[Oral sedation in pediatric outpatient dentistry]. / Primenenie peroral'noi sedatsii pri ambulatornom stomatologicheskom vmeshatel'stve u detei.

THE AIM OF THE STUDY: Was to improve the quality of treatment in pediatric outpatient dentistry with the effective use of oral sedation. MATERIALS AND METHODS: The study comprised 60 children aged 3-12 years who were undergoing therapeutic/surgical dental treatment. All children's somatic state was assessed as ASAI-II. All children met a number of psychological, anamnestic and procedural criteria. Midazolam and chloropyramine in a dose calculated for the patient's body weight were used as components of oral sedation. The estimated sedation depth was Ramsay II-III. The study included an analysis of objective (the time of comfortable treatment, the amount of treated or removed teeth per visit, the possibility of treatment without anesthesia during further visits) and subjective (the possibility of contact with the child during treatment, behavioral reactions at home and on further visits) criteria. Negative behavioral reactions and dental effects were also assessed. RESULTS: The treatment features correlated with the age category and gender of the patient. In the older age group of 7-12 years, the amount of comfortable treatment time was higher, the possibility of contact with the child reached 100% (which is twice as much as in the younger one), and also a larger number of patients were treated during further visits without an anesthetic aid. At the same time, in the younger age group of 3-6 years, the volume of treatment per visit was higher, since it takes less time to treat a primary tooth than for a permanent one. Side effects (visual hallucinations, diplopia, hyperactivity, tearfulness and aggressiveness) were more often recorded in the younger age group, but emotional instability was equally manifested in both groups. CONCLUSION: In order to maximize the effectiveness of using oral sedation as a method, it is necessary to take into account the duration and traumatism of the proposed procedure, the peculiarities of age psychology and the peculiarities of the psychological development of boys and girls.

[Pulp revascularization procedure for external inflammatory dental root resorption treatment]. / Primenenie metodiki regeneratsii pul'popodobnoi tkani dlya ostanovki naruzhnoi vospalitel'noi rezorbtsii kornya zuba.

THE AIM OF THE STUDY: To assess the effectiveness of pulp revascularization procedure in children with external inflammatory root resorption (EIRR) after constant teeth injury. MATERIALS AND METHOS: The study comprised 17 children aged 6-10 years diagnosed with EIRR as a long-term complication of dental trauma in 19 teeth. EIRR was diagnosed with periapical radiographs and CBCT was performed to further assess the pathology extension. Pulp revascularization was carried out in all 19 teeth. RESULTS: There was no resorption progression in all cases. EIRR areas were substituted by bone. In 10 from 19 teeth with early stages of root development bone or cement-like tissue ingrowth into the root canal was observed radiologically. In cases of severe EIRR this ingrowth may partially compensate for lost tissues which is confirmed by a high percentage (94.7%) of functional teeth during mean follow up time of 38±10 months. CONCLUSION: Pulp revascularization is an effective method for retaining teeth with EIRR for a relatively long period of time and allows maintaining alveolar bone volume both due to functional tooth preservation and healing of bone lesions in periapical and resorption areas.

[The quality of dental care in children with permanent teeth trauma according to analysis of medical records in an emergency unit of a municipal dental clinic]. / Kachestvo okazaniya neotlozhnoi pomoshchi detyam s travmami postoyannykh zubov po dannym analiza dokumentatsii otdeleniya neotlozhnoi pomoshchi gorodskoi stomatologicheskoi polikliniki.

THE AIM OF THE STUDY: Was to assess the efficacy and timing of emergency dental care in children with permanent teeth trauma according to analysis of medical records in an emergency unit of a municipal dental clinic. MATERIAL AND METHODS: The study involved 320 medical records of pediatric patients admitted to emergency dental care unit of a municipal dental clinic in 2021 because of maxillofacial trauma from which 221 records of children with acute dental trauma were extracted. The quality of documentation of the medical records, rationale for diagnosis and adequacy of emergency dental treatment were analyzed. RESULTS: No records included diagnosis code according to ICD-10. Trauma history was described in the majority of records by in 67% of them no trauma time was stated with proper precision. In 67.6% of permanent teeth trauma cases emergency aid was carried out inadequately. All patients with uncomplicated crown fractures were dismissed with no treatment. In complicated crown fractures needing pulp vitality preservation the pulp was devitalized or just anesthetized. Tooth replantation in avulsion cases was not performed. In 13.5% of records the treatment was not properly described. In 67.6% of records there were no recommendations for follow-ups. CONCLUSION: There is a strong need for the improvement of knowledge of traumatic dental injuries management among Russian pediatric dentists by elaboration and implementation of protocols for dental traumas treatment.

