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17/06/2011 at 3:28 pm #12167AnonymousOnlineTopics: 0Replies: 1150Has thanked: 0 timesBeen thanked: 1 time
Ectodermal Dysplasia is the term used to describe a group of rare, inherited disorder characterized by dysplasia of tissues of ectodermal origin-primarily nail, teeth and skin and occasionally dysplasia of mesiodermally derived tissues1. It represents a large and complex nosological group of congenital diseases which were first described by Thurnam in 1948 and later in the 19th century by Darwin. Its relation to X chromosome was determined by Thadani in 19212. The condition is thought to occur in approximately 1 of 1, 00, 000 live births. Ectodermal Dysplasia restricted to teeth, jaw bones and palms and soles has been reported in past with a very few cases.
The Ectodermal dysplasias are a heterogeneous group of disorders with primary defect in hair, teeth, nail and sweat gland function. Numerous types have been described and several classifications exist. Hypohidrotic ectodermal dysplasia is a rare congenital disease that affects several ectodermal structures. The condition is usually transmitted as an x-linked recessive trait, in which gene is carried by the females and manifested in males. Whereas hidrotic ectodermal dysplasia presents with anomalies such as enamel hypoplasia, hypodontia and facial dysmorphy. In the developed countries diagnosis of such cases done during childhood. But in the developing countries patients fail to report for various reasons.
17/06/2011 at 4:18 pm #17344DrsumitraOfflineRegistered On: 06/10/2011Topics: 238Replies: 542Has thanked: 0 timesBeen thanked: 0 timesCAUSE OF ECTODERMAL DYSPLASIA:
Ectodermal Dysplasia is caused by a single abnormal gene or pair of abnormal genes. The chance for parents to have an affected child depends on the type of Ectodermal Dysplasia that exists in the family. In some families the mistake in the gene was a fresh mistake (mutation) in their child and the likelihood of another child being affected is very low. There are other families however that have an inherited form of Ectodermal Dysplasia with recurrence risk ranging from 25% to 50%.
SWEAT GLANDS:
Diminished or absent sweating is a common problem. The sweat glands are absent, reduced in
number, or may not function normally. Reduced sweating may result in very high fevers, because the body regulates its temperature by sweating. Often, the first clue that the sweat glands are absent or are not functioning normally is an elevated temperature.Elevations in body temperature are often caused by high environmental temperatures, excessive
activity, or heavy clothing. When the body temperature is elevated, the skin feels dry, hot and may be flushed or pale.HAIR:
The scalp hair is absent, sparse, fine, lightly pigmented, or abnormal in texture. The hair may also be fragile and unruly, sticking out in all directions and difficult to comb. The hair is dry because the oil glands are absent or poorly developed.
Some defects of the hair are evident at birth, while others are not noted until later in life. Hair growth is slow and haircuts are not often needed. After puberty hair growth improves in some persons.
The eyebrows, eyelashes, and other body hair may also be absent or sparse, but beard growth in males is usually normal.
NAILS:
Most people with Ectodermal Dysplasia do not have nail abnormalities, although the nails are frequently dry and rough. A distinctive finding in one of the forms of Ectodermal Dysplasia is a short nail that fails to grow to the end of the finger. In others, the nails may be thin and fragile, thick and distorted, or brittle and slow- growing. Nails with any of the listed abnormalities may be prone to infection.
TEETH:
The teeth are missing altogether or reduced in number. Teeth that are present are widely spaced, tapered, or malformed. In persons with some types of Ectodermal Dysplasia, the enamel (outer layer of the teeth) is defective and there may be an excessive number of cavities. When teeth are missing the jawbones in which they are ordinarily embedded do not develop well, leading to a typical aged appearance in the face.
EAR, NOSE AND THROAT:
The generalized underproduction of body fluids leads to several problems. Saliva is sparse, causing problems with chewing, tasting, and swallowing foods. The mucous secretions of the nose are excessively thick, forming a crusty mass. Nasal infections are common. A hoarse, raspy voice is common. Abnormal ear wax production may be noticed in some people with Ectodermal Dysplasia. The most frequent problem is accumulation of wax in the ear canal. Hearing loss may occur secondary to impacted wax or to nerve degeneration.
EYES:
Tears are reduced, causing irritation of the eyes, conjunctivitis, and sensitivity to sunlight. There may be cloudy corneas or cataracts.
RESPIRATORY PROBLEMS:
The linings of the nose, larynx, trachea and lungs are moistened by various glands, some of which may be defective in Ectodermal Dysplasia. Respiratory problems are therefore common.
17/06/2011 at 4:26 pm #17345AnonymousUsing endosseous dental implants for patients with ectodermal dysplasia.
Ectodermal dysplasia (ED) is a genetic birth defect that often results in dental abnormalities such as missing or abnormally small teeth. Hair, nail, and sweat gland abnormalities are also commonly seen in persons with ED. Treatments for the dental problems have traditionally involved fitting the patient with partial or complete dentures. Although dentures are a useful treatment, they do not always provide enough structure in the mouth for proper development and they are not readily accepted by children. A recently developed technique offers ED patients an alternative to dentures. Oral endosseous titanium screw-type implants can be used to replace missing or abnormal teeth. The implants can provide the proper support that normal teeth would, allowing proper development and maintenance of the healthy teeth. Early and extensive planning is required if these implants are to be used in treating ED patients. Healthy teeth should be saved, but questionable teeth may need to be removed. Bone development is often abnormal in ED patients and bone grafting may be necessary to provide support for the implants. Temporary dentures may be needed while determinations are being made as to which teeth can be saved and which must go. Also, it is probably best to hold off on implants until adolescence. This allows for changes in facial structure that could alter the best placement of the implants. With careful planning, endosseous implants are an effective treatment for the dental problems of ED patients.
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