Oral Manifestations of a Patient Suffering from a Rare Gilbert’s Syndrome: A Case Report

Gilbert's syndrome is a rare genetic disorder characterized by abnormal glucuronidation of bilirubin in the liver, presenting as unconjugated hyperbilirubinemia in the absence of hepatocellular injury or hemolysis. Diagnosis of this pathology is primarily made during routine examination described as the presence of a yellowish tinge in the eyes and skin in general. Normally, the oral manifestations of Gilbert's syndrome are present but mostly go unnoticed as the teeth are minimally affected which are visible to the patient and surrounding mucosa in the oral cavity, where yellow discoloration can be appreciated. Dental treatments are smoothly carried out for such patients like extractions, root canal treatment, cleaning prophylaxis. The patient in this case safely underwent the root canal treatment after being diagnosed with irreversible pulpitis without any unusual discomfort. Local anesthesia can also be safely administered to such patients such as infiltration and inferior alveolar block anesthesia.

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Occurrence of Recurrent Aphthous Stomatitis (RAS) as a Rare Oral Manifestation in a Patient with Gilbert’s Syndrome

Case Reports in Dentistry ◽

10.1155/2021/6648729 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Artak Heboyan ◽

Anna Avetisyan ◽

Hans Erling Skallevold ◽

Dinesh Rokaya ◽

Vinay Marla ◽

...

Keyword(s):

Early Identification ◽

Genetic Disorder ◽

Recurrent Aphthous Stomatitis ◽

Aphthous Stomatitis ◽

Trigger Factors ◽

Unconjugated Hyperbilirubinemia ◽

Gilbert’S Syndrome ◽

Oral Manifestation ◽

Gilbert's Syndrome

Recurrent aphthous stomatitis is an ulcerative disease of the oral cavity and can occur in isolation or as a manifestation of many systemic diseases. It is a quite common entity and may hence often be overlooked as an isolated lesion. Gilbert’s syndrome is a genetic disorder where a deficiency of an enzyme associated with the conjugation of bilirubin results in unconjugated hyperbilirubinemia. The disease is generally asymptomatic and is aggravated by certain trigger factors. No associated oral manifestations are known. In this case report, we discuss the concomitant presence of recurrent aphthous stomatitis in a patient of Gilbert’s syndrome. The presence of such recurrent stomatitis may represent as an oral manifestation of Gilbert’s syndrome. Early identification of these entities may improve the overall quality of life of the patient.

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Vital Pulp Therapy in Permanent Mature Posterior Teeth with Symptomatic Irreversible Pulpitis: A Systematic Review of Treatment Outcomes

Medicina ◽

10.3390/medicina57060573 ◽

2021 ◽

Vol 57 (6) ◽

pp. 573

Author(s):

João Miguel Santos ◽

Joana F. Pereira ◽

Andréa Marques ◽

Diana B. Sequeira ◽

Shimon Friedman

Keyword(s):

