Anodontia

厌食症
  • 文章类型: Case Reports
    无汗性外胚层发育不良(AED),或者Christ-Siemens-Touraine综合征,是X连锁隐性皮肤病.罕见的发病率,它影响了十万分之一的新生儿,主要是男孩。通过这个观察,我们详述了导致我们怀疑诊断的临床症状,这种病理是如何被证实的,以及我们进行的治疗管理。我们介绍了一个10个月大的男孩,其表现改变了几乎所有的外胚层结构,如皮肤,头发,指甲,牙齿,皮脂腺,汗腺,和泪腺。他也有完全的牙齿缺失和口干。在各种卫生专业人员的合作下,对患者进行了多学科治疗。尽管Christ-Siemens-Touraine综合征是一种罕见的疾病,尽早认识到这一点对改善这些患者的护理和预后至关重要,同时减轻病情对儿童和父母的心理影响。
    Anhidrotic ectodermal dysplasia (AED), or Christ-Siemens-Touraine syndrome, is an X-linked recessive dermatosis. Rare in incidence, it affects 1 in 100,000 births, mostly boys. Through this observation, we detail the clinical signs that led us to suspect the diagnosis, how this pathology was confirmed, and the therapeutic management we carried out. We present a case of a 10-month-old boy presenting with altered manifestations affecting almost all the ectodermal structures like skin, hair, nails, teeth, sebaceous glands, sweat glands, and tear glands. He also had complete anodontia and a dry mouth. A multidisciplinary treatment was given to the patient with the collaboration of various health professionals. Although Christ-Siemens-Touraine syndrome is a rare condition, it is vital to recognize it early to improve care and prognosis for these patients, while mitigating the psychological impact of the condition on both children and parents.
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  • 文章类型: Journal Article
    我们的职业有责任重新评估我们对常规更换缺失的单个上颌切牙的偏好,尤其是上颌侧切牙,在一个年轻的成年人的牙科植入物。牙科文献充满了使用该领域植入物的美丽修复效果,但是关于这种治疗的长期后果的讨论很少。上颌侧切牙是最常见的牙齿缺失之一,它也是最常见的牙齿之一,由于创伤在发育中的儿童。更换的决定必须考虑长远,因为这些修复物通常放置在18至21岁之间,并且必须为患者服务数十年。植入物可能与并发症甚至失败有关的原因有很多,包括以下内容:(1)颅面持续生长,它具有主要的前部和垂直分量,并已被证明发生在上颌骨,导致植入物牙冠明显浸没,因为天然牙齿相对于植入物2,3-没有证据表明这可以预测,更不用说它可能发生在多远的未来;(2)种植体周围炎,根据最近的系统评价的结果,其患者水平的患病率估计接近25%;4(3)由于植入物放置不良而导致的植入物周围粘膜变薄和衰退,假体管理不足,和/或案例选择不佳,经常导致美学受损和种植体周围疾病的发生和发展的倾向;和(4)植入物的机械故障,基台螺钉,经粘膜基台,和/或皇冠。临床医生也应该记住,一旦植入物被放置在上颌骨前部,它排除了成人患者腭扩张的可能性,因为扩张产生的空间不能在正畸上重新分布。犬牙置换是一种传统的上颌侧切牙置换方法。当犬齿具有可接受的形状和颜色时,它仍然是一个可行的选择,并且替代不会损害遮挡。5此外,粘结单翼氧化锆桥已成为主要的治疗选择。6氧化锆具有金属的强度和瓷质的美感,这使得它成为粘合桥的理想基底。文献已经证明了这种替代方法对于缺失的上颌切牙的长期成功。7在年轻人中,用植入物替代单个缺失的上颌切牙显然有许多潜在的长期缺点。我们应该为更换这些牙齿开出侵入性最小的治疗方案。因此,当年轻成年人上颌切牙缺失的治疗计划时,植入物治疗的替代方法-例如粘合的单翼氧化锆桥和犬替代-应该是主要的治疗选择。仅当其他选择不可行或先前失败时,才应将植入物视为二次治疗。
    It is incumbent upon our profession to reevaluate our preference for routinely replacing a missing single maxillary incisor, especially a maxillary lateral incisor, with a dental implant in a young adult. The dental literature is replete with beautiful restorative results using implants in this area, but there is minimal discussion regarding the long-term consequences of this treatment. The maxillary lateral incisor is one of the most commonly missing teeth due to agenesis, and it is also one of the most common teeth to be lost due to trauma in the developing child.1 Therefore, the decision for replacement must be made with the long-term in mind, as these restorations are commonly placed between ages 18 and 21 and must serve the patient for many decades. There are several reasons that implants can be associated with complications or even fail, including the following: (1) Continued craniofacial growth, which has a predominant anterior and vertical component and has been shown to occur in the maxilla, resulting in the apparent submersion of the implant crown as the natural teeth move incisally in relation to the implant2,3-there is no evidence that this can be predicted, let