Mostrando entradas con la etiqueta Oral Medicine. Mostrar todas las entradas
Mostrando entradas con la etiqueta Oral Medicine. Mostrar todas las entradas


CLINICAL CASE : Brain abscess secondary to a dental infection in an 11 year old child

Clinical Case

A primary molar dental abscess was implicated as the cause of a brain abscess in an 11-year-old boy.

This case report describes the neurological signs and symptoms, and acute management of a brain abscess in a child.

A brain abscess is provisionally diagnosed from the patient’s medical history, as well as the presence of signs and symptoms such as fever, headache, nausea, vomiting, focal neurological deficit, altered mentation, speech alterations, papillary edema, and neck stiffness or seizures.

A definitive diagnosis of brain abscess is confirmed through imaging.

The dental source of infection is identified by the exclusion of more probable foci such as the ears, heart, lungs, eyes or sinuses.

Read Also: EMERGENCY : Multidisciplinary approach in the immediate replantation of a maxillary central incisor

Introduction : Dental abscesses and facial cellulitis put dentists on alert for potentially life-threatening conditions such as sepsis or airway obstruction, but the risk of a brain abscess is a complication of odontogenic infection that dentists rarely consider.

This report describes the case of an 11-year-old boy whose brain abscess and associated neurological signs were most likely attributable to an abscessed primary molar.

The description of the neurological signs and symptoms, and the history and management of this case will inform dentists about the real possibility of a brain abscess of dental origin.


°Canadian Dental Association
°Dr. Hibberd / Dr. Nguyen


ORAL PATHOLOGY : Congenital epulis with auto-resolution: case report

Congenital epulis

Congenital epulis is an uncommon benign lesion that affects the oral cavity of newborns, and presents histological features which are similar to those of granular cell tumor.

The origin of this lesion has not been fully elucidated, and many hypotheses are considered due to the large variety of cell types observed in histological sections.

Epulis development occurs further in the prenatal period, and is more common in newborn females, frequently in the maxilla.

This lesion usually is presentend as a nodule covered by normal oral mucosa, which in some cases, interferes with baby's breathing and feeding.

This report describes the case of a two-month-old male baby who presented a pedunculated intraoral lesion in the mandibular alveolar ridge.

Read Also: Reimplantation of avulsed dry permanent teeth after three days

Histological sections revealed presence of mucosal fragments with atrophic squamous stratified epithelium, and fibrous connective tissue composed of cells with granular and eosinophilic cytoplasm.

A few days after initial exam, the lesion detached from alveolar ridge, and healed spontaneously.


° Adriane Sousa de SIQUEIRA, Márcia Regina Dias de CARVALHO, Ana Celina Dourado MONTEIRO, Maria das Graças Rodrigues PINHEIRO, Lucas Rodrigues PINHEIRO, João de Jesus Viana PINHEIRO


ORAL PATHOLOGY : Dental Anomalies in Children

oral pathology

Human dentitions are subject to considerable variation in size, form, number of teeth and to the structure of the dental tissues.

Disorders of the development of teeth may be inheritedor acquired.

The primary dentition begins to form at approximately six weeks in utero and the permanent dentition continues through late adolescence.

The dentition is thereforesusceptible to environmental influencesfor many years.

Diagnosing abnormal dental development requires thorough evaluation of the patient, including a medical, dental and family history, clinical examination, and radiographic evaluation and, in some cases, special laboratory tests are also required.

Read Also: ORTHODONTIC : Malocclusion in Down syndrome - a review

Genetic consultation is important not merely to put a name to the condition, but also to give appropriate advice on the prognosis and the risk of recurrence in future generations.

It is impossible, in the context of this article, to describe in detail all dental anomalies that occur in children.


Jinous F Tahmassebi / Peter F Day / Kyriacos Jack Toumba


An Interdisciplinary Approach for Rehabilitating a Patient with Amelogenesis Imperfecta: A Case Report

Amelogenesis Imperfecta

Amelogenesis imperfecta (AI) has been defined as a group of hereditary enamel defects. It can be characterized by enamel hypoplasia, hypomaturation, or hypocalcification of the teeth.

