The persistence of thumb sucking might also be harmful as it might be associated with the development of complications seen on the thumb as paronychia and nail deformities and in the mouth level as malocclusions. In this review, we have looked up studies in the literature to identify the effect of thumb sucking on the development of malocclusion. Thumb sucking in children usually occurs as a primitive reflex that appears in early childhood with no apparent causative factors. Children usually develop this thumb sucking habit because in this way they feel more comfortable and secure. The main cause behind the development of thumb sucking is the prolonged presence of the thumb in the mouth which creates pressure against the developing jaw and teeth. This may interfere with the process of tooth eruption leading to delayed or abrupt eruption events and malformations. The severity of malocclusion deformities is significantly associated with the chronicity and period of thumb-sucking habits. Other forms of occlusions secondary to thumb sucking include: anterior open bite, exaggerated overjet, posterior crossbite, retrognathic mandible, a diastema, temporomandibular joint disorders and the retroclined low anterior. Thumb sucking, however, is a self-limiting phenomenon and usually disappears as children grow older. However, when persistence is noticed, immediate management should be approached to avoid any potential complications.
Spondyloepiphyseal dysplasia (SEDKF) is a rare skeletal dysplasia associated with kyphosis and low bone mineral density, significantly delayed growth, and skeletal deformities. Blood lysosomal enzyme levels have also been shown to be elevated with a delay in development. The first variant described was compound heterozygosity for mutations in the MBTPS1 gene: a 1-bp duplication and a missense mutation. In the current study, we examined a Saudi consanguineous family. Clinical features like spondyloepiphyseal dysplasia, indicative of characteristic skeletal abnormalities, and impaired cognitive abilities were observed. Our patient has dysmorphic facial features, short stature, and significant skeletal deformities. A homozygous missense MBTPS1 (c.2634C > A p. (Ser878Arg)) with unknown significance was discovered in the whole exome; pathogenic MBTPS1 variants cause the autosomal recessive Kondo-Fu type of spondyloepiphyseal dysplasia (SEDKF, OMIM®: 618392). The whole exome sequence, which described a homozygous missense variant of unknown clinical significance (VUS, class 3 variant) in the MBTPS1 gene, was heterozygous in both asymptomatic parents. We are mindful that changing the classification of a variant of unknown significance is challenging. Considering clinical phenotypes and radiological findings produced by the pathogenic mutation in the MBTPS1 gene, the identified c.2634C > A variant is supported and may be categorized as likely pathogenic based on clinical symptoms.
A pontic is an artificial tooth that substitutes a lost natural tooth, preserves its function, and typically fills the space left by the actual crown. Sanitary/hygienic and modified sanitary/hygienic designs do not contact the alveolar mucosa. On the other hand, ridge lap, modified ridge lap, ovate, modified ovate, and conical are designs that maintain contact with the mucosa. The ideal biological properties to be taken into consideration while designing pontics are periodontal health, access for oral hygiene, no food trapping and occlusal harmony. Accumulation of dental plaque has been implicated in the onset of gingival and periodontal disease as well as caries in the vicinity of the fixed restoration. The connection of the pontic to the supporting crowns must be constructed in such a way as to make a flushable area in the direction of the gingiva, in order to ensure that this area can be cleaned by toothbrushing and flossing but not the large triangular spaces that make it easy for food particles to cling. Modified ridge lap and ovate types, out of all the pontic shapes described below, exhibit convex cleansable faces. Ovate pontics are most effective for use in anterior regions, while the modified ridge lap design can be utilized predominantly in fixed partial denture designs posteriorly. The important etiological factor for gingivitis, periodontitis and peri-implantitis is bacterial colonization which is impacted by the individual's immunologic response and genetic predisposition in addition to dental care practices and pontic design. It is believed that no matter what the material of the pontic is, it must provide a highly polished intaglio surface to help floss slide through and make contact with the full base of the pontic in order to minimize plaque accumulation.
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