Malocclusion of the whole mouth of the first patient. Figure 4. Scars of the cleft palate including the narrow maxilla of the patient no 1. The patient received panoramic, postero-anterior, and lateral cephalometric radiographs with detailed intraoral radiographs (Figure 5). The radiographs revealed deep dentin caries of the left mandibular first molar tooth and nearly left maxillary first molar tooth as well as impacted mandibular third molar teeth. Her right maxillary second pre-molar, left first premolar, left mandibular second premolar, and right first molar teeth were missing. Her dental condition is also summarized in Table 1. Figure 5. Detailed intraoral radiographs of patient no. 1. Periodontal health was qualified by gingival plaque indices and periodontal pocket depths.
16,17 A periodontal WHO probe (Leibinger, Germany) was used to assess the inflammation (gingival score; scale: 0=none to 3=severe) and dental plaque accumulation (dental plaque score; scale: 0=none to 3=abundant). The means of the 4 regional gingival and dental plaque scores were calculated for each tooth, and the gingival and dental plaque indices in patient was calculated as the mean scores of all teeth. Pocket depth, defined as the distance between the base of the pocket and the gingival margin, was measured around each tooth, and the mean depth was calculated. Periodontal pockets, which result from destruction of the underlying periodontal tissues, measure 2 to 3 mm in periodontally healthy individuals. In this patient, deep periodontal pocket depths due to cleft palate at the maxillary anterior site were recorded.
The test results showed high plaque accumulation. The other periodontal conditions were within normal limitations (Table 2). An examination revealed skeletal Class III malocclusion because of the growth retardation of the maxilla followed by cleft palate formation. This retardation is shown by a sella-nasion anterior nasal spina (SNA) angle, which is used to determine the maxillary position to the cranium. In this case, the decrease amount of 10 revealed the backward of the maxilla when compared with the cranium. This type of skeletal Class III malocclusion is called micrognathie superior. Orthodontic measurements are shown in a lateral cephalometric radiograph in Figure 6. Figure 6. Orthodontic measurements related with the first patient were shown by lateral cephalometric radiograph (SNA=72��, SNB=74��, ANB=?2��, SN/Go-Gn=38��).
After consultation with the patient��s hematologist, an oral prophylaxis and topical fluoride treatment were performed. Further treatments were postponed until Drug_discovery after the bone marrow transplantation. Case 2 A 3-year-old Caucasian girl came to the Periodontology Department, Samsun, Turkey, for a consultation regarding her general dental health and an investigation of possible anomalies associated with DBA. She was the second sibling of nonconsanguineous parents. The first sibling was healthy systematically and hematologically.