Systematic Review ◽

Root Canal ◽

Small Sample ◽

Risk Of Bias ◽

Root Canal Treatment ◽

Cochrane Library ◽

Posterior Teeth ◽

Pulp Therapy ◽

Vital Pulp Therapy ◽

Irreversible Pulpitis

Background and Objectives: Symptomatic irreversible pulpitis in permanent mature teeth is a common indication for nonsurgical root canal treatment (NSRCT), but contemporary studies have reported on vital pulp therapy (VPT) applied in such teeth as a less invasive treatment. This systematic review assessed the outcomes of VPT, including partial and full pulpotomy performed with hydraulic calcium silicate cements (HCSCs) in permanent mature posterior teeth diagnosed with symptomatic irreversible pulpitis. Materials and Methods: The PRISMA guidelines were followed. The search strategy included PubMed®, EMBASE, Cochrane library and grey literature electronic databases. The quality assessment of the identified studies followed the Cochrane Collaboration Risk of Bias, ROBINS-I and Newcastle–Ottawa Scale tools. Results: The search of primary databases identified 142 articles, of which 9 randomized controlled trials and 3 prospective cohort studies were selected for review. The risk-of-bias was assessed as ‘high’ or ‘serious’, ‘fair’, and ‘low’ for three, seven and two articles, respectively. One to five years after VPT using HCSCs, the success rates mostly ranged from 78 to 90%. Based on two articles, the outcomes of the VPT and NSRCT were comparable at one and five years. Despite the necessity for the intra-operative pulp assessment in VPT procedures, the majority of the studies did not fully report on this step or on the time needed to achieve hemostasis. Small sample sizes, of under 23 teeth, were reported in three studies. Conclusions: The reviewed 12 articles reported favorable outcomes of the VPT performed with HCSCs in permanent mature posterior teeth with symptomatic irreversible pulpitis, with radiographic success in the range of 81 to 90%. Two articles suggested comparable outcomes of the VPT and root canal treatment. Universal case selection and outcome criteria needs to be established for VPT when considered as an alternative to NSRCT. This evidence supports the need for further research comparing longer-term outcomes of both of the treatment modalities.

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A COMPARATIVE EVALUATION OF ANESTHETIC EFFICACY OF 4% ARTICAINE WITH 1:100000 EPINEPHRINE AND 2% LIDOCAINE WITH 1:100000 EPINEPHRINE FOR INFERIOR ALVEOLAR NERVE BLOCK AND LONG BUCCAL NERVE BLOCK DURING ROOT CANAL TREATMENT: AN IN VIVO STUDY

10.36106/ijsr/8416424 ◽

2021 ◽

pp. 56-59

Author(s):

Nupur Vasava ◽

Chintan Joshi ◽

Vaishali Parekh

Keyword(s):

Local Anesthesia ◽

Nerve Block ◽

Root Canal ◽

Inferior Alveolar Nerve ◽

Mean Value ◽

Root Canal Treatment ◽

Anesthetic Techniques ◽

Inferior Alveolar Nerve Block ◽

The Mean ◽

Irreversible Pulpitis

Background: It is important to control the pain associated with root canal treatment (RCT) in endodontic. Pain accompanying fear and anxiety due to endodontic treatment can be reduced by anesthetic techniques. The present study aims to compare the effect of articaine versus lidocaine local anesthesia for inferior alveolar nerve block (IANB) and long buccal nerve block on pain during RCT. METHODS: Twenty patients diagnosed with symptomatic irreversible pulpitis of mandibular posterior tooth were selected. The patients randomly received either cartridge of lidocaine or articaine using IANB and long buccal nerve block. The patients were randomly divided into two groups of ten. Group 1: patients received IANB and long buccal nerve block 2% lidocaine with 1:100000 epinephrine. Group 2: patients received IANB and long buccal nerve block with 4% articaine with 1:100000 epinephrine. Before the Injection, the patient received all information about the visual analysis scale (VAS). Pain was evaluated using VAS scale in numberic value 1 to 10 number. The pain was evaluated at three different stages: before administration of LA, after immediate access opening, and after immediate obturation procedure. Data were analyzed using various suitable statistical tests. RESULT: The mean value of efcacy of pain before administration of local anesthesia (LA) was 8.50 ± 0.97 for lidocaine and 8.30 ± 0.48 for articaine had no signicant difference. A signicant difference was observed at two different duration after immediate access opening and after immediate obturation where articaine has a lower mean value 3.60 ± 1.08 and 1.60 ± 0.17 respectively (P>0.05) as compared to the mean value of lidocaine 4.10 ± 1.10 and 1.60 ± 0.17 respectively Conclusion: Within the limitations of the study, in cases of symptomatic irreversible pulpitis articaine 4% did not alleviate pain much and showed better anesthetic efcacy than 2% lidocaine with IANB and long buccal nerve block.

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Supplementary techniques for pain control during root canal treatment of lower posterior teeth with irreversible pulpitis: A systematic review and meta-analysis

Australian Endodontic Journal ◽

10.1111/aej.12212 ◽

2017 ◽

Vol 44 (1) ◽

pp. 14-25 ◽

Cited By ~ 11

Author(s):

Pinpana Tupyota ◽

Pattama Chailertvanitkul ◽

Malinee Laopaiboon ◽

Chetta Ngamjarus ◽

Paul V. Abbott ◽

...

