ByNajma Mohamed

Alamami

Patient name: Marwan Mohamed Abd Alkawi

Gender: male Age: 7years Patient Address: Alexandria . Operation date: 4 - 4 – 2014 Phone no :01222950087 Occupation: Resident, Pediatric

Dentistry and Dental Public Health Department, Faculty of Dentistry. Alexandria- University.

Marwan Mohamed Abd Alkawi accompanied by his mather, was presented to the clinics of the Pediatric dentistry department, Alexandria University in April 2014.complain of carious anterior teeth, with history of extraction .

He has early childhood caries

Pre mature missing #54 , #55 , # 65 , #64 .

Badly decayed #51 , #52 , #61, #62.

#63,#53,73, #83 proximal caries.

Abnormal path of eruption of lower anterior permanent incisor

Mental retardation . Post axial Polydactyly

(unlerpolydycatly ) in two hands. abnormal facial feature as

oclular hyper telorism and micrognatia .

Macrocephaly and high prominent forehead .

speech delayed. Flat right tympanic membrane

(no reflex )

abnormal facial feature as oclular hyper telorism and micrognatia .

Macrocephaly and high prominent forehead .

Post axial Polydactyl (unlerpolydycatly ) in two hands.

Flat right tympanic membrane (no reflex )

His parents are relative His brother(10 years old ) has same problem

 After examining the patient dentally and medically , it was concluded that she is medically suffering from Mental retardation , Post axial Polydactyly (unlerpolydycatly ) in two hands , abnormal facial feature as ocular hyper telorism and micrognatia , Macrocephaly and high prominent forehead , speech delayed. Flat right tympanic membrane (no reflex )

,dentally suffering from early child hood caries and Abnormal path of eruption of lower anterior permanent incisor( from panoramic x ray )

1)Consultation phase His mother said she done genetic

counseling for Marwan and his brother Ahmed and she will bring it but she did not came back .

2)Restorative Phase : pit and fissure sealent

for #16 ,# 26 , #36 ,#46 .

Composite restoration # 53 , #63 , all lower anterior primary incisors and canines.

Topical fouride .

3) Surgical PhaseExtraction of #51

,#52 ,#61 ,#62 ..

4)Maintenance Phase Post operative instruction. Recall after one week . Periodic follow up for

Reinforcement of OHI.

1) Greig cephalopolysyndactyly syndrome

is a disorder that affects development of the limbs, head, and face. The features of this syndrome are highly variable, ranging from very mild to severe. People with this condition typically have one or more extra fingers or toes (polydactyly) or an abnormally wide thumb or big toe (hallux).

2) Smith–Lemli–Opitz syndrome( SLOS) can present itself differently in different cases, depending on the severity of the mutation and other factors. Originally, SLOS patients were classified into two categories (classic and severe) based on external behaviours, physical characteristics, and other clinical features. Since the discovery of the specific biochemical defect responsible for SLOS, patients are given a severity score based on their levels of cerebral, ocular, oral, and genital defects. It is then used to classify patients as having mild, classical, or severe SLOS