[Treatment options for external inflammatory root resorption]. / Sposoby lecheniya naruzhnoi vospalitel'noi rezorbtsii kornya zuba.

THE AIM OF THE STUDY: Was to compare the efficacy of various treatment options for external inflammatory root resorption according to literature data. MATERIALS AND METHODS: Literature was searched in electronic databases «eLibrary¼ and «PubMed¼ for key words «external inflammatory resorption treatment¼, «external inflammatory resorption management¼. Inclusion criteria comprised publications in Russian or English, clinical and experimental studies, full description of treatment protocol and obtained results. Studies with no full text, describing root resorption of orthodontic origin, clinical cases and clinical case series were excluded from the study. RESULTS: The problem of external inflammatory root resorption is poorly described in the Russian scientific literature. There are no registered protocols for its prevention and treatment or therapeutic agents with proved efficacy available in Russia. The only accessible approach for external inflammatory root resorption remains timely pulp extirpation after dental trauma which importance is underlined by all authors involved in the field of dental trauma studies. MTA and calcium hydroxide being popular as intracanal medications still have significant inconveniences as they potentially provoke root dentine fractures or replacement resorption. CONCLUSION: There is a need for elaboration and implementation of new prevention and treatment options for external inflammatory root resorption after dental trauma.

[On the reasons for ankyloglossia relapse. Part 2. Laser technique pitfalls]. / O prichinakh povtornoi plastiki uzdechki yazyka. Chast' 2. Narushenie tekhniki primeneniya lazera.

The paper presents typical complications after laser lingual frenectomy. Laser and scalpel frenectomy are comparable in terms of functional results. Laser technique has some advantages (less pain and discomfort during the procedure and in the early postoperative period, less need for local anesthesia, lower average surgery time) but the exact knowledge of laser technical features is mandatory for optimal surgery results. Laser technique methodology is described allowing to avoid the complications.

[On the reasons for ankyloglossia relapse. Part 1. Frenotomy in newborns]. / O prichinakh povtornoi plastiki uzdechki yazyka. Chast' 1. Frenulotomiya v grudnom vozraste.

The article presents modern data on the structure of the lingual frenulum in newborns and factors associated with restricted tongue mobility besides the length of the mucosal part of the frenulum. The diversity of these factors dictates to limit the indications for frenectomy in newborns to cases with breastfeeding negative events evaluated and documented by a pediatrician. The assessment protocol should include weight gain but also child and mother position, duration, and comfort of the breastfeeding sessions, as well as breast condition in mother. The cases of long-term complications of frenotomy performed in newborns are described, as well as a case illustrating indications for frenotomy associated with chronic injury (Riga-Fede disease).

[The impact of dental caries prevention program on the anthropometric measurements of preschool children]. / Vliyanie programmy profilaktiki kariesa zubov, provodimoi v doshkol'nykh uchrezhdeniyakh, na rostovesovye pokazateli detei.

THE AIM OF THE STUDY: Was to compare body mass indices (BMI) of children receiving and not receiving dental caries prevention program in preschool institutions at the age of 3-6 years. MATERIAL AND METHODS: The study comprised163 children (76 boys and 87 girls) initially examined at the age of 3 years in nurseries of the Khimki city region. In one of the nurseries 54 children received dental caries prevention and educational program for 3 years. Other 109 children not receiving any special programs served as controls. Data on caries prevalence and intensity as well as weight and height were collected at baseline examination and 3 years after. BMI was calculated by standard formula and WHO criteria for weight deficiency, normal weight, overweight and obesity for children aged 2-5 and 6-17 years were applied. RESULTS: Caries prevalence in 3-years-old was 34.1% with dmft median of 1.4 teeth. After 3 years the prevalence of dental caries reached 72.5% in controls and was almost twice as low in the main group (39.3%). Caries intensity growth was also significantly higher in controls (p<0.0001). There was statistically significant difference on the rate of underweight and normal weight in children receiving and not receiving dental caries preventive program (p<0.05). The rate of normal and low BMI in the main group was 82.6% (vs. 66% in controls) and 7.7% (vs. 22%), correspondingly. The higher the caries intensity the more is the risk for being underweight (11.5% in caries-free children vs 25.7% in having DMFT+dft more than 4, p=0.034). CONCLUSION: Our study showed positive impact of dental caries prevention program on the anthropometric measurements of children aged 3-6 years which increases the significance of this type of programs in pre-school institutions.