AI may be associated with some other dental and skeletal developmental defects. Restoration for patients with this condition should be oriented toward the functional and esthetic rehabilitation.

This clinical report describes the oral rehabilitation of a young patient diagnosed with the hypoplastic type of AI in posterior teeth and hypomatured type of AI in anterior teeth.

Introduction : Amelogenesis imperfecta (AI) is a diverse group of hereditary disorders that primarily affect the quantity, structure, and composition of enamel. The inheritance pattern of AI may be autosomal dominant, autosomal recessive, or X-linked.

Read Also: Clinical Management of Regional Odontodysplasia. Clinical Case

According to the Witkop classification system, there are four main forms of AI: type I hypoplastic enamel, type II hypomatured enamel, type III hypocalcified enamel, and type IV hypomatured-hypoplastic enamel with taurodontism.

Clinical presentation of AI varies considerably among the different AI types. In the hypomature type, the affected teeth exhibit mottled, opaque white-brown or yellow discolored enamel, which is softer than normal.


° Niloufar Khodaeian / Mahmoud Sabouhi / Ebrahim Ataei


ORAL MEDICINE : How to treat oral thrush in newborns

Oral Thrush

Thrush is an infection caused by a yeast germ called Candida. The mouth is a common site where Candida causes infection. Candidal infection in the mouth is called oral thrush.

Other common sites for thrush to develop are the vagina, nappy area, and nail folds.

Small numbers of Candida organisms commonly live on healthy skin and in a healthy mouth.

They are usually harmless. However, an overgrowth of Candida can occur in the mouth of some babies. This can cause a bout of oral thrush.

This overgrowth may happen because the baby's immune system is still quite immature and so it cannot control the Candida levels.

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Another possible cause for oral thrush infection is if your baby has had a recent course of antibiotic medication.

This is because the antibiotics can kill off healthy germs (bacteria) that live in your baby's mouth. These healthy bacteria normally help to control the levels of Candida in your baby's mouth.

If there are fewer healthy bacteria around, candidal overgrowth can occur. Also, if you are breast-feeding and you have recently been on antibiotics yourself, the levels of your healthy bacteria can be affected. This can make you, or your baby, more likely to develop thrush.

Youtube / ehowhealth


ORAL MEDICINE : Clinical Management of Regional Odontodysplasia. Clinical Case

Oral Medicine

Regional odontodysplasia (ROD) is a relatively rare localized developmental anomaly of the dental tissues with specific clinical, radiographic, and histologic characteristics.

Crawford ascribed the first report of ROD to Hitchin in 1934, while others suggested that McCall and Wald were the first to describe this condition in 1947.

It was not until 1963, however, that Zegarelli et al coined the term “odontodysplasia” and Pindborg added the prefix “regional” in 1970.

In an extensive review of ROD in 1989, Crawford and Aldred stated females are more often affected than males (1.4:1) and that there was no association with race.

These authors listed several etiological factors such as local circulatory disorders, viral infections, pharmacotherapy during pregnancy, facial asymmetry, local trauma, metabolic disturbances, somatic and neural mutations, and syndromal involvement.

They also suggested that a combination of factors might be involved. In spite of this, ROD’s etiology remains undetermined.

Read Also: ORAL MEDICINE : How to treat oral thrush in newborns

The criteria for ROD diagnosis are based on clinical, radiographic, and histologic findings. The maxilla is typically affected twice as often as the mandible.

Clinically, the condition is usually unilateral and rarely crosses the midline; exceptions are, however, occasionally found. In most cases in which the damage crosses the midline, only the central incisor on the opposite side is affected.

The teeth are likely to be small, brown, grooved, and hypoplastic. Eruption failure or delay is frequently seen as well as abscesses or fistulae in the absence of caries.

Radiographically, there is a lack of contrast between the enamel and dentin, both of which are less radiopaque than unaffected counterparts.

