By E W Odell
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Extra resources for Clinical problem solving in dentistry
Example text
Down’s syndrome is caused by complete or partial trisomy of chromosome 21. The majority of patients have a complete third copy of the chromosome, but there are several different ways in which cells can acquire additional chromosome 21 DNA. This is important because not all individuals with Down’s syndrome have a similar phenotype. 1. � How does this cause the condition? The long arm of chromosome 21 includes a region called the Down syndrome critical region. Genes at this site encode transcription factors that control development, including that of the brain.
In this case the patient maintained good plaque control but the recession worsened slowly over a period of several years until there was a lack of functional attached gingiva. � What other treatments might be possible? Are they effective? 2 shows alternative treatments. 2 � What do you see; is the graft successful? Yes, the graft appears successful. Palatal connective tissue and overlying epithelium has been placed apical to the lower incisor gingival margin to provide a wider zone of attached keratinized gingiva.
Prevent and treat dental caries — Avoid sweets or overuse of citrus fruit to stimulate salivary flow. — Appropriate dietary analysis, preventive advice and fluoride treatment. — Treat caries. • Consider using saliva substitutes though these are generally unsatisfactory and not liked by patients. — Carboxymethyl-cellulose and similar starch-based liquids. — Mucin-based preparations are more effective and generally better tolerated. • Warn patient about, and follow up for, attacks of acute bacterial ascending sialadenitis in the major glands, which destroys residual gland function.