[Anesthesia for dental care management in children with dystrophic epidermolysis bullosa]. / Anesteziologicheskoe obespechenie stomatologicheskikh vmeshatel'stv u detei s distroficheskim bulleznym epidermolizom.

THE AIM OF THE STUDY: Was to summarize our experience in dental treatment of children with dystrophic epidermolysis bullosa (DEB) under deep intravenous sedation. MATERIAL AND METHODS: The study comprised 11 DEB patients aged 2-17 years who received full oral rehabilitation under deep sedation in Hospital Pediatric Dentistry department of the Central Research Institute of Dentistry and Maxillofacial Surgery in 2021-2022. Intravenous induction was used if a child already had venous access installed or it was feasible before sedation. If not the case inhalation induction with sevoflurane was performed for vein catheterization. Sedation was sustained by propofol infusion up to aimed concentration. Both dental treatment and extractions were carried out. RESULTS: In 11 children 37 teeth were treated and 14 extracted. Mean duration of the procedure under deep sedation was 53 min (30-190 min). In two children multiple dental extractions resulted in extensive oral mucosa injury with bullae and erosions formation in vermillion, cheeks, and hard palate areas. No skin injuries, airway obstruction or long-term complications of both anesthesiologic an dental procedure were observed. The paper describes main preventive measures minimizing risks of skin and mucosa adverse events. CONCLUSION: Intravenous sedation with spontaneous respiration allows full oral rehabilitation in DEB children with minimal risks of skin and mucosal injury associated with intubation techniques when performing described preventive measures. Use of cofferdam is crucial for success and safety of the procedure as it prevents water, dust and dental fragments contamination of oropharynx which is especially important in case of sedation with spontaneous respiration.

[Dental caries prevention program in children and adolescents living in residential institutions]. / Model' profilaktiki kariesa zubov sredi detei i podrostkov, prozhivayushchikh v organizovannom detskom kollektive.

THE AIM OF THE STUDY: Was to assess the effectiveness of a new dental caries prevention program in children of various ages living in residential institutions. MATERIALS AND METHODS: The program of oral health promotion and caries prevention was introduced in the autonomous non-profit organization «Social rehabilitation center Solba¼. The study comprised 98 children aged 12-17 years divided into two groups: the main group of 52 children aged 12-16 years enrolled in the program in 2013 in pre-school (32 children) and primary school age (20 children) and the control group of 46 adolescents aged 12-17 years not included in the program. DMFT and OHI-S index were compared in both groups as well as in children enrolled in the program at various ages. RESULTS: The overall caries prevalence was 84.7%. Statistically significant differences were documented between children enrolled in the program in pre-school and primary school ages regarding both caries prevalence (78% and 89%, respectively) and intensity (3.5 and 5.4 tooth, respectively (p=0.01)). Non-satisfactory, poor and very poor OHI-S was observed in 15.4% of children in the main group and 54.3% of controls. Good oral hygiene was seen in 67.3 and 37%, satisfactory - in 17.3 and 8.7% of children, respectively (p<0.05). CONCLUSION: Programs of dental caries prevention with oral health promotion component are effective for oral hygiene improvement in children living in residential institutions. The key for long-term effectiveness and dental caries prevalence and intensity reduction is the start of the program in pre-school age and education of caregivers and teachers to provide control of dental care in pre-school and primary school children.

[Morphological and functional assessment of the oral mucosa in children with dystrophic epidermolysis bullosa]. / Otsenka morfologicheskogo i funktsional'nogo sostoyaniya slizistoi obolochki rta u detei s distroficheskim bulleznym epidermolizom.

THE AIM OF THE STUDY: To validate modified oral index (MOI) for the assessment of the oral mucosa in children with dystrophic epidermolysis bullosa (DYB). MATERIALS AND METHOS: The study comprised 27 DYB children aged 4 to 18 years. Morphological component of MOI was documented by an intraoral camera with the registration of pathological elements in various of the oral cavity and differentiated scoring. Functional component included registration of ankyloglossia and microstomia measured by Bristol assessment system and orthodontic caliper, correspondingly, and then referred to normal age-matched values. RESULTS: Oral mucosa condition deteriorates in DYB children with age both in morphological and functional aspects. MOI values more than 40 should be seen as prognostically unfavorable as they are always associated with severe functional restrictions. These restrictions are always present in children older than 6. If present in younger age they may indicate poor functional status in future. CONCLUSION: The MOI may be a useful tool for the assessment of the efficacy of the pharmacological agents' impact on the oral mucosa and disease prognosis. Correlation of MOI and general condition of DYB children needs further investigation.

