Gingivitis in children with down syndrome: Review of local and systemic factors

Objective@#To describe various local and systemic factors as the cause of gingivitis and to find out the main etiological factors of gingivitis in children with DS.@*Methods@#We searched PubMed and Google Scholar for Indonesian and English references either in the form of textbook, research results, reviews, and internet articles on the topic. We screened and selected the relevant articles for inclusion into the review. @*Results@#In children with DS, apart from poor oral hygiene, the increasing incidence of gingivitis is caused by changes in other local factors related to systemic factors, such as oral dysfunction, dental and gingival abnormalities, changes in the oral microbial profile, and salivary characteristics. Furthermore, systemic immunodeficiency, changes in inflammatory mediators and proteolytic enzymes, and intellectual subnormality are considered as systemic factors.@*Conclusion@#There is no main etiological factor of gingivitis in children with DS since various local and systemic factors are interrelated with each other causing gingivitis. The severity of gingivitis in children with DS presumably were caused by the systemic factors. Furthermore, good oral hygiene habits and the dentist's intervention in periodontal health can significantly reduce gingivitis in DS patients.

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.

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.