alone how far into the future it may happen; (2) peri-implantitis, which has a patient-level prevalence estimate of nearly 25% according to the findings of a recent systematic review;4 (3) thinning and recession of the peri-implant mucosa due to poor implant placement, inadequate prosthetic management, and/or poor case selection, often resulting in compromised esthetics and a predisposition for the onset and progression of peri-implant diseases; and (4) mechanical failure of the implant, abutment screw, transmucosal abutment, and/or crown. Clinicians should also keep in mind that, once an implant is placed in the anterior maxilla, it precludes the possibility for palatal expansion in the adult patient because the space created by the expansion cannot be redistributed orthodontically. Canine substitution is one traditional method for replacement of the missing maxillary lateral incisor. It is still a viable option when the canine tooth has an acceptable shape and color, and the occlusion will not be compromised by the substitution.5 Additionally, the bonded single-wing zirconia bridge has become a primary treatment option.6 Zirconia has the strength of metal and beauty of porcelain, which makes it an ideal substrate for a bonded bridge. The literature has demonstrated the long-term success of this replacement option for the missing maxillary incisor.7 There are clearly many potential long-term disadvantages associated with replacing a single missing maxillary incisor with an implant in young adults. We should be prescribing the least-invasive treatment option for the replacement of these teeth. Therefore, when treatment-planning for a missing maxillary incisor in a young adult, alternatives to implant therapy-such as the bonded single-wing zirconia bridge and canine substitution-should be the primary treatment options. The implant should only be considered as a secondary treatment when the other options are not viable or have previously failed.
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  • 文章类型: Case Reports
    牙齿发育不全是人类最常见的发育异常之一,通常与其他几种口腔异常有关。本病例描述了一个21岁男孩的非家族性恒牙发育不全,没有明显的全身性异常。治疗包括涉及牙髓的个性化和跨学科方法,正畸学,植入物支持的修复和修复治疗。使用照相分析彻底阐述了治疗计划,研究模型,正像图,CBCT和脑电图。虚拟微笑设计,诊断打蜡和模型预先说明了治疗目标。通过插入牙科植入物和整体式氧化锆植入物支撑的修复体来重建无牙空间。最终结果显示了高度的美学和功能康复。定期检查表明,结果的稳定性得到了很好的保持,并且植入物支撑的修复体是患有多发性牙齿缺失症的患者的最佳解决方案。
    Dental agenesis is one of the most common developmental anomalies in humans and it is frequently associated with several other oral abnormalities. The present case describes non-familial agenesis of permanent teeth in a twenty-one-year-old boy with no apparent systemic abnormalities. The treatment included a personalized and interdisciplinary approach involving endodontics, orthodontics, implant-supported restorations and prosthetic treatments. The treatment plan was thoroughly elaborated using photographic analysis, study models, orthopantomogram, CBCT and cephalograms. Virtual smile design, diagnostic waxing and mock-ups previsualized the treatment objectives. The edentulous spaces were reconstructed by inserting dental implants and monolithic zirconia implant-supported restorations. The final results showed a highly esthetic and functional rehabilitation. Periodic check-ups have shown that the stability of the result is well maintained and that the implant-supported restorations are an optimal solution for patients with multiple anodontia.
