Dental characteristics of Rickets disorder. Case report Ana Lucia A, Capelozza; Roberta H. Abujamra; Izabel R.F.R Bullen. Faculdade de Odontologia de Bauru University Of São Paulo Brazil

Signs and symptoms Delayed growth: short stature and deformity of extremities Breastbone projection Pain in the spine , pelvis and legs Muscle weakness http://www.doctoryum.org/wp-content/uploads/2011/04/rickets.jpg Skeletal deformities Bowed legs Thickened wrists and ankles

Rickets disorder (affects the growing skeleton in infants and children) Osteomalacia ( affects the mature skeleton in adults) Occurs due to a genetic condition Skeletal deformities due to deficiency of vitamin D

Radiographic features of the jaws Mandibular border or the walls of the mandibular canal thin Trabeculae: reduced in density, number and thickness Teeth: hypoplasia of the dental enamel erupted and unerupted teeth Lamina dura and cortical boundarry of tooth follicles may be thin or missing Pulp chambers: Large Bone loss around the teeth External root resorption

Differential diagnosis Amelogênese imperfeita Identification is made primarily by clinical examination low or absent cusp square shape of the crown thin opaque layer of enamel Differential diagnosis Dentin Dysplasia (opalescent dentin) altered color occluded pulp chambers Dentinogenesis imperfecta history of familial envolvment bulbous crows narrow roots obliteration of pulp chambers and root canals Regional Odontodysplasia enamel and dentin are hypoplastic and hypocacified not hereditary segment of the arch are affected

Report of case A 12 year old male patient was referred from Bauru School of dentistry due orthodontic evaluation. The parents reported that the patient is one of triplets and at the birth were the biggest new born . The diagnosis was made when he was 3 years old.

Signs Symptoms Extraoral exploration : lower limb bow, frontal bulging bone, short and orthopedic deformities of extremities. Patient reports: bone pain in the hip region feets, ankles and back. Tooth pain Pus in the structures that surround the teeth Intra-oral examination spontaneous dental abscesses, delay in teeth eruption.

enlarged pulp chambers with pull horns extending up to dentin-enamel junction, presence of a radiolucent area along the lower incisors

Dental examination should be carried out at least twice a year. Patients should received multiple integrated treatments as surgeries, orthodontic and orthopedic assistance Dental radiographs may be performed to identify periapical lesions and other alterations The multidisciplinary treatment included prophylactic pulpotomies and chrome steel crowns in molars and resin in anterior teeth Dental examination should be carried out at least twice a year.