Moreover, enamel and dentin layers are thin, giving the teeth a “ghost like” appearance. The pulp chambers are large, and usually present areas of relatively radiodense tissue (pulp stones or denticles). The follicles of unerupted teeth are enlarged.


° Abel Cahuana, PhD, MD, DDS Yndira González, DDS Camila Palma, DDS


CLINICAL CASES : Crown-Root Fractures in Primary Teeth

Emergency Pediatric Dentistry

Crown-root fractures involve enamel, dentin and cement.

These are not usually found in primary dentition, and approximately 2% of all types of traumatic dental injures (TDI).

Frequently, this kind of dental trauma spreads to the subgingival or intraosseous level, which complicates the establishment of the extent and direction of fracture lines, even with the assistance of radiographic examination.

Read Also: Clinical Management of Regional Odontodysplasia. Clinical Case

The difficulty of tooth maintenance and periodontal health require an interdisciplinary approach to enable the appropriate treatment of this type of TDI.

Crown-root fractures in primary teeth are singular events with wide variations of fracture patterns and that making the correct diagnosis and treatment plan can be complex.

In addition, there have been very few reports regarding this type of trauma and studies that describe the best approaches for each situation are necessary to enable dentists to make the best treatment decision.

Therefore, the aim of the present study was to present a case series of crown-root fractures in primary teeth of patients who were followed-up until the eruption of permanent successor teeth.


Fuente :
Autores : Vanessa Polina Pereira da Costa , Luisa Jardim Correa Oliveira , Denise Paiva Rosa , Mariana Gonzalez Cademartori , Dione Dias Torriani(in memoriam)


HIV : Oral manifestations of human immunodeficiency virus in children


Human immunodeficiency virus (HIV) infection is considered a pandemic by the World Health Organization (WHO).

From its discovery in 1981 to 2006, acquired immunodeficiency syndrome (AIDS) has killed more than 25 million people.

HIV infects about 0.6% of the world's population. In 2005, AIDS claimed an estimated 2.4-3.3 million lives, of which more than 570,000 were children. Most of the cases are seen in sub-Saharan countries and developing nations.

Antiretroviral treatment reduces both the mortality and the morbidity rates of HIV infection, but routine access to antiretroviral medication is not available in all countries. HIV transmission in children occurs mainly through vertical transmission (mother to child).

The risk of transmission by an infected mother occurring before or during birth (without medical intervention) is around 15-20%. Breast feeding by an infected mother increases the risk by 5-20% to a total of 20- 45%.

Read Also: Hypoplastic Enamel Treatment in Permanent Anterior Teeth of a Child

In a study conducted in Brazil, vertical transmission was seen in 97.5% in children. Studies in India had reported that vertical transmission is seen in 51 to 83% of children.

Oral manifestations are amongst the earliest and most important indicators of HIV infection. At present three groups of oral manifestations are defined by Greenspan et al, based on their intensity and features.


°Srinivas Rao Ponnam, Gautam Srivastava, Kotaih Theruru

Esthetic Reconstruction of Teeth in Patient with Dentinogenesis Imperfecta – A Case Report

Dentinogenesis Imperfecta

Dentinogenesis imperfecta (DI) is the result of a dominant genetic defect and affects both the deciduous and permanent dentitions.

It is characterized by opalescent teeth composed of irregularly formed and undemineralized dentin which obliterates pulp chamber and root canal.

DI can appear as a separate disorder or with osteogenesis imperfecta (OI).

The teeth with DI show a grayish-blue to brown hue with dislodged enamel, dysplastic dentine with irregular dentinal tubules and interglobular dentine, short roots and pulpal obliteration, which all may lead to rapid and extensive attrition which require adequate crown reconstruction.

The aim of this study was to show a reconstruction of frontal teeth in upper jaw with direct composite veneers in young adult patient with DI.

Read Also: ORTHODONTIC : Diagnosing Early Interceptive Orthodontic Problems – Part 1

Introduction : Dentinogenesis imperfecta (DI) is a hereditary defect consisting of opalescent teeth composed of irregularly formed and undemineralized dentin that obliterates the pulp chamber and root canals.