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  • 文章类型: Case Reports
    在此病例报告中提供的患者是一个10岁的男孩,其骨骼过度发散II类,与第二前磨牙的家族遗传变异有关。选择的治疗计划是使用口腔固定的双腋窝矫治器关闭发育不全的空间。讨论了这种治疗方案的优缺点。结果是稳定的,可以避免植入假体溶液,随着时间的推移,这无疑会更加严格。
    The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time.
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  • 文章类型: Case Reports
    本文报道1例以多数恒牙先天缺失、余留牙不齐为临床表现的患者的多学科联合诊疗过程。通过多学科联合诊疗确定前牙位置并进行美学设计,正畸治疗排齐牙列,调整修复间隙,并通过数字化设计预测种植位点,最终完成种植修复并获得良好的疗效。文内总结并探讨以正畸-种植修复为核心的多学科联合诊疗多数恒牙先天缺失患者过程中的诊疗要点。.
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  • 文章类型: Case Reports
    牙齿发育不全是人类最常见的发育异常,它通常与各种其他口腔异常有关。Oligodontia,无牙齿,缺牙症是文献中用来表示牙齿缺失的词。虽然牙齿发育不全不是一个严重的公共卫生问题,它可以引起言语,咀嚼,美学,和功能问题。多学科方法是建立综合治疗计划的必要条件,咨询会议,和频繁的随访,为了获得稳定,功能,和心理康复,这将最终提高患者的生活质量。在这个案例研究中,在考虑了患者的年龄和成长以及他的财务状况之后,已讨论了一种保守的方法来修复非综合征性少牙患者,并进行了12年的随访和制造上颌覆盖义齿和下颌常规全口义齿。
    Dental agenesis is the most common developmental aberration in humans, and it is typically linked with a variety of other oral anomalies. Oligodontia, anodontia, and hypodontia are the words used in the literature to denote missing teeth. Although tooth agenesis is not a serious public health problem, it can cause speech, masticatory, aesthetic, and functional problems. A multidisciplinary approach is necessary to establish comprehensive treatment planning, counselling sessions, and frequent follow-ups, to obtain stable, functional, and psychological rehabilitation, which will eventually improves the patient\'s quality of life. In this case study, after considering the young age and growth of the patient and also his financial status, a conservative approach to rehabilitate the non-syndromic oligodontia patient with a 12-year follow-up and fabrication of maxillary overlay denture and mandibular conventional complete denture has been discussed.
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  • 文章类型: Case Reports
    背景:双齿是牙齿异常,可导致美学和正畸问题。
    方法:本报告讨论了两名9岁和10岁女孩的两例涉及融合有多余牙齿的永久性上颌左外侧切牙的多学科管理的病例。在口腔内和影像学检查之后,一个被诊断为融合,另一个被诊断患有癌症。使用毛刺分离融合的门牙的牙冠,并在口腔内提取。使用激光将凹陷的门牙沿其长度分开,并有意进行外种植。经过6年的随访,在融合切牙中未观察到病理征象。然而,经过11年的随访,在凹陷切牙中观察到外部吸收。
    结论:在整个观察期间,两种切牙均无症状。本病例报告重点介绍了两种不同的有效方法来保护自然功能,形式,和双门牙的美学。
    BACKGROUND: Double teeth are dental anomalies that can lead to aesthetic and orthodontic problems.
    METHODS: This report discusses two cases involving the multidisciplinary management of permanent maxillary left lateral incisors fused with a supernumerary tooth in two girls aged 9 and 10. Following intraoral and radiographic examinations, one was diagnosed with fusion, and the other was diagnosed with concrescence. The crown of the fused incisor was separated using a burs and extracted intraorally. The concrescent incisor was separated along its length using a laser and intentionally replanted extraorally. After a 6-year follow-up, no pathological signs were observed in the fused incisor. However, after an 11-year follow-up, external resorption was observed in the concrescent incisor.