[Oral microbiome in children with dystrophic recessive epidermolysis bullosa]. / Mikrobiota slizistoi obolochki rta u detei s retsessivnym distroficheskim bulleznym epidermolizom.

THE AIM OF THE STUDY: Was to assess bacterial load in oral wounds in children with recessive dystrophic epidermolysis bullosa (RDEB). MATERIALS AND METHODS: The study comprised 77 RDEB children aged 3-18 years (mean age 9.5±3.6 years) and 27 healthy children aged 4-18 years (mean age 9.8±4.1 years) who served as controls. Swabs for bacteriological study were taken from the oral wounds in RDEB patients and non-affected corresponding oral mucosa areas in controls. The microorganism growth was assessed after 24, 48 and 72 hours of incubation (37 °C and 30 °C) with subsequent identification in automatic bacteriological analyzer MicroScan Walk Away (Simens, USA). Results. The study revealed high prevalence and concentrations of Candida albicans (in 40.3% children), Staphilococcus aureus (23.4%), Enterobacter cloacae (9.1%), and Enterobacteria (10.4%) in RDEB children. From these species, only Candida albicans was present in controls (26%). The prevalence and concentration of commensal and pathogenic species correlated positively with age and significant difference was revealed between children at the age of 3-6 and 7-10 years (p=0.001). Thus, bacterial load in oral wounds correlates with the RDEB natural history and fibrosis progression. Delayed oral wound healing was associated with microbiome shift towards biofilm-producing bacteria Staphilococcus aureus and Enterobacter cloacae. CONCLUSION: Oral wounds microbiome may be an indicator of RDEB severity and tendency to oral fibrosis. The decrease of bacterial load in the oral wounds may remove one of the healing obstacles and serve as fibrosis prevention measure.

[Child's weight as a risk factor for early childhood caries]. / Ves rebenka kak faktor riska kariesa rannego detskogo vozrasta.

THE AIM OF THE STUDY: Was to reveal possible correlation between child's birth weight, BMI at examination, dental caries prevalence and intensity. MATERIALS AND METHODS: The study comprised 220 healthy children aged 3-6 born mature and attending nursery schools in Khimky city (Moscow region, Russia). Data on birth weight were extracted from a healthcare reports database, current height and weight were measured and BMI was calculated and interpreted according to WHO criteria. Calibrated pediatric dentists performed oral examination registering the dmft index. RESULTS: Children suffering from dental caries at the age of 3-6, have lower birth weight and struggle to put it on later in life. This results in higher proportion of children with underweight. Among children with caries 69.2% had BMI lower than 15th percentile, and 28.3% had very low IMT (lower than 5th percentile) vs 5.6% in the group without caries (p<0.05). The mechanisms and the direction of this correlation are unclear. CONCLUSION: There is a necessity for further investigations on the role of various factors associated with body weight and alimentary status in the development of the early childhood caries.

[Prevalence, intensity, and efficacy of dental caries treatment in pre-school children living in the town of Khimki]. / Rasprostranennost', intensivnost' i effektivnost' lecheniya kariesa zubov u detei doshkol'nogo vozrasta, prozhivayushchikh v gorodskom okruge Khimki.

THE AIM OF THE STUDY: Was to assess the prevalence, intensity, and treatment efficacy of dental caries in children aged 3 to 6 years residents of the town of Khimki, Moscow region. The number of decayed, filled, and missed due to caries teeth was registered. The parents were interviewed in order to reveal dental caries treatment experience as well as reasons for negative experience, age of the first dental office visit and the reasons for it. RESULTS: The incidence of dental caries in 3-6 years old living in Khimki is 52%. The prevalence and incidence unsurprisingly grow with age as well as the number of children having the experience of toothache and early extractions. The vast majority of children including these with positive dental treatment experience have untreated carious lesions. The difference of decayed teeth between children having negative and positive treatment experience in statistically insignificant (p=0.57), and the number of filling is equally small in both subgroups (p=0.99). This means even cooperative children who underwent dental treatment have untreated (or previously treated but having no fillings - in 22.6% of treatment cases) cavities. CONCLUSION: The dental caries intensity growth outpaces the possibilities of the Khimky dental service resulting in the low number of caries-free previously treated children (17.9% of all treated). All this dictates the necessity for dental caries prevention programs and implementation of new models for dental care organization in preschool children.

