Orthodontic treatment and management of limited mouth opening and oral lesions in a patient with congenital insensitivity to pain: case report

Authors: PADUANO, S.¹; IODICE, G.²; FARELLA, M.; SILVA, R.¹; MICHELOTTI, A.²

Source: Journal of Oral Rehabilitation, Volume 36, Number 1, January 2009 , pp. 71-78(8)

Buy & download fulltext article:

Price: $48.00 plus tax (Refund Policy)

Abstract:

Summary

Congenital insensitivity to pain is a rare clinical syndrome characterized by dramatic impairment of pain perception since birth and is generally caused by a hereditary sensory and autonomic neuropathy with loss of the small-calibre, nociceptive nerve fibres. We report a 9-year-old case, with a generalized congenital insensitivity to pain. The patient was referred to our Department by a private orthodontist for severe limited mouth opening and multiple oral ulcers which greatly worsened after starting the orthodontic treatment. The management of his oral lesions of the limited mouth opening and of the orthodontic treatment are described. The management approach aimed to improve mandibular range of motion and associated stretching and a self-modeling mouthguard to avoid cheek self-biting. This protocol allowed continuing the orthodontic treatment to restore the occlusion. Finally, good occlusion, normal function and better quality of patient's life were achieved.

Keywords: hereditary sensory and autonomic neuropathy; congenital insensitivity to pain; pain; insensitivity; orthodontics; mouth ulcer; literature review

Document Type: Case report

DOI: http://dx.doi.org/10.1111/j.1365-2842.2008.01887.x

Affiliations: 1: Department of Dental, Oral and Maxillo-Facial Sciences, University of Catanzaro Magna Graecia, Italy 2: Department of Orthodontics, Universiy of Napoli Federico II, Italy

Publication date: 2009-01-01