CASE REPORT Fig. 5 Andy’s elated post tx. smile. result desired, as well as restore the vertical dimension. (Fig. 4) The most challenging part of the case was to achieve symmetry as well as ensure a correct path of insertion to avoid any reduction to young Andy’s teeth. The diagnostic wax-up was critical in giving the direction and the realistic outlook of the final esthetic end result. Restoring the vertical dimension also allowed the improvement in occlusal function and the removal of lateral and protrusive interfer-ences due to the deep overbite. The case was manufactured using Ceramage composite by Shofu Inc, Japan. Ceramage is an extremely esthetic material that has good flexure strength which is ideal for restoring a case such as Andy’s. It also has good color stability and can be used for both permanent and temporary restora-tions. An important requirement was for a material that would adhere to bonded orthodontic brackets as needed. The composite final result was an exact duplicate of the diagnostic wax-up. The bridges and single unit restorations were cemented with Excel ® -a fluoride releasing orthodon-tic bonding adhesive (Fig. 5). ences to smile with joy and self confidence. (Fig. 6) Fig. 6 Team Andy. “A Smile is Forever”. thin, sparse hair. Infants with ecto-dermal dysplasia may go undetected. The eruption of conical teeth, however, is an important sign that should be examined closely. The dental practitioner should be empa-thetic and proactive in applying his/her expertise to these special needs children. REFERENCES Jordan S. Orange, et al. Deficient Natural Killer Cell cytoxicity in patients with IKK-b/NEMO Mutations. J Clin Invest. 2002 June 1; 109(11): 1501-1509. Jordan S. Orange, Raif S. Geha. Finding NEMO: Genetic disorders of NF-kB activa-tion. J Clin Invest. 2003 October 1; 112(7): 983-985. Young-Shia Dai, MD, et al. Characteris-tics of mycobacterial infection in patients with immunodeficiency and nuclear factore kB essential modulator mutation, with or without ectodermal dysplasia. American Academy of Dermaltology doi: 10.1016/j.jaad. 2004.05.03 Pai Sy, et al. Allogeneic transplantation successfully corrects immune defects, but not susceptibility to colitis, in a patient with nuclear factor -Kappa B essential modulator deficiency. J Allergy Clin Immunol, 2008 Dec; 122(6): 1113-1118. el. E pub 2008 Oct 11. Andres Trevino, Kate Kruschwitz. Andy & Sofia – Stem cells, scientific miracles and “one fit savior” copyright © 2011 Andres L. Trevino. Website: www.andy.org,mx Craig Galbraith (BSC Dent Tech) Quality Control Manager daVinci Dental Studios. 22135 Roscoe Boulevard West Hills, CA 91304 1-800-874-7239. Craig@davin-cilab.com Paul Gange. Reliance Orthodontic Prod-ucts, Inc. 1540 West Thorndale Ave. Itasca, IL 60143. 1-800-323-4348. paulgropi@aol.com NEMO can be a difficult diag-nosis because of the wide range of presentations. Three typical presentations have their effect on dental development: ᕡ Susceptibility to pyogenic infections ᕢ Susceptibility to mycobacte-rial infections ᕣ Ectodermal dysplasia Ectodermal dysplasia is difficult to recognize early in life. As infants often have eczematous rashes and CONCLUSION DISCUSSION The AOS Foundation’s “Smile Builders” Program contributed to a life-changing experience that allowed a young boy who had previous courageous medical experi-30 September/October 2012 JAOS
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