Marsupialization and decompression constitute a well-established procedure for treating cavitary bone lesions of the jaw. The technique can be a primary treatment option, especially for pediatric patients with large cysts or lesions involving vital anatomical structures, such as a developing tooth germ. In this procedure, a decompression stent, such as a customized acrylic obturator or space-maintaining appliance, silicone tube, or nasal cannula, is inserted to maintain the patency of the cyst. However, this may cause clinical problems, such as irritation or trauma to the adjacent tissues, as well as discomfort to the patient, or failure of the stent due to cyst shrinkage. It can also be a reason for patient noncompliance. In the cases described here, a minimally invasive marsupialization technique using a metal tube made from a 16-gauge needle was used for odontogenic cysts in pediatric patients associated with unerupted teeth. Through this method, the lesions were removed, with patient cooperation, and the cyst-associated teeth erupted spontaneously.
Pierre Robin syndrome (PRS) is characterized by the triad of congenital mandibular hypoplasia, glossoptosis and cleft palate. Infant PRS patients are frequently suffering from upper airway obstruction, gastroesophageal reflux and growth retardation caused by above mentioned problems.We report a dental caries treatment of 3-year old girl with Pierre Robin syndrome with multiple caries.The cause of multiple caries was mainly presumed as patient' s eating habit caused by her general condition. She had some feeding problems and had history of gastric tube. She was still using milk bottle and took more than an hour to finish a meal.The treatment was performed under general anesthesia considering patient' s condition; mild autism, poor cooperation and respiratory problem due to micrognathia. Severely affected upper incisors were treated with pulp treatment and restored with zirconia crown for esthetic purpose. Lower incisors were treated with pulp treatment and restored with composite resin. Upper right first primary molar was restored with stainless steel crown and other primary molars were treated with composite resin. There were no postoperative complications.According to her parents, the patient' s compliance to oral hygiene management was greatly improved after the treatment since she was very pleased with the esthetic result and highly motivated by her looks.
Lowe syndrome is X-linked gene disorder, characterized by cataracts, renal dysfunction and brain abnormalities. Oral healthcare of young patients with Lowe syndrome could be easily neglected due to the uncooperative behavior or other systemic condition of the child. We are presenting a case of successful treatment under general anesthesia with uncooperative child with Lowe syndrome.A 3-year old boy with Lowe syndrome visited Seoul National University Dental Hospital for multiple caries. He had been suffering from congenital cataract, medullary nephrocalcinosis and hypotonia. Multiple caries were observed from clinical and radiographic examination.Concerning behavior management problem and possibility of aspiration due to hypotonia, dental treatment under general anesthesia was planned. Left upper primary first molar was extracted to prevent further infection. Other teeth were treated with Stainless steel crown or composite resin restoration based upon the extent and the severity of dental caries. Under general anesthesia, dental procedure was carried out successfully and safely.Considering uncooperative behavior and other medical conditions of the patient, general anesthesia could be effective. Home oral care and periodic visit to dental clinic should be emphasized to the caregiver of patient with Lowe syndrome, considering the susceptibility of dental caries and other oral manifestation.
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