrostomy, and intractable epilepsy was referred by her pediatrician for a dental assessment with a view to extracting her anterior teeth as a means of preventing repeated damage to the skin over the proximal phalanx of her left thumb, which she sucked at night. This was the time of day when the frequency of her epileptic seizures was highest. A simple solution to the problem was developed by a dentist and an occupational therapist In which nylon-coated 3-mm neoprene sheeting (wet-suit material) was formed into a thumb-sock with a simple Velcro fastening around the wrist. No trauma to the thumb from epileptic seizures has occurred since the thumb-sock was fitted 24 months ago .     

M-mode echomyography: functional assessment of the effects of thumb-sucking habit on masticatory and circumoral musculature

Aim  

To assess and compare the function of masticatory and circumoral musculature in patients with and without thumb-sucking habit by using M-mode ultrasonography.     

Dental treatment of a child with Rubinstein-Taybi syndrome

Rubinstein-Taybi syndrome (RTS) is a human genetic disorder characterized by mental retardation and physical abnormalities including broad thumbs, big and broad toes, short stature, and craniofacial anomalies. The oral manifestations include small oral opening, pouting lower lip, retro/micrognathia. and higher arched, narrow palate. The purpose of this case report was to demonstrate the complicated dental treatment of a 12-year-old, developmentally disabled girl, living with a foster family, who suffered from RTS, extensive caries, and very poor oral hygiene. The patient demonstrated total lack of cooperation. The dental treatment had been carried out under general anesthesia (GA). Possible problems during GA in such patients are described. Fiberoptic video-assisted bronchoscope was prepared for the GA in case of airway emergency and/or difficult intubation. The GA process was uneventful, despite the extensive treatment delivered to the patient. Prospects for future good oral and dental status in this patient are questionable because of her extreme lack of cooperation.     

An unusual sucking habit in a child

Presence of oral habit in 3-6 year old children is an important finding in the clinical examination. An oral habit is no longer considered as normal for children near the end of this age group. In pre-school children, digit and dummy sucking is a predominant habit, and girls are found to have a higher level of sucking habit then boys do. Here is a case report of a unique sucking habit, which if not stopped, will lead to dental problem in the child.     

Hurler's syndrome: dental findings in a case treated with bone marrow transplantation in infancy

Hurler's syndrome, also known as mucopolysaccharidosis I (MPS I-H), is a rare condition inherited as an autosomal recessive trait. It is caused by a deficiency in alpha-L-iduronidase, an enzyme that participates in the degradation of the glycosaminoglycans (GAGs) heparin sulphate and dermatan sulphate. Children with Hurler's syndrome appear nearly normal at birth but, left untreated, show a progressive mental and physical deterioration caused by a build-up of GAGs in all organs of the body. Death is often caused by cardiac or respiratory failure and usually occurs before the second decade of life. In recent years, bone marrow transplantation (BMT) has been employed in the management of patients with Hurler's syndrome. However, the dental findings observed in these cases have not previously been reported in the dental literature. Here we report a patient aged 11 years and 6 months, presented to a Specialist Paediatric Dentistry Unit, who was successfully treated by BMT at 18 months of age.     

Oral findings and dental treatment in a child with West syndrome

West syndrome (WS) is a rare, severe form of epilepsy that typically manifests early in infancy. It is considered a malignant condition that combines episodes of spasms that occur in clusters (infantile spasm), hypsarrhythmia on the electroencephalogram, and neuropsychomotor delay. Although WS has been widely investigated from a medical standpoint, few reports have focused on the oral findings in patients with this syndrome. This article reports the case history of a 7-year-old child diagnosed with WS. The major clinical features were generalized tooth wear and gingival enlargement, altered chronology and sequence of dental eruption, primary canine cusp-to-cusp relationship, ectopic dental eruption, and mildly arched palate. Multiple white spot lesions were also observed, possibly associated with poor oral hygiene, due to a fermentable carbohydrate-rich diet, and continuous use of sugar-containing medications. Dental care management of patients with special needs is discussed and the dental treatment for this child with WS is described.     

Clinical treatment of oral manifestations of Beckwith-Wiedeman syndrome in a child

Orthodontic treatment in a young patient with Beckwith-Wiedeman Syndrome (BWS) is reported and a multidisciplinary approach to the management of this syndrome is reviewed. The patient presented with a tendency to Class III malocclusion, an open-bite and a slight macroglossia, which was treated at an early age by glossotomy. It was decided to monitor growth without treatment and to wait for the best time to begin therapy. It was based only on functional rehabilitation, without any fixed appliances, in which optimum intercuspation of the teeth and the skeletal Class I relationship was achieved and maintained after the retention period of three years. In conclusion the treatment of BWS patients requires a multidisciplinary approach that includes orthodontics, orthopaedics and surgical intervention. It is also necessary to underline the significance of diagnosis at an early age and timely treatment to reduce the development of dento-skeletal alterations.     

Prilocaine-induced methemoglobinemia in a child with Shwachman syndrome

A case of methemoglobinemia after injection of prilocaine in a patient who had Shwachman syndrome (Shwachman-Diamond syndrome) is presented. The report reinforces the need to be cognizant of dose/weight/mass relationships in patients receiving medications capable of oxidizing hemoglobin.     

Orofacial manifestations in a child with Fanconi's syndrome

Orofacial and dental findings in a child with Fanconi's syndrome and accompanying glycogen storage disease are presented. Remarkable retardation of skeletal growth, resulting in dwarfism, was noted. Cephalometric analyses revealed that the size of the patient's craniofacial bones at 10 years of age was as small as that of the average 4-year-old child. Development of the permanent dentition was retarded for 3 to 4 years. Histologic examination of an exfoliated primary canine showed hypomineralization of the dentin structure.     

Treatment of macroglossia in a child with Weaver syndrome

Weaver syndrome is a rare disorder, characterized by accelerated growth, advanced osseous maturation and distinct craniofacial features. Macroglossia and hypothyroidism are seldom mentioned in the literature as clinical findings associated with the syndrome. This paper describes a patient with Weaver syndrome, referred for consultation and treatment of macroglossia, who also suffered from congenital hypothyroidism. This is the first reported case of Weaver syndrome treated with partial glossectomy (tongue reduction). The paper describes the clinical findings of the syndrome, emphasizing the difficulty in identifying it, the indications for partial glossectomy and the authors' recommended operative technique.     

An innovative approach to cessation of thumb‐sucking in a child with epilepsy: a case report

The thumb‐sucking habit is acquired in infancy, but if it persists beyond preschool age, it can have deleterious effects on facial growth, oral function, occlusal relationship, and aesthetics, leading to dental and skeletal deformities. This paper presents a clinical case history of using nonpunitive reminder therapy to intercept the thumb‐sucking habits of an 8‐year‐old child with epilepsy. A modified Bluegrass appliance was used along with the positive reinforcement. The modified Bluegrass appliance utilized an acrylic roller and was very comfortable for the patient; it was also successful in eliminating the habit within a short period of time.     

Dental findings of a child with Wolf-Hirschhorn syndrome

The case presented is that of a 5-year-old female with Wolf-Hirschhorn syndrome. Dental findings were severe hypodontia, late dental development, taurodontism of the primary molars, microdontia, and spacing. Hypodontia has previously been reported and therefore this case adds to the evidence that hypodontia may be a common feature of this syndrome. It also suggests that other dental anomalies could occur in children with Wolf-Hirschhorn syndrome.