Background
Rehabilitation of the entire dentition with amelogenesis imperfecta (AI) tends to pose a great challenge to the clinician. Most of the cases of amelogenesis imperfecta are reported to be associated with skeletal and dental deformities which results in severe sensitivity of the dental tissues.
Case presentation
This clinical case report marks out the total restoration of the oral condition of a young Indian patient diagnosed with the hypoplastic type of amelogenesis imperfecta. Fixed metal ceramic prosthesis were planned to strengthen the masticatory activity, aesthetics, to banish the dental sensitivity and to build up the general persona of the patient. The patient was followed-up at 6 months, 1 year and 2 years intervals. Functional and esthetic impairment was not visible after the follow up period and the treatment outcome was successful. The entire treatment plan was intended to enhance the functional, esthetic and the masticatory component of the occlusal architecture.
Conclusion
This case report details the presentation, characteristic radiographic findings, and management of a patient with an extremely rare condition of amelogenesis imperfecta.
Purpose:
To report the spectrum of posterior segment manifestations and visual outcomes in a large series of patients with systemic lupus erythematosus (SLE).
Methods:
Retrospective study at a tertiary referral eye center in south India between 2016 and 2022.
Results:
Charts of 109 patients diagnosed to have SLE were retrieved from our medical database. Only nine cases of SLE (8.25%) had posterior segment involvement. The male: female ratio was 1:8. The mean age was 28 years. Unilaterality was the most common presentation in eight cases (88.89%). Lupus nephritis was the most common systemic presentation in five cases (55.56%). Antiphospholipid antibodies (APLA) positivity was seen in two cases (22.22%). Ocular manifestations included microangiopathy (cotton wool spots) in one case, occlusive retinal vasculitis with cotton wool spots in four cases (five eyes), optic disc edema with combined venous and arterial occlusion (one case), central retinal vein occlusion with cotton wool spots and hemorrhages (one case), macular edema (four cases), posterior scleritis with optic disc edema and exudative retinal detachment in the posterior pole (one case), and tubercular choroidal granuloma (one case). Treatment included systemic steroids, hydroxychloroquine sulfate (HCQS), and immunosuppression in all cases, blood thinners in two cases, and laser photocoagulation in four cases. HCQS-related retinal toxicity was not seen in any of the 109 cases. Ocular manifestation was the initial presentation of SLE in one case. Visual outcome was poor in three cases.
Conclusion:
Presence of posterior segment findings in cases with SLE may suggest a severe systemic disease. Early detection and aggressive treatment result in better visual outcomes. Ophthalmologists could play a vital role in guiding systemic therapy.
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