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Transcript
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.