[Phantom root as dental trauma complication in immature teeth (systematic literature and clinical cases review)]. / Fantomnyi koren' ­ oslozhnenie travmy zubov s nesformirovannymi kornyami (analiz literatury i sobstvennykh klinicheskikh sluchaev).

The paper presents literature review and the analysis of three clinical cases of phantom root development. Phantom root is a rare complication occurring as a result of apical papilla detachment, usually after dental trauma. Some authors suggest regenerative endodontic procedure may contribute to phantom root development because of rude intervention in periapical tissues needed to induce apical bleeding required for intracanal blood clot formation. Phantom root is not an indication for endodontic treatment. The prognosis depends on initial root formation stage and root to crow length ratio at the time of trauma. In the majority of cases the teeth may be preserved, but continuous root development is not to be expected.

[Dental age in children with epidermolysis bullosa]. / Zubnoi vozrast u detei s bulleznym epidermolizom.

THE AIM OF THE STUDY: Was to assess dental age and the frequency of dental extractions in children with epidermolysis bullosa (EB) compared to controls. MATERIALS AND METHODS: The study comprised 22 EB children (8 boys and 14 girls aged 4-16 years, mean age 11.1±3.5 years) and 25 healthy children (9 boys and 16 girls aged 4-14 years, mean age 10.1±2.4 years). Dental age was measured on panoramic X-ray by Demirjian method and then compared to child's physical age to estimate retardation or advance in dental maturity. RESULTS: Only in 5 from 22 EB children dental age corresponded to physical age, there was dental age retardation in 7 patients (13 to 68 months, 27±21.5 months in average), but in 10 dental age exceeded physical (4 to 21 months, 12.9±7.8 months in average). In controls where was only one boy with dental age retardation by 18 months, in 7 children dental age corresponded to physical, in 17 dental age advance by 5-45 months (16.0±11.0 months in average) was revealed. Conclusion. Possible dental age retardation in EB patients should be considered when undertaking dental extractions for orthodontic reasons. For more precise orthodontic treatment timing further studies are needed to correlate dental age, skeletal age and BMI in children with EB.

[Age-related dynamics of mouth opening and tongue mobility in children with various forms of epidermolysis bullosa]. / Vozrastnaya dinamika stepeni otkryvaniya rta i podvizhnosti yazyka u detei s razlichnymi formami bulleznogo epidermoliza.

THE AIM OF THE STUDY: Was to assess age-related changes in mouth opening and tongue mobility in children with various forms of epidermolysis bullosa (EB). Materials and methods. The study comprised 50 EB children (mean age 8.8±3.9 years). Oral slit width (the distance between mouth commissures at rest), mouth opening amplitude (the distance between incisive edges of the lower and upper incisors) were measured by orthodontic caliper. Tongue mobility was assessed using Bristol Tongue Assessment Tools (BTAT). The results were compared with 55 healthy age-matched controls (mean age 9.3±3.7 years). RESULTS: Mean moth opening in EB group was 22.6±11.1 mm which is twice lower than in controls (44.3±7.2 mm). The amplitude was progressively increasing in EB patients in the mixed dentition period but then dropped drastically in the permanent dentition because of oral fibrosis. Tongue mobility was lower in EB group when compared to controls even in cases with anatomically appropriate frenulum fixation sites. In permanent dentition maximal tongue raising was 8 times lower than in controls. Microstomia and ankyloglossia were very specific for dystrophic EB patients while in EB simplex, junctional EB and Kindler syndrome the values were similar to healthy controls. CONCLUSION: Microstomia, limited mouth opening and tongue mobility are typical oral features of dystrophic EB patients. Age-related dynamics shows progressive growth of the values in mixed dentition with significant lowering after so preventive measures for oral fibrosis are more feasible before permanent dentition phase.

[Comparative analysis of calcium hydroxide apexification and regenerative endodontic procedure for root dentine growth stimulation in immature incisors with pulp necrosis]. / Sravnitel'nyi analiz metodik apeksifikatsii gidroksidom kal'tsiya i regeneratsii pul'popodobnoi tkani dlya stimulirovaniya rosta kornevogo dentina v reztsakh s nesformirovannymi kornyami i nekrozom pul'py.

THE AIM OF THE STUDY: Was to compare the efficacy of Ca(OH)2 apexification and regenerative endodontic procedure (REP) in immature teeth with pulp necrosis. The pilot study included 12 children aged 89 to 126 months having pulp necrosis in immature incisors. Dental trauma was the etiology for pulp necrosis in all cases and initial X-rays showed periapical translucency lesions (PTL). The patients were randomly divided in 2 groups with either Ca(OH)2 apexification (group 1, n=6) or REP (group 2, n=6). The root length and the growth of root wall thickness, as well as root to crown ratio and dentinal wall to root canal space ratio was assessed radiologically in 6, 12 and 24 months. The root length increase was detected in 83% of all cases, but the pattern of root dentine growth in the groups was different. Dentin thickness in REP group was more prominent in the apical third and was observed in 100% of cases while in group 1 dentin thickness increased mainly in the coronal and middle third of the root, dentin thickness increased only in 33% of all cases in the apexification group. PTL were successfully eliminated in both groups. CONCLUSION: Results and complications of both methods allow limiting indications for their usage. Ca(OH)2 apexification is more reliable in cases of pulp necrosis in teeth with III and IV stages of root formation when an estimated time for apexification is 3 to 6 months, under condition of good patient cooperation and possibility for good marginal fit of the restoration. REP is indicated in cases with I, II and III stages of root formation, as well as initial root resorption signs regardless of root formation stage.

Development prospects of curable osteoplastic materials in dentistry and maxillofacial surgery.

The article presents classification of the thermosetting materials for bone augmentation. The physical, mechanical, biological, and clinical properties of such materials are reviewed. There are two main types of curable osteoplastic materials: bone cements and hydrogels. Compared to hydrogels, bone cements have high strength features, but their biological properties are not ideal and must be improved. Hydrogels are biocompatible and closely mimic the extracellular matrix. They can be used as cytocompatible scaffolds for tissue engineering, as can protein- and nucleic acid-activated structures. Hydrogels may be impregnated with osteoinductors such as proteins and genetic vectors without conformational changes. However, the mechanical properties of hydrogels limit their use for load-bearing bone defects. Thus, improving the strength properties of hydrogels is one of the possible strategies to achieve the basis for an ideal osteoplastic material.

[Perinatal risk factors of the early childhood caries]. / Perinatal'nye faktory riska kariesa vremennykh zubov.

THE AIM: Of the study was to find possible correlations between early childhood caries (ECC) prevalence and intensity and perinatal factors, such as pregnancy and birth adverse events, terms and mode of delivery, child's weight at birth. MATERIALS AND METHODS: The study comprised 165 3-6 years old healthy children (80 boys and 85 girls) examined in Khimki nurseries. Perinatal background data were collected through validated questionnaires. RESULTS: ECC prevalence and dmft median were 41.2% and 1.2 teeth, correspondingly, in 3-years-olds and values growth up to 64.8% and 3.5 teeth was seen in 6-years-olds. Exact Fisher test showed significant positive correlation between adverse pregnancy events and caries risk, as ECC had 8.6 and 51.7% of children born from complicated and non-complicated pregnancies, correspondingly (p<0.05). In children born by cesarean section ECC was detected more often, than in born via vaginal delivery (62.8 vs 49.6%, correspondingly). The correlation became statistically significant by the age of 6 (p=0.02). In 6-years-olds we also noted significant correlation between mode of delivery and dmft numbers (p<0.05). CONCLUSION: Adverse pregnancy events and cesarean section are ECC risk factor affecting the intensity of the disease.

[Maxillofacial manifestations in children and adolescents with neurofibromatosis 1]. / Stomatologicheskie proyavleniya neirofibromatoza I tipa u detei i podrostkov.

The aim of the study was to summarize literature data on oral and maxillofacial manifestations of neurofibromatosis I (NFI) and to analyze clinical case in with dentist had the leading role in proper diagnosis of the disease. Literature review showed main oral alterations in NFI to be: neurofibroma formation seen in 8-14% of children and adolescents, dysplastic «orthodontic¼ phenotype with shortened mandible, maxilla and sphenoid bones; radiologic signs including alveolar nerve canal and mental foramen widening in almost one third of patients; lesions of cranial nerves (mainly trigeminal, facial and glossopharyngeal), with non-specific paralysis clinic. These symptoms, however, develop gradually throughout the life and may be evident only in late adolescents. The most pathagnomic sigh is café-au-lait spots as they present in 95% of children at birth. The described clinical case demonstrates the difficulties in diagnostic of NFI in children in the absence of mutilating plexiform neurofibromas. The disease provoked significant functional disorders in maxillofacial area which resulted not only in lower quality of life but also mimicked iatrogenic complications of routine dental treatment.