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An unusual case of amelogenesis imperfecta with gingival hyperplasia [Times New
Roman; 12 pt, bold]
C.L. GARDENER & P. F. ASHLEY [12 pt; presenting author underscored; all capitals]
Eastman Dental Hospital, UCLH, London, UK [12 pt, italics]
Background: An anxious 11 year old was referred by her general dental practitioner (GDP)
for management of delayed eruption, amelogenesis imperfect (AI), gingival hyperplasia and
dental anxiety.
Presenting problem: The patient presented complaining of the appearance of her teeth and
their sensitivity to cold. She had previously been diagnosed with AI and gingival hyperplasia.
She had not received treatment previously due to dental anxiety. On examination we noted
hypomineralised/ hypoplastic AI and generalized gingival hyperplasia. Teeth were microdont,
there was delayed eruption of permanent teeth, infraoccluded primary molars and impacted
permanent molars.
Clinical
management:
Anxiety
was
managed
with
non-pharmacological
and
pharmacological behavior management techniques (including inhalation sedation and play
therapy). Following multi-disciplinary review, the infraoccluded primary dentition was
removed. Periodontal surgery was carried out for the upper anterior teeth under inhalation
sedation (IS). These teeth were then restored with composite. Further surgery under IS was
carried out on the molars which were restored with performed metal crowns. Impacted teeth
were kept under review. CB is now much less anxious, has an intact and functioning dentition
which looks pleasing to her. Sensitivity is reduced.
Discussion: Generalised gingival hyperplasia associated with AI is a rare condition and
poorly understood. The complexities of CB’s case required multi-disciplinary input into her
management including play therapy, behavioural management, orthodontic/ paediatric
consultation as well as planning on the periodontal clinic.