1/2. Autosomal dominant osteosclerosis: report of a kindred.Autosomal dominant osteosclerosis (ADO), a rare inherited craniotubular bone disorder, is a generalized hyperostosis that manifests itself as increased cortical thickening of the skull, mandible, metacarpals, metatarsals, long bones, vertebral bodies, ribs, and clavicles. jaw abnormalities, which clinically resemble the widening and deepening of the mandible seen in cherubism, begin in childhood and have been reported to stabilize after puberty. Teeth and alveolar bone are normal. ADO must be distinguished from Van Buchem's disease, which is characterized by elevated serum alkaline phosphatase, neurologic complications, exopthalmos, periosteal excrescences, and an autosomal recessive pattern of inheritance, as well as from other craniotubular bone disorders such as osteopetrosis. We present clinical and radiographic documentation of members of a kindred representing 4 generations affected with ADO. At initial examination of the proband, a differential diagnosis included cherubism, fibrous dysplasia, osteopetrosis, and Paget's disease. Radiographic examination revealed extensive radiopacity of the inferior border and basal bone of the mandible. The proband's clavicles and humerus were also affected. All family members examined were similarly affected and had mandibular and palatal tori. Authors of a previously published report on the dental and dentoalveolar management of patients with craniotubular bone disorders have recommended prophylactic antibiotics to minimize risk of osteomyelitis in all such cases. The members of our kindred received extensive dental treatment before diagnosis, including extractions of severely carious teeth, preprosthetic dentoalveolar surgery, and endodontic therapy; there was no incidence of osteomyelitis or postsurgical complications. Therefore, the use of prophylactic antibiotics may not be warranted in patients with ADO who have otherwise normal medical histories.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/2. Chincup therapy for a young woman with anterior displacement and obtuse angle of the mandible in Class I malocclusion.INTRODUCTION: Dolichofacial skeletal patterns are a challenge for the orthodontist. Even when treatment for a long-face patient begins before the adolescent growth spurt, excellent compliance is generally needed. The patient whose care is presented here started treatment at age 14. RESULTS: The extraction of 4 premolars, rapid palatal expansion, and excellent compliance wearing a combination occipital and vertical-pull chincup over a 2-year period led to good results at age 16, with minimal dental or skeletal relapse at age 18 years 5 months.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |