Esthetic rehabilitation in primary and permanent successors incisors in a child with conoidal and absence teeth: a case report

Objective: To show the aesthetic treatment performed in deciduous incisors and in permanent successors in a child with congenital dental abnormalities (conoid and missing teeth), which associated with bone disproportion of the middle third of the face led to a suspicious diagnosis of ectodermal dysplasia. Case report: This report was written following the CARE Statement. A 6-year-old girl attended the Pediatric Dental Clinic complaining about bullying due to appearance her teeth. The reanatomization of the conoid-shaped deciduous incisors was done with direct composite resin using preformed acetate crowns. After 15 months, the deciduous incisors had exfoliated and the permanent incisors erupted also with a conoid shape. For aesthetic rehabilitation, direct composite restorations were performed using the incremental technique guided by a silicone matrix made based on the diagnostic wax-up. Conclusion: In the follow-up, the patient and guardians reported satisfaction with appearance of her smile and an increased self-esteem. The case remains under follow-up and future planning will include orthodontics and prosthodontics.

Objetivo: Mostrar o tratamento estético realizado em incisivos decíduos e em seus sucessores permanentes em uma criança com anomalias dentárias congênitas (dentes conoides e ausentes), que associado a desproporção óssea do terço médio da face levaram a um diagnóstico suspeito de displasia ectodérmica. Relato de caso: Este relato foi redigido seguindo o CARE Statement. Menina de 6 anos de idade compareceu à Clínica de Odontopediatria com queixa de bullying devido à aparência de seus dentes. A reanatomização dos incisivos decíduos conoides foi feita com coroas de acetato pré-formadas e resina composta direta. Após 15 meses, os incisivos decíduos esfoliaram e os incisivos permanentes irromperam também com formato conoide. Para a reabilitação estética, foram realizadas restaurações diretas com resina composta pela técnica incremental guiada por matriz de silicone confeccionada a partir do enceramento diagnóstico. Conclusão: No seguimento, paciente e responsáveis relataram satisfação com a aparência do sorriso e aumento da autoestima. O caso continua em acompanhamento e o planejamento futuro incluirá ortodontia e prótese dentária.

Exploring the behavioral and cognitive phenotype of KBG syndrome.

KBG syndrome is a neurodevelopmental disorder, caused by dominant mutations in ANKRD11, that is characterized by developmental delay/intellectual disability, mild craniofacial dysmorphisms, and short stature. Behavior and cognition have hardly been studied, but anecdotal evidence suggests higher frequencies of ADHD-symptoms and social-emotional impairments. In this study, the behavioral and cognitive profile of KBG syndrome will be investigated in order to examine if and how cognitive deficits contribute to behavioral difficulties. A total of 18 patients with KBG syndrome and a control group consisting of 17 patients with other genetic disorders with comparable intelligence levels, completed neuropsychological assessment. Age-appropriate tasks were selected, covering overall intelligence, attention, memory, executive functioning, social cognition and visuoconstruction. Results were compared using Cohen's d effect sizes. As to behavior, fewer difficulties in social functioning and slightly more attentional problems, hyperactivity, oppositional defiant behavior and conduct problems were found in the KBG syndrome group. Regarding cognitive functioning, inspection of the observed differences shows that patients with KBG syndrome showed lower scores on sustained attention, cognitive flexibility, and visuoconstruction. In contrast, the KBG syndrome group demonstrated higher scores on visual memory, social cognition and emotion recognition. The cognitive profile of KBG syndrome in this sample indicates problems in attention and executive functioning that may underlie the behavior profile which primarily comprises impulsive behavior. Contrary to expectations based on previous (case) reports, no deficits were found in social cognitive functioning. These findings are important for counseling purposes, for tailored education planning, and for the development of personalized intervention.

[Deformities and therapeutic attitudes]. / Dysmorphies et attitude thérapeutique.

