Tetralogy of Fallot Associated with Amelogenesis Imperfecta: a Case Report

Manna, Maria P.N.C.; Tashima, Mirelle A. M.; Costa, Matheus C.; Gallottini, Marina; Martins, Fabiana

doi:10.15517/2kga2y88

Authors

Maria P.N.C. Manna Department of Operative Dentistry, School of Dentistry of São Paulo, University of São Paulo, São Paulo, São Paulo, Brazil. Author https://orcid.org/0000-0002-9315-1507
Mirelle A. M. Tashima Special Care Dentistry center-CAPE/FOUSP, São Paulo, Brazil. Author https://orcid.org/0009-0008-2312-1207
Matheus C. Costa Department of Operative Dentistry, Endodontics and Dental Materials, School of Dentistry of Bauru, University of São Paulo, Bauru, São Paulo, Brazil. Author https://orcid.org/0000-0001-7689-2226
Marina Gallottini Department of Stomatology and CAPE/FOUSP, Dental School, University of São Paulo, São Paulo, São Paulo, Brazil. Author https://orcid.org/0000-0001-6071-5110
Fabiana Martins Department of Stomatology and CAPE/FOUSP, Dental School, University of São Paulo, São Paulo, São Paulo, Brazil. Postgraduate program in Dentistry, School of Dentistry, University of Santo Amaro, São Paulo - SP, Brazil. Author https://orcid.org/0000-0002-4352-7959

DOI:

https://doi.org/10.15517/2kga2y88

Keywords:

Tetralogy of Fallot; Amelogenesis imperfecta; Infective endocarditis; Dental prophylaxis; Composite resin.

Abstract

Tetralogy of Fallot (TOF) is the prevalent cyanotic congenital cardiac anomaly, accounting for 80% of all cases. Despite the incidence rate, the etiopathogenesis of TOF remains unknown. Amelogenesis imperfecta (AI) is a hereditary condition that impacts enamel development, resulting in morphological and functional tooth modifications. This report aims to present the case of a young patient with TOF and AI who received direct restorative treatment, emphasizing the medical and dental factors involved in enhancing oral health and dental esthetics. The patient has a history of cardiac procedures, including the implantation of a metallic pulmonary valve, along with moderate intellectual disability and a prior seizure episode. The intraoral examination indicated extensive gingivitis, inadequate oral hygiene, hypomineralized enamel with structural deterioration, and numerous plaque retention niches, resulting in pain during mastication and oral hygiene practices. Due to the high risk of infective endocarditis, infected foci were eliminated, and antibiotic prophylaxis was administered according to the American Heart Association guidelines. Restorative therapy was conducted utilizing direct composite resin veneers to restore dental aesthetics and functionality. Post-treatment, the patient had enhanced self-esteem, maintained dental hygiene, and achieved remission of gingivitis. This case demonstrates the significance of comprehensive dental care for patients with complex congenital heart conditions and enamel developmental disorders, stressing the necessity for preventive measures, effective periodontal management, and advanced restorative techniques to reduce the risks of systemic infections.

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References

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