DI may be present as a single disorder or in association with osteogenesis imperfecta (OI).


° A. Kne`evi} et al.: Dentinogenesis Imperfecta, Coll. Antropol. 30 (2006) 1: 231–234


ORAL PATHOLOGY : Guideline on Dental Management of Heritable Dental Developmental Anomalies


The American Academy of Pediatric Dentistry (AAPD) recognizes that pediatric dentists are uniquely qualified to manage the oral health care needs of children with heritable dental developmental anomalies.

These children have multiple, complex problems as their dental conditions affect both form and function and can have significant psychological impact.

These conditions may present early in life and require both immediate intervention and management of a protracted nature, including coordination of multi-disciplinary care.

The AAPD’s Guideline on Management of Dental Patients with Special Health Care Needs alludes to this patient population but does not make specific treatment recommendations for the oral manifestations of such diagnoses.

This guideline is intended to address the diagnosis, principles of management, and objectives of therapy of children with heritable dental developmental anomalies rather than provide specific treatment recommendations.

Read Also: EMERGENCY : Dentinogenesis imperfecta type II: approach for dental treatment

This guideline will focus on the following heritable dental developmental anomalies: amelogenesis imperfecta (AI), dentinogenesis imperfecta (DI), and dentin dysplasia (DD).

Ectodermal dysplasia has been thoroughly studied and reported in the National Foundation for Ectodermal Dysplasia’s “Parameters of Oral Health Care for Individuals Affected by Ectodermal Dysplasia Syndromes.” Refer to that document for care of children with ectodermal dysplasia




ORAL PATHOLOGY : Oral lichen planus in childhood

Oral Hygiene

Oral lichen planus (OLP) is a chronic inflammatory condition characterized by mucosal lesions of varying appearance and severity.

It affects 1 to 2 percent of the general adult population; the reported prevalence rates in the Indian population is 2.6 percent.

Oral lichen planus has been reported to be more frequent in females and occurs more predominantly in Asians.

The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. Oral lichen planus is classified into reticular, erosive, atrophic, and bullous types.

The reticular form is the most common type and presents as papules and plaques with interlacing white keratotic lines (Wickham striae) with an erythematous border.

The striae are typically located bilaterally on the buccal mucosa, mucobuccal fold, gingiva, and less commonly, the tongue, palate, and lips. The reticular type has been reported to occur significantly more often in men compared to women and is usually asymptomatic. Erosive, atrophic, or bullous type lesions cause burning sensation and pain.

Read Also: ORAL PATHOLOGY : Dental erosion in children: A literature review

Oral lichen planus affects primarily middle-aged adults and is rare in children. There are few reports of childhood OLP in children in the literature. This article describes a rare case involving a 7-year-old child affected with OLP who was successfully treated with topical application of corticosteroid cream and plaque control regime.

Case description

A seven-year-old boy reported to the Department of Pedodontics with a complaint of white discoloration of the lips and tongue for the past eight months.

He gave a history of occasional soreness of the tongue while eating spicy foods. His medical and family histories were unremarkable and there was no history of any drug intake during the last 12 months. On examination, no cutaneous lesions were evident other than areas of gray to whitish striae arranged in lacy pattern on upper and lower lips.

The intraoral examination revealed white striae affecting the posterior buccal mucosa, dorsal surface and lateral borders of the tongue, and the floor of the mouth. The dorsal surface of the tongue showed two areas of depapillation and white patches in a circinate pattern measuring approximately 1.5 x 2.0 cm. The patient presented with a partial tongue-tie and was in the early mixed dentition stage with carious lesions in the lower left first and second primary molars; no amalgam restorations were evident.

Generalized mild to moderate plaque accumulation was seen. There were no signs of ulceration and the symptoms of discomfort were exacerbated by spicy foods. Routine hematological investigations and biochemistry yielded negative results. An incisional biopsy of the lower labial mucosa on histo-pathological examination showed hyperparakeratosis of stratified squamous epithelium and basal cell degeneration.