Because dental dysmorphias make up a large part of the problems we deal with in our daily practices, it is important that we classify them according to their severity. Accordingly, we should define the relevant concepts of norm, anomaly, dysmorphia, and malformation. Over the years these notions have been viewed in a great variety of ways depending on the epoch and the particular society. It seems that nowadays our concepts, enflamed by a relentless media, are orienting themselves toward a more and more narrow concept of what constitutes normality. Our professional attitude is not immune to this societal problem, and many practitioners are tempted to propose treatment when the need for it is uncertain.

[Psychology and psychosomatics of the orthodontic treatment]. / Pszichológia és pszichoszomatika a fogszabályozásban irodalmi áttekintés.

Psychosomatic problems related to orthodontic treatment are a special group of oral psychosomatic disorders. The most frequent complaints are related to aesthetics and occlusion. Most of the patients are children, adolescence or young adults, with special emotional problems. Authors reviewed the most important knowledge related to this specific field, but some general aspects of oral psychosomatics are also discussed.

Management of ectodermal dysplasia in children--an overview.

Oral rehabilitation is often difficult for the young child with ectodermal dysplasia. Most affected children require extensive dental treatment in order to restore their appearance and function. Early intervention also helps children develop a positive self-image. This paper will review the dental management and timing of different treatment modalities for children with ectodermal dysplasia.

[Psychosomatic correlations in orthodontics--the impact of dentition anomalies on the mental status]. / Pszichoszomatikus összefüggések az orthodontiában--a fogazati rendellenességek kihatása a lelki alkatra.

Authors present the essence of psychosomatics with particular emphasis on the impact of dento-occlusal and cranio-facial anomalies on the mental constitution. In their representation--after giving a historical review--they show the main features of the present state of knowledge in this branch of science based on literary publications by completing it with their own clinical experience.

Developmental defects of enamel in regularly attending adolescent dental patients in Scotland; prevalence and patient awareness.

Contemporary dental literature contains many reports of the prevalence of developmental defects of enamel in a variety of populations. Little information is available relating to patients' perceptions of such defects. The aim of this study was to compare the prevalence of developmental defects of enamel in a sample of regularly attending adolescent dental patients with the patients' own views as to whether they thought they had marks on their teeth. The index used for the assessment of defects, the SCOTS Version of the Modified DDE Index (SCOTS/DDE Index), includes both a dentist and patient assessment of defects. Four hundred and eighty-five adolescent dental patients of 41 general dental practitioners in Scotland were examined under standardised conditions in a mobile dental surgery by one trained and calibrated examiner. Approximately half the sample had some sort of developmental defect of enamel, as classified by the SCOTS/DDE Index. However, only 14 per cent of the sample claimed to be aware of marks on their front teeth which would not brush off.

[The psychosocial aspects in orthodontically treated and untreated adults with similar, clearly visible tooth malalignments]. / Psychosoziale Aspekte bei kieferorthopädisch behandelten und unbehandelten Erwachsenen mit ähnlichen, gut sichtbaren Zahnstellungsfehlern.

A study was undertaken to compare the psychosocial aspects of orthodontic treatment or non-treatment of female adults, 25 of whom underwent treatment and 25 of whom did not, with similar, visible malocclusion. Interviews, for which 52 standardized questions were prepared in collaboration with a graduate psychologist, served as the methodological basis of the study. The results of the study indicate that in relation to the aesthetic aspects of orthodontic treatment, the treated group showed a high degree of sensitivity and self perception. Following orthodontic treatment members of this group exhibited a highly significant improvement in their subjective perception of the aesthetic aspects of their dental and facial appearance. In spite of the differences observed in the 2 groups, it nevertheless remains difficult to draw general conclusions or to recommend guidelines which would cover all cases. When the question is to orthodontically treat or not treat female adults, the answer rests with the individual patient.

Sequencing and timing of treatment in the correction of dentofacial deformities in adult patients with clefts.

During the past six years, 107 patients with various dentofacial deformities secondary to primary clefts were treated in the cleft palate clinic. An overall treatment plan was formulated before any definitive secondary treatment was started. The sequencing and timing of the various aspects of secondary treatment were established to provide optimum esthetic, functional, and psychologic results.