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)