A dense band-like lymphocytic infiltration was found at the epithelial-connective tissue interface and there were areas of atrophic epithelium with saw-tooth rete ridges. Histopathological findings were consistent with a diagnosis of oral lichen planus. The patient was educated and motivated regarding a proper plaque control regimen that included brushing thrice daily with a soft brush and tooth paste and rinsing twice daily with alcohol free chlorhexidine.

The patient was advised to avoid eating spicy foods while his lichen planus was active and to use topical corticosteroid cream containing 0.1 percent triamcinolone acetonide (Kenacort), when symptomatic.

Initial review after a three-month period showed a reduction in symptoms and severity of the reticular lichen planus. The patient is currently continuing follow-up.


The exact etiology of OLP is not well understood. However, OLP occurrence is related to a T-cell mediated immune response. Activation of the inflammatory mediator nuclear factor kappaB , and the inhibition of the transforming growth factor control pathway may result in the hyper-proliferation of keratinocytes, thereby causing the white lesions in OLP.

Current data suggests that OLP is a T-cell mediated autoimmune disease in which autocytotoxic CD8+ T-cells trigger the apoptosis of oral epithelial cells, leading to chronic inflammation. The reported prevalence of OLP in childhood is 0.03 percent, a figure significantly lower than that seen in adults.

This difference in prevalence rates has been partially attributed to the low number of associated systemic diseases, autoimmune phenomena, drugs, and dental restorations in childhood. Moreover, as the onset of OLP is insidious, the diagnosis may be missed because of irregular dental visits, a low level of symptoms, and ignorance .

Studies have related higher levels of anxiety and depression, mechanical trauma of dental procedures, lip chewing habits, and intake of citrus and spicy foods to the exacerbation of OLP. Chronic low-grade irritation from dental plaque and calculus has been suggested to cause exacerbation of gingival lichen planus. In our patient the gingivae were not affected with lichen planus in spite of mild to moderate accumulation of plaque.

Moreover, exacerbation of symptoms in our patient may be related to intake of spicy foods. Absence of cutaneous involvement in the present case is not unusual considering that associated lesions are typically found in only approximately 15 percent of patients with OLP. Handa and Sahoo had reported that seven out of 87 cases of childhood lichen planus presented with concomitant involvement of the oral mucosa and that only one child had isolated OLP. They suggested less common involvement of oral mucosa in children with lichen planus compared to that in adults.

However, Sharma and Maheshwari reported concomitant oral lesions in 15 cases of the total 50 children affected with LP. Our case can be considered rare and unique owing to its age of occurrence and involvement of lips, which has been reported to be less common. The diagnosis may be made using clinical features alone or may require clinicopathologic correlation to rule out malignant conditions or atypical presentations.

The differential diagnosis depends on the age of the patient, clinical variant of OLP, and the severity and persistence of lesions. The clinical differential diagnoses include lichenoid drug reaction (LR), leukoplakia, lupus erythematous, and graft versus host disease (GVHD). Lichenoid reactions to dental amalgam and drugs have been reported to exhibit histopathologic features similar to OLP. A detailed history and absence of amalgam restorations excluded the possible diagnosis of LR in the present case.

The age of the patient, pathognomonic appearance of reticular OLP (Wickham striae) on the buccal mucosa, and the histopathologic findings excluded the possibility of lupus erythematous, leukoplakia, and GVHD. Various studies have reported possible association or non-association of hepatitis C virus (HCV) infection and lichen planus and have related this to variations in genetic, environmental, and geographic factors. However, no such association was found in the present case.

Children affected with OLP are often asymptomatic or minimally symptomatic. The recommended treatment goal for most cases of lichen planus is controlling the severity of symptoms because there is no established cure.

The most widely accepted treatment for lesions of OLP includes topical or systemic corticosteroids. Topical corticosteroids are the drugs of choice for treating mild to moderate symptomatic OLP because they have fewer side effects. However, widespread, symptomatic lesions require systemic drugs. Most patients with the reticular pattern of lichen planus are asymptomatic and require no active treatment.