Keyword(s):

Systematic Review ◽

Root Canal ◽

Pain Control ◽

Meta Analysis ◽

Root Canal Treatment ◽

Posterior Teeth ◽

Irreversible Pulpitis

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Diagnosis and treatment of phenobarbital in patients with Gilbert's syndrome

Kazan medical journal ◽

10.17816/kazmj61649 ◽

1985 ◽

Vol 66 (3) ◽

pp. 212-215

Author(s):

M. M. Eseleev ◽

P. G. Scepuro

Keyword(s):

Diagnosis And Treatment ◽

Unconjugated Hyperbilirubinemia ◽

Gilbert’S Syndrome ◽

Gilbert's Syndrome ◽

Medical Network

Until now, the diagnosis of unconjugated hyperbilirubinemia presents certain difficulties, which is to a certain extent related to the lack of awareness among doctors of a wide medical network [1, 2, 4, 8].

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Gilbert’s syndrome - a frequent cause of unconjugated hyperbilirubinemia in children after orthotopic liver transplantation

Pediatric Transplantation ◽

10.1111/j.1399-3046.2012.01662.x ◽

2012 ◽

Vol 16 (2) ◽

pp. 201-204 ◽

Cited By ~ 6

Author(s):

Simone Kathemann ◽

Elke Lainka ◽

Hideo A. Baba ◽

Peter F. Hoyer ◽

Patrick Gerner

Keyword(s):

Liver Transplantation ◽

Orthotopic Liver Transplantation ◽

Unconjugated Hyperbilirubinemia ◽

Gilbert’S Syndrome ◽

Gilbert's Syndrome

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Clinical features of schizophrenia associated with idiopathic unconjugated hyperbilirubinemia (Gilbert's Syndrome)

International Journal of Psychiatry in Clinical Practice ◽

10.1080/13651500310001455 ◽

2003 ◽

Vol 7 (3) ◽

pp. 199-203 ◽

Cited By ~ 10

Author(s):

Tsuyoshi Miyaoka ◽

Rei Yasukawa ◽

Sohichi Mizuno ◽

Tsuruhei Sukegawa ◽

Takuji Inagaki ◽

...

Keyword(s):

Clinical Features ◽

Unconjugated Hyperbilirubinemia ◽

Gilbert’S Syndrome ◽

Gilbert's Syndrome

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Clinical and Radiographic Evaluation of Mineral Trioxide Aggregate Pulpotomy in Permanent Teeth

Dental Journal of Advance Studies ◽

10.1055/s-0038-1672067 ◽

2016 ◽

Vol 04 (03) ◽

pp. 183-188

Author(s):

Neha Verma ◽

Avninder Kaur ◽

Shivesh Acharya ◽

Sunila Sharma

Keyword(s):

Root Canal ◽

Mineral Trioxide Aggregate ◽

Root Canal Treatment ◽

Permanent Teeth ◽

Radiographic Evaluation ◽

Future Research ◽

Standard Protocol ◽

Radiographic Outcome ◽

Irreversible Pulpitis

Abstract Aim and objective: The aim of the present study was to evaluate clinical and radiographic outcome of MTA as a pulpotomy agent in permanent teeth as an alternative to conventional root canal treatment. Materials and Methods: Ten permanent teeth with symptoms of irreversible pulpitis with vital pulp were selected for the study. MTAPulpotomy procedure was done in all the cases using standard protocol. Teeth were evaluated for various clinical and radiographic parameters at 3, 6, 9 and 12 months of follow up. Results: None of the patients reported any kind of clinical discomfort or radiographic abnormality during the follow up period of 3, 6, 9 and 12 months. All the teeth responded positive on electric pulp test at all successive follow ups. Conclusions: MTA Pulpotomy may be used as an alternative treatment modality to root canal treatment in permanent teeth with irreversible pulpitis, if future research continues to show promising results.

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