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2/2017
vol. 70 abstract:
Exfoliation of non-resorbed primary incisors in a 4-year-old child – case report and literature review
Ilona Wieczkowska
1
,
Anna Jarząbek
1
,
Magdalena Gońda-Domin
1
,
Karolina Węsierska
1
,
Rafał Rojek
2
,
Joanna Mikołajczyk
1
,
Hanna Bielawska-Victorini
3
Online publish date: 2017/04/30
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Introduction. Early exfoliation of non-resorbed
tooth can be a symptom of severe systemic disease, even a fatal one. Case description. A 4-year-old boy presented with increased mobility of the lower incisors which resulted in missing 81; the tooth exfoliated with non-resorbed root six months earlier. Intra-oral examination revealed that mobility of 71 was more pronounced than that of the lateral incisors (it exfoliated non-resorbed within the next three months), while the remaining teeth were of normal mobility. Additionally, teeth 51 and 61 had pinkish crowns with horizontal gingival recessions. The boy was caries-free and had not experienced any dental trauma (DMF=0). His oral mucosa was sound, but he presented poor oral hygiene. The pantomogram showed a horizontal reduction of the maxillary front alveolar bone height. The patient was mouth breathing due to recurrent infections of the upper respiratory tract with adenoid hypertrophy. The skin of the hands and feet was normal. There was a case of inherited skeletal disorder in the patient’s family. The patient was consulted by the paediatric haematologist, orthopaedic surgeon and laryngologist (adenoidectomy). The laboratory tests showed proper blood cell count and no signs of calcium-phosphate metabolism disorders. The boy stayed under dental observation for six years without any further abnormal exfoliations. Discussion. Careful medical and dental diagnostics was required to exclude possible reasons for the tooth loss such as quantitative or qualitative neutrophil defects, metabolic or connective tissue disorders or neoplasia. Conclusion. This was a case of idiopathic early teeth exfoliation, which self-limited. Nevertheless, thorough diagnostics, adenoidectomy and oral hygiene improvement were fundamental for the diagnostic and treatment process. |
