474 - Case Report: The Dental Treatment for Patient with Osteogenesis Imperfecta

Introduction: Osteogenesis imperfecta (OI) is a genetic or heritable disease in which bones fracture easily. Patient with osteogenesis imperfecta usually have Bisphosphonate medication therapy. There are more than 20 subtypes of osteogenesis imperfecta, with symptoms that range from mild deforming to lethal. Clinically, the disease manifests as short stature, moderate to severe bone fragility, triangular faces, blue sclera. Dentinogenesis imperfecta (DI) sometimes is accompanied with OI, especially in osteogenesis imperfecta type IV. Patients with DI have the tooth features like discoloration and transparent appearance.

 Case report: This presentation discusses a 4-year-old boy who was referred from local dental clinic for evaluation of full mouth dental caries management in September 2023. His medical history is osteogenesis imperfecta type IV. He had Bisphosphonate medication (Pamidronate) therapy since June 2022. Clinical and radiographic examination revealed dentinogenesis imperfecta, multiple caries and some may be unrestorable, and a gumboil over soft tissue of lower left region. We consulted with his pediatric geneticist for evaluating patient’s health condition and establishing treatment plan, then arranged patient having full mouth dental treatment under general anesthesia. Treatment plan includes pulpectomy and crown fabrication over teeth with deep caries. The unrestorable teeth and residual roots were preserved with a conservative treatment plan due to patient’s bone with poor healing ability. We advise his parents to reinforce his oral hygiene, keep regular dental checkup and have fluoride supplement. This report will include clinical and radiographic findings associated with osteogenesis imperfecta, and treatment rendered to our patient.

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