Henoch-Schönlein Purpura (Childhood Immunoglobulin A Vasculitis) caused by dental infection in one of fraternal twins: A case report

@#Henoch-Schönlein purpura (HSP) is the most common form of vasculitis in children that is clinically characterized by the classic triad of palpable purpura, joint symptoms, and abdominal pain. A 6-year-old girl, one of fraternal twins, was admitted to the Pediatric Department, Universitas Airlangga with fever, rashes on legs and arms and intermittent mild abdominal pain. She had multiple purpuric rashes on her extremities, abdomen and buttocks. Laboratory investigation revealed immunoglobulin A level of 289.6 mg/dL. The patient was diagnosed as HSP vasculitis according to EULAR criteria and treated with intravenous methylprednisolone. She was discharged after three days with normal physical examination and laboratory findings. Intraoral examination showed dental infection in the upper tooth region. The paediatrician suspected a correlation between HSP and her dental infection. The dental infection and genetic susceptibility may be the stimulant factors for the autoimmune reactions that caused HSP vasculitis. Hence, it might be useful to investigate the presence of dental infection in the etiology of HSP cases.

Myofunctional therapy using twin block appliance in a class II Malocclusion patient with ADHD

@#A 9-year-old male ADHD patient with class II dentoskeletal malocclusion came to the Pediatric Department of Universitas Airlangga, Surabaya, with a chief complaint of a protrusive look. The patient had a behavior disorder of ADHD (Attention Deficit Hyperactivity Disorder), in which its symptoms may be challenging in dental treatment since it heavily depends on the patient’s obedience and case selection. References and similar studies of myofunctional therapy in Class II Malocclusion Patients with ADHD are still scarce. Most patients with class II malocclusion present with hyperactive perioral muscle and altered tongue position. Hence, myofunctional appliance is a reliable treatment choice. A special rule where the patient was asked to focus on the operator’s instruction for 10 minutes and then a 5-minute break, was applied to this patient to overcome ADHD symptoms as a behavior management strategy. This is in line with a theory stating that children with ADHD are prone to distraction, causing them to have a shorter duration of focus, limited sustained attention span, poor impulse control, and motor overactivity compared to normal children. This strategy gave a positive result in maintaining the cooperation of the patient using the twin block for 6 months which is lead to positive progress in malocclusion correction.

Orthodontics treatment strategy and management in a child with attention deficit hyperactivity disorder

@#This is a case of an 8-year-old male patient diagnosed with class 1 angle malocclusion, 9 mm overjet and 4.5 mm overbite, with thumb-sucking habit. The patient also has attention deficit hyperactivity disorder (ADHD). The goal of this study is to identify and determine appropriate orthodontics treatment management for patients with ADHD. Management behavior using behavioral shaping and tell-show-do technique during orthodontic treatment in patients with special needs contributes to how well the patient will cooperate with the dentists during treatment.

Suspected non-syndromic Oligodontia - A rare case with 13 agenesis

@#Oligodontia is a condition in which the patient has more than six ageneses, excluding the third molars. Whereas the absence of one tooth is quite common, oligodontia is a rare congenital condition that can happen with or without the syndrome. The condition happens due to disturbances during odontogenesis process. Management of oligodontia is a long-term process, and it involves prosthetic, restorative, and orthodontic treatment to support the oral function and esthetic of the patient. This article aims to report a rare case of agenesis of 13 permanent teeth (excluding third molars) in an 11-year-old girl and her treatment plan.