    CONCLUSIONS: Both incisors remained asymptomatic throughout the observation period. This case report highlights two different and effective methods employed to preserve the natural function, form, and aesthetics of double incisors.
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  • 文章类型: Review
    背景:肾病综合征是一种以大量蛋白尿为特征的慢性疾病,低蛋白血症,高脂血症,和水肿。特发性微小病变是儿童中最常见的疾病。皮质类固醇是治疗特发性肾病综合征(INS)的基石,根据对治疗的反应和复发的频率,使用不同的治疗方案。此病例报告介绍了INS患者植入治疗后的并发症。
    方法:20岁女性患者接受植入咨询。病史包括儿童早期的INS,她正在服用不同的药物来控制病情,包括长期使用类固醇。牙科病史显示,在多次尝试后,植入物治疗均未成功。她在左下第一下颌磨牙区域植入了植入物,在射线照相检查中显示出增加的移动性和射线透明度。诊断为植入物失败,植入物被移除,该区域被清洁和缝合。患者决定用固定的局部义齿代替她缺失的牙齿,并被转诊为牙齿修复师。综述了类固醇使用的潜在不良反应以及可能影响骨代谢和植入物骨整合的潜在机制。
    结论:慢性类固醇使用者的牙种植管理需要临床实践指南。
    Nephrotic syndrome is a chronic disorder characterized by heavy proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Idiopathic minimal-change disease is the most common form encountered in children. Corticosteroids are the cornerstone for the treatment of idiopathic nephrotic syndrome (INS), with different regimens depending on the response to therapy and frequency of relapses. This case report presents complications after implant treatment in patient with INS.
    20 years old female patient presented for implant consultation. Medical history includes INS since early childhood, and she is on different medications to control her condition, including long-term steroid use. Dental history revealed that implant treatment was unsuccessful after multiple attempts. She presented with an implant on the area of lower left first mandibular molar, that shows increased mobility and radiolucency on radiographic examination. A diagnosis of implant failure was made, the implant was removed, and the area was cleaned and sutured. The patient decided to replace her missing teeth with fixed partial denture and was referred for prosthodontist. The potential adverse effect of steroid use and the possible underlying mechanism that could affect bone metabolism and implants osseointegration are reviewed.
    Clinical practice guidelines are needed for the management of dental implants in chronic steroid users.
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  • 文章类型: Case Reports
    目的:POLR3-HLD或4H脑白质营养不良是一种常染色体隐性遗传性疾病,其特征是骨髓增生异常,缺省症,和低促性腺激素性性腺功能减退,由POLR3A的变异体引起,POLR3B,POLR1C,或POLR3K基因。神经系统和非神经系统的临床特征和疾病严重程度各不相同。虽然以前的研究参考变量认知,这是4H的第一份报告,详细介绍了全面的神经心理学评估。方法:目前的研究提出了一个20岁的,说英语,右撇子,非西班牙裔白人女性,接受过12年的教育,患有经基因证实的4HPOLR3B相关性脑白质营养不良,无需激素替代治疗。结果:4岁时,发育迟缓,共济失调,听力损失,并且存在异常牙列。成像,内分泌学,神经系统检查显示骨髓增生异常,小脑体积减少,骨密度延迟,骨质减少,和肾上腺素的证据没有真正的青春期的迹象。20岁时的神经心理学评估显示,注意,言语记忆检索,建筑,执行者(例如处理速度,持续关注)和数学计算缺陷,以及行为失调。结论:我们对4H脑白质营养不良患者进行了首次详细的神经心理学评估。神经心理学评估显示,在影像学上观察到的认知和行为执行障碍与脊髓过少相一致。需要进一步的纵向研究来阐明与这种疾病相关的神经行为表现,以帮助护理提供者。病人,和他们的家人。
    Objective: POLR3-HLD or 4H leukodystrophy is an autosomal recessive disorder characterized by hypomyelination, hypodontia, and hypogonadotropic hypogonadism, and caused by variants in POLR3A, POLR3B, POLR1C, or POLR3K genes. Neurological and non-neurological clinical features and disease severity vary. While previous studies reference variable cognition, this is the first report of 4H detailing a comprehensive neuropsychological assessment. Method: The current study presents a 20-year-old, English-speaking, right-handed, non-Hispanic White female with 12 years of education with genetically confirmed 4H POLR3B-related