In the present case reticular lesions were successfully managed with topical application of 0.1 percent triamcinolone acetonide cream, chlorhexidine rinse, and a plaque control regimen.

Plaque control is crucial because OLP is an inflammatory condition and local irritants, such as plaque and calculus, consistently trigger exacerbations. An alcohol-free rinse should be prescribed to avoid desiccation and irritation of oral tissues. Furthermore, prophylactic use of 0.12 percent chlorhexidine gluconate rinse reduces the incidence of candidiasis during the corticosteroid therapy.

Other documented modalities of OLP treatment include retinoids, cyclosporine rinse, PUVA treatment, dapsone, and cryotherapy. The use of other modalities such as CO2 laser, Diode laser, and photodynamic therapy have also been reported.


Topical corticosteroid therapy and a plaque control regimen in children with symptomatic reticular OLP have shown favorable responses. Although OLP in childhood is rare, pedodontists should be aware of its clinical presentation, diagnosis, and management. Although not yet reported in children, periodic follow-up visits should be emphasized to evaluate possible malignant transformation.

°M GunaShekhar MDS, Reddy Sudhakar MDS, Mohammad Shahul MDS, John Tenny MDS, Manyam Ravikanth MDS, N Manikyakumar BDS

How to treat chapped lips in a newborn


Newborn babies sometimes get dry skin, and their lips may appear chapped as their skin adjusts to the environment outside the womb.

Several home remedies can help moisturize their lips and ease any discomfort.

It is common for a newborn's lips to appear more dry and red than an older baby's, but this is unlikely to cause any signs of pain or discomfort.

It may occasionally seem that chapped lips are uncomfortable for a newborn, but this symptom is not usually a cause for concern.

If a baby has chapped lips but seems comfortable and is feeding well, caregivers may choose to monitor them for other symptoms and mention it to their pediatrician at the next visit.

If chapped lips seem to bother a baby, caregivers can try out a range of gentle, effective home remedies to relieve this symptom.

Read Also: ORAL MEDICINE : How to manage a pediatric patient with oral ulcers

If other symptoms are also present, chapped lips can suggest an underlying condition, such as an infection or dehydration. If a newborn baby has chronic chapped lips or other symptoms, it is best to see a doctor to rule out any serious causes.


° By Bethany Cadman

ORAL MEDICINE : Dental manifestations of patient with Vitamin D-resistant rickets

Oral Medicine

Patients with Vitamin D-resistant rickets have abnormal tooth morphology such as thin globular dentin and enlarged pulp horns that extend into the dentino-enamel junction.

Invasion of the pulp by microorganisms and toxins is inevitable.

The increased fibrotic content of the pulp, together with a reduced number of odontoblasts, decreases the response to pulp infection.

The most important oral findings are characterized by spontaneous gingival and dental abscesses occuring without history of trauma or caries.

Radiographic examinations revealed large pulp chambers, short roots, poorly defined lamina dura and hypoplastic alveolar ridge.

These dental abscesses are common and therefore the extraction and pulpectomy are the treatment of choice.

The purpose of this article is to report a case of Vitamin D-resistant rickets in a 5 year-old boy, describing the dental findings and the treatment to be performed in these cases.

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Vitamin D - resistant rickets (VDRR), also known as hereditary or familial hypophosphatemia, is characterized by a metabolic disturbance which causes defective calcification of mineralized structures.

VDRR is well established genetically as an X-linked dominant metabolic disorder, that may be characterized bye persistemt hypophosphatemia and hyperphosphaturea associated with decreased renal tubular reabsortion of inorganic phosphates.


°Journal of Applied Oral Science
°Andréia Pereira SOUZA / Tatiana Yuriko KOBAYASHI / Natalino LOURENÇO NETO / Salete Moura Bonifácio SILVA / Maria Aparecida Andrade Moreira MACHADO / Thais Marchini OLIVEIRA


Idiopathic multiple unerupted permanent teeth: A rare case report

Oral medicine

A disturbed eruption process creates a clinical situation that is challenging to diagnose and treat.

