Longitudinal Dental Management of Hypophosphatemic Rickets

IDE Masamichi, KOGUSHI Nobuo, ASADA Yoshinobu

doi:10.11411/jspd.50.4_313

Hypophosphatemic rickets (HR) is a rare hereditary disease in which spontaneous formation of a gingival abscess (GA) is a dental problem. This report describes longitudinal dental management of a child with HR from primary to permanent dentition.A 2-year-1-month-old boy with HR visited our pediatric dentistry clinic complaining of pain and swelling in the gingiva in the area of the maxillary left primary central incisor. Although caries was detected in that tooth, the extent was not considered severe enough to cause apical periodontitis existing in the same tooth. Since resorption and destruction of periodontal tissue were minimal, root canal treatment was performed. Eventually, GA formation occurred in a total of 17 primary teeth, of which 2 were indicated for extraction and the remaining 15 for root canal treatment. Formation of GA recurred in 4 of those teeth after root canal filling, thus that was repeated. All primary teeth that underwent root canal treatment maintained their function until the eruption stage of the successive permanent teeth, which then received prophylactic treatment. Normal permanent dentition was thus attained without occurrence of caries and GA.Our findings indicate that root canal treatment may be an effective treatment method for children with HR whose primary teeth are complicated with GA. Furthermore, instead of extraction, root canal treatment should be considered as the first choice of treatment for cases with minimal root resorption and periodontal tissue damage.

Longitudinal Dental Management of Hypophosphatemic Rickets

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