leukodystrophy without hormonal replacement treatment. Results: At age 4, developmental delays, ataxia, hearing loss, and abnormal dentition were present. Imaging, endocrinology, and neurologic examinations revealed hypomyelination, reduced cerebellar volume, delayed bone age density, osteopenia, and evidence of adrenarche without signs of true puberty. Neuropsychological assessment at age 20 revealed global cognitive impairment with intellectual, attention, verbal memory retrieval, construction, executive (e.g. processing speed, sustained attention) and math computation deficits, along with behavioral dysregulation. Conclusion: We present the first detailed neuropsychological assessment of a patient with 4H leukodystrophy. The neuropsychological assessment revealed cognitive and behavioral dysexecutive deficits aligning with hypomyelination observed on imaging. Further longitudinal studies are needed to shed light on the neurobehavioral presentation associated with this disorder to assist care providers, patients, and their families.
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  • 文章类型: Journal Article
    背景:本研究的目的是确定磨牙切牙矿化不足与发育性牙齿异常之间是否存在关联。
    方法:两名儿科牙医评估了429名8-14岁磨牙门牙入矿不足的儿童(研究组)和437名无磨牙门牙入矿的儿童(对照组)的发育性牙齿异常的全景X线照片。十二种不同的发育牙齿异常被分为四种类型:大小(microdontia,巨大牙体);位置(上颌永久性第一磨牙的异位萌出,初级磨牙的内咬合);形状(融合,双生,撕裂,牛磺酸症,钉形上颌侧切牙);和数量(牙体发育不全,寡头,hyperdontia)异常。
    结果:研究组和对照组之间的牙齿发育异常频率没有显着差异,女性,和男性(p>0.05)。在发育大小的分布之间发现了统计学上的显着差异,position,形状,研究组和对照组之间的数量异常(p=0.024)。两组中最常见的异常是牙体发育不全(6.3%和5.9%,分别)。在所有儿童和女性的形状异常亚型方面,研究组与对照组之间存在显着差异(分别为p=0.045和p=0.05)。
    结论:虽然在有和没有磨牙门牙入矿的个体之间观察到发育牙齿异常类型的分布之间存在显着差异,在发育性牙齿异常的频率方面没有差异。
    The aim of this study was to determine whether there is any association between molar incisor hypomineralization and developmental dental anomalies.
    Two pediatric dentists evaluated panoramic radiographs of 429 children aged 8-14 years with molar incisor hypomineralization (study group) and 437 children without molar incisor hypomineralization (control group) in terms of developmental dental anomalies. Twelve different developmental dental anomalies were categorized into four types: size (microdontia, macrodontia); position (ectopic eruption of maxillary permanent first molars, infraocclusion of primary molars); shape (fusion, gemination, dilaceration, taurodontism, peg-shaped maxillary lateral incisors); and number (hypodontia, oligodontia, hyperdontia) anomalies.
    No significant difference was observed in the frequencies of developmental dental anomalies between the study and control groups in total, females, and males (p > 0.05). A statistically significant difference was found between the distribution of developmental size, position, shape, and number anomalies between the study and control groups (p = 0.024). The most common anomaly in both groups was hypodontia (6.3% and 5.9%, respectively). There was a significant difference between the study and control groups in terms of subtypes of shape anomaly in all children and females (p = 0.045 and p = 0.05, respectively).
    While a significant difference was observed between the distributions of types of developmental dental anomalies between individuals with and without molar incisor hypomineralization, there was no difference in terms of the frequency of developmental dental anomalies.
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