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  Endodontic management of a patient with X-linked hypophosphatemic rickets

The opinions within this web page are not ours. Authors have been credited
for the individual posts where they are. Photos courtesy: Noemí Pascual - ROOTS

From: "Noemí Pascual"
To: "ROOTS" Sent: Tuesday, September 26, 2006 3:59 AM
Subject: [roots] Endodontic management of a patient with X-linked hypophosphatemic rickets

Endodontic management of a patient with X-linked hypophosphatemic rickets

These are the information sources available at PubMed. I have treated one patient with this disease and the results were very frustrating. There simply is no predicting how many of the teeth will go non-vital. First one, then another, then another - all virgin. More puzzling still is the low rate of treatment success with these cases. There is no question that this has to do with the infection in the canals (even with multi-step CaOH) but I also have some concerns as to how well we can seal these teeth considering that they originally became contaminated through what we would assume is an "intact" (dentin/enamel/ cementum) tooth. If the virgin natural tooth ( in this patient) must be considered essentially permeable - what are the chances that cleaning out the canals and trying to stuff them will make any appreciable difference - in the long run? As much as I'm not a hug fan of Resilon - this might be a good case to try. What have we got to lose? I'll see if I can dig up the chart tomorrow. I seem to remember doing at least 6 teeth - with a couple of molar failures. :-( - Rob K 1: Pereira CM, de Andrade CR, Vargas PA, Coletta RD, de Almeida OP, Lopes MA. Dental alterations associated with X-linked hypophosphatemic rickets. J Endod. 2004 Apr;30(4):241-5. PMID: 15085056 [PubMed - indexed for MEDLINE] 2: Alexander S, Moloney L, Kilpatrick N. Endodontic management of a patient with X-linked hypophosphataemic rickets. Aust Endod J. 2001 Aug;27(2):57-61. Review. No abstract available. PMID: 12360687 [PubMed - indexed for MEDLINE] 3: Shroff DV, McWhorter AG, Seale NS. Evaluation of aggressive pulp therapy in a population of vitamin D-resistant rickets patients: a follow-up of 4 cases. Pediatr Dent. 2002 Jul-Aug;24(4):347-9. PMID: 12212880 [PubMed - indexed for MEDLINE] 4: Murayama T, Iwatsubo R, Akiyama S, Amano A, Morisaki I. Familial hypophosphatemic vitamin D-resistant rickets: dental findings and histologic study of teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Sep;90(3):310-6. PMID: 10982952 [PubMed - indexed for MEDLINE] 5: Rakocz M, Keating J 3rd, Johnson R. Management of the primary dentition in vitamin D-resistant rickets. Oral Surg Oral Med Oral Pathol. 1982 Aug;54(2):166-71. PMID: 6289221 [PubMed - indexed for MEDLINE] 6: Ainley JE Jr. Manifestations of familial hypophosphatemia. J Endod. 1978 Jan;4(1):26-8. No abstract available. PMID: 277626 [PubMed - indexed for MEDLINE] 7: Cohen S, Becker GL. Origin, diagnosis, and treatment of the dental manifestations of vitamin D-resistant rickets: review of the literature and report of case. J Am Dent Assoc. 1976 Jan;92(1):120-9. Review. Rob Kaufmann DMD MS(Endo)

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