The clinical spectrum of tooth eruption disorders includes both syndromic and nonsyndromic problems ranging from delayed eruption to a complete failure of eruption.

Failure of permanent teeth to erupt without obvious etiology is a rare dental anomaly. Various local and systemic factors have been implicated in failure of eruption of multiple permanent teeth.

The present case report discusses the clinical and radiographic details of a 21-year-old asymptomatic and nonsyndromic patient with multiple unerupted permanent teeth.

Introduction : Tooth eruption has been defined as the movement of a tooth in an axial and occlusal direction from its developmental position within the jaw to its final functional position in the occlusal plane.

Read Also: ORTHODONTIC : Diagnosing Early Interceptive Orthodontic Problems – Part 1

The eruption pattern of deciduous and permanent teeth is usually comprehensive and takes place at different chronological age levels. A significant deviation in eruption of tooth, premature eruption and delayed tooth eruption are commonly noted in a clinical practice.

Possible etiologies for failure of eruption of teeth fall into two broad categories: systemic and local factors. Some of the systemic conditions that can lead to delayed or failed eruption are genetic disorders such as cleidocranial dysplasia, Gardner syndrome and osteopetrosis.

Sandra Vani / Anitha Nooney / Kakarla Subba Raju / Melpati Hemadri


PERIODONTICS : Generalized Aggressive Periodontitis in Preschoolers: Report of a case in a 3-1/2 Year Old


The importance of a prompt diagnosis and treatment of periodontitis in children is emphasized by the association between the presence of periodontitis in primary dentition and periodontitis at older ages in the same individual.

The 1999 International Workshop for a Classification of Periodontal Diseases and Conditions classified periodontal disease in children as follows:

°Dental plaque-induced gingival diseases; aggressive periodontitis (previously known as “prepubertal” or “early onset periodontitis”); chronic periodontitis; periodontitis as a manifestation of a systemic disease; and necrotizing periodontal diseases.

Aggressive and chronic periodontitis is subdivided into localized or generalized, depending on the size of the area affected. Most of the literature reports of severe periodontal destruction in children are associated with systemic diseases such as hypophosphatasia, cyclic neutropenia, agranulocytosis, histiocytosis X, leukocyte adhesion deficiency, Papillon-Lefèvre syndrome and leukemia.

Although destructive forms of periodontal disease in infants are relatively uncommon, children and adolescents may manifest any form of periodontitis. However, it has been shown that aggressive periodontitis may be more common in children and adolescents, while chronic periodontitis is more frequent in adults.

The etiology of aggressive periodontitis may be broadly divided into two categories: bacterial plaque with highly pathogenic bacteria, and impaired host defense mechanism.

Read Also: EMERGENCY : Managing Patients With Primary Incisor Root Fracture

As far as pathological microflora is concerned, the most important bacteria appear to be highly virulent strains of Aggregatibacter actinomycetemcomitans previously known as Actinobacillus actinomycetemcomitans in combination with Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola, however other bacteria may be present.

Although there seems to be a genetic predisposition for periodontal diseases, it has also been shown that periodontopathic bacteria are transmissible among family members or between children and their caregivers.

Camila Palma Portaro / Yndira Gonzalez Chópite / Abel Cahuana Cárdenas

Medical-dental considerations in the care of children with facial cellulitis of odontogenic origin

Dental Emergency

An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria).

It comprises various clinical conditions, whose importance varies depending on their frequency and potential severity.

It is the most common type of oral infection and its treatment involves up to 10% of all antibiotic prescriptions.

Facial cellulitis is a diffuse inflammation of soft tissue that is not confined or limited to a specific region and tends to spread.

Read Also: Reimplantation of avulsed dry permanent teeth after three days

The objective of this review is to update the aspects considered in the care of children with facial cellulitis of odontogenic origin and the multidisciplinary management between dentists and pediatricians.


°Claudia Giunta Crescente, Dentist / Milagro Soto de Facchin, M.D. / Andreína M. Acevedo Rodríguez, Dentist