case summary by Libyan dentist: najma alamami Intraoral examination:  He has early childhood caries  Pre mature missing #54 , #55 , # 65 , #64 .  Badly decayed #51 , #52 , #61, #62.  #63,#53,73, #83 proximal caries. medical history  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 ) Family history  His parents are relative  His brother(10 years old ) has same problem

1. By
Najma Mohamed
Alamami

2.  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.

3. 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 .

4.  He has early childhood
caries
 Pre mature missing #54 ,
#55 , # 65 , #64 .
 Badly decayed #51 , #52 ,
#61, #62.
 #63,#53,73, #83 proximal
caries.

6. Abnormal path of eruption
of lower anterior permanent
incisor

7.  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

8.  abnormal facial feature as oclular hyper telorism
and micrognatia .
 Macrocephaly and high prominent forehead .

9. Post axial Polydactyl (unlerpolydycatly ) in two
hands.

10. Flat right tympanic membrane (no
reflex )

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

12. 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

13. 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 .

15. 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 .

16. 3) Surgical Phase
Extraction of #51
,#52 ,#61 ,#62 ..

17. 4)Maintenance Phase
 Post operative instruction.
 Recall after one week .
 Periodic follow up for
Reinforcement of OHI.

18. 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).

19. 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