See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/279629176 Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation Article in International Journal of Clinical Pediatric Dentistry · June 2015 DOI: 10.5005/jp-journals-10005-1283 · Source: PubMed CITATIONS READS 5 127 2 authors: Kavita Hotwani Krishna Sharma VSPM's Dental College & Research Centre Datta Meghe Institute of Medical Sciences (Deemed University) 19 PUBLICATIONS 139 CITATIONS 26 PUBLICATIONS 229 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: smartphones and toothbrushing View project Lingual Dental Biomechanics View project All content following this page was uploaded by Krishna Sharma on 11 March 2016. The user has requested enhancement of the downloaded file.
IJCPD IJCPD 10.5005/jp-journals-10005-1283 Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation CASE REPORT Oral Rehabilitation for Amniotic Band Syndrome: An Unusual Presentation 1 Kavita Hotwani, 2 Krishna Sharma ABSTRACT We present a case of a patient with ABS and concomi- tant dental fjndings. A brief review of the syndrome and Amniotic band syndrome (ABS) is a congenital disorder caused goals of dental treatment are also discussed. by entrapment of fetal parts in fjbrous amniotic bands while in utero . The syndrome is underdiagnosed and its presentation is variable. The syndrome has been well described in the CASE REPORT pediatric, orthopedic and obstetric literature; however, despite An 8-year-old patient reported to the department of the discernable craniomaxillofacial involvement, ABS has not been reported in the dental literature very often. The present pedodontics with the chief complaint of poor esthetics. report describes a case of a patient with ABS and concomitant On clinical examination, it was found that the patient dental fjndings. had multiple carious lesions and over-retained deciduous Keywords: Amniotic band syndrome, Oral rehabilitation, teeth. Patient was a known case of ABS. On further Craniofacial, Unusual. medical evaluation and clinical examination, it was found How to cite this article: Hotwani K, Sharma K. Oral that the patient had congenital deformity of phalanges of Rehabilitation for Amniotic Band Syndrome: An Unusual left hand with rudimentary fjngers. The nail beds were Presentation. Int J Clin Pediatr Dent 2015;8(1):55-57. absent and fjnger grip was weak (Figs 1 and 2). Source of support: Nil On systemic evaluation, patient was found to have Confmict of interest: None frequent gastric regurgitations. A review of relevant medical records showed a history of premature birth with INTRODUCTION cesarean delivery and traumatic experience of mother Amniotic band syndrome (ABS) is a congenital disorder during pregnancy. Intraoral examination showed presence of over- caused by entrapment of fetal parts in fjbrous amniotic bands while in utero . The rupture of the amnion has retained 51 and 52. Attrition was noted with 54 and secondary effects on the fetus, which produces malfor- arrested caries with 64. Occlusal caries was present with mation and deformation due to interruption of normal 65 and 85. Multisurface caries was prominent with 84 and morphogenesis. It is also known as ADAM complex. 1 lingual caries with 74. Patient’s dietary history was also The syndrome is underdiagnosed and its presentation recorded and was found to be unbalanced with increased is so variable that no two cases are exactly identical. sugar exposures. Intraoral periapical radiographs were Pathogenesis of this defect is probably heterogeneous. 2 taken which confjrmed the multiple carious lesions. Deformities of the extremities, thorax and craniofacial A fjnal diagnosis of rampant caries was made. After skeleton and soft tissues occur individually or collectively thorough medical evaluation, consent was obtained from with varying degrees of severity. 1,2 The syndrome has the pediatrician, and patient was evaluated for fjtness. been well described in the pediatric, orthopedic, and A treatment plan was formulated and the rehabilitation obstetric literature; however, despite the discernable resulted in restoration of patient’s oral health considerably craniofacial involvement, ABS has not been reported in (Table 1 and Fig. 1). the dental literature very often. DISCUSSION The characteristic features described are the constriction 1,2 Senior Lecturer of appendages by amniotic bands that may result in: 1 Department of Pediatric and Preventive Dentistry, VSPM’s • Constriction rings around the digits, arms and legs Dental College and Research Centre, Nagpur, Maharashtra, India • Swelling of the extremities distal to the point of 2 Department of Orthodontics and Dentofacial Orthopedics constriction Sharad Pawar Dental College, Wardha, Maharashtra, India • Amputation of digits, arms and legs 2 Corresponding Author: Kavita Hotwani, Senior Lecturer In the present case, congenital deformity of phalanges Department of Pediatric and Preventive Dentistry, VSPM’s Dental College and Research Centre, Nagpur, Maharashtra of left hand and rudimentary fjngers were observed. India, Phone: 9975206525, e-mail: hotwani.kavita@gmail.com The proposed theories may explain the cause of ABS to International Journal of Clinical Pediatric Dentistry, January-April 2015;8(1):55-57 55
Kavita Hotwani, Krishna Sharma Fig. 1: Intraoral photographs Fig. 2: Rudimentary fjngers, absent nail bed and weak fjnger grip (congenital deformity of phalanges of left hand) histogenesis causes fetal disruption leading to defective Table 1: Phase-wise treatment plan for oral rehabilitation tissue. 1. Medical phase • Evaluation for fjtness Some studies found connection between ABS and 2. Dental • Extraction of root stumps with 51,52 rehabilitation mother’s age, prematurity, abdominal trauma and • Pit and fjssure sealants with 16, 26 and 36, 46 some drugs. 2,5 In the present case, a positive history of • Caries excavation with 54, 64, 74, 84 premature birth and abdominal trauma was established. followed by stainless steel crowns The most frequent organs involved in ABS are the • Glass ionomer restorations with 55, 65, 75 and 85 fjngers and toes, with or without association with cleft 3. Preventive • Oral hygiene instructions lip and palate. Early amniotic rupture, during first measures • Dietary counseling and modifjcation 45 days, leads to the most severe craniofacial and • Periodic recall visceral malformations. Most often, there are minor defects, such as constriction rings or digit amputa- some extent. According to amniotic disruption theory proposed by Torpin, 3 ABS occurs due to a partial rupture tions. If bands compress the fetal head or face, different craniofacial disturbances appear: asymmetric face clefts, of the amniotic sac. The embryonic dysplasia theory proposed in 1930 by Streeter 4 suggested that abnormal orbital defects, corneal abnormalities. 1-5 It is also reported 56
Recommend
More recommend
