Almutiry Amal, Alotaibi Fares, Almutiry Bashayer, Aldowsari Mannaa K, Alotaibi Maha, Boucelham Aboubekri
Department of Pediatric Dentistry, King Saud Medical City, Riyadh, Saudi Arabia.
Department of Pediatric Dentistry and Orthodontics, college of dentistry King Saud University, Riyadh, Saudi Arabia.
Int J Clin Pediatr Dent. 2023 Mar-Apr;16(2):409-415. doi: 10.5005/jp-journals-10005-2589.
The aim of this case report is to describe the dentofacial manifestations of achondroplasia and highlight concerns associated with dental management of pediatric patients with achondroplasia.
Achondroplasia is the most common form of skeletal dysplasia (dwarfism) with clinical manifestations including disproportionate limb shortening and stunted stature. The craniofacial characteristics of achondroplasia are relative macrocephaly, depression of the nasal bridge, and maxillary hypoplasia. Special precautions are necessary during dental management of pediatric patients with achondroplasia due to a large head size, implanted shunts, airway obstruction, and difficulty in head control.
A 6 years and 7 months male, the patient was diagnosed with achondroplasia, currently receiving vitamin D, no known drug allergy, and a mixed dentition stage with multiple caries, mouth breather, and a high risk of further caries based on a caries risk assessment due to poor oral hygiene. As the patient was uncooperative and required extensive dental care, dental rehabilitation was conducted under general anesthesia using oral intubation due to nasal obstruction. Future examinations were planned for every 3 months.
The current case demonstrated that the characteristics of achondroplasia might cause respiratory, neurological, skeletal, orthodontic, and psychological difficulties. Pediatric dentists who treat these patients must be able to detect these characteristics and difficulties, as dental treatment is limited by practical issues associated with this condition.
The characteristic features of achondroplasia are attributed to skeletal, respiratory, neurologic, orthodontic, and psychosocial issues. The dentist should be aware of the features of achondroplasia, which can potentially restrict dental management.
Almutiry A, Alotaibi F, Almutiry B, Craniofacial and Dental Manifestations in Pediatric Patients with Achondroplasia: A Case Report and Clinical View. Int J Clin Pediatr Dent 2023;16(2):409-415.
本病例报告旨在描述软骨发育不全的牙颌面表现，并强调与软骨发育不全患儿牙科治疗相关的问题。
软骨发育不全是骨骼发育异常（侏儒症）最常见的形式，临床表现包括四肢不成比例缩短和身材矮小。软骨发育不全的颅面特征为相对巨头畸形、鼻梁凹陷和上颌骨发育不全。由于头部较大、植入分流器、气道阻塞以及头部控制困难，在对软骨发育不全患儿进行牙科治疗时需要采取特殊预防措施。
一名6岁7个月的男性患者，被诊断为软骨发育不全，目前正在接受维生素D治疗，无已知药物过敏史，处于混合牙列期，有多颗龋齿，口呼吸，根据龋病风险评估，由于口腔卫生差，有进一步患龋的高风险。由于患者不配合且需要广泛的牙科治疗，因鼻塞在全身麻醉下采用口腔插管进行牙科修复。计划每3个月进行一次复查。
本病例表明，软骨发育不全的特征可能导致呼吸、神经、骨骼、正畸和心理方面的困难。治疗这些患者的儿科牙医必须能够发现这些特征和困难，因为牙科治疗受到与该病症相关实际问题的限制。
软骨发育不全的特征性表现归因于骨骼、呼吸、神经、正畸和社会心理问题。牙医应了解软骨发育不全的特征，这些特征可能会限制牙科治疗。
Almutiry A, Alotaibi F, Almutiry B, 软骨发育不全患儿的颅面和牙齿表现：病例报告及临床观点。《国际临床儿科牙科学杂志》2023年；16(2):409 - 415。
