title: Dental treatment of an adult patient with a history of biliary atresia.
abstract: OBJECTIVE
  Biliary atresia is a congenital disease treated by liver transplantation. Adults may have oral consequences of the medical therapy. Green teeth are oral manifestations of the induced hyperbilirubinemia. Gingival enlargement is associated with the immunosuppressive drug. This case report describes the successful treatment of an 18-year-old patient displaying severe green teeth and gingival enlargement.
  
  
  METHODS
  The gingival enlargement was treated by reducing the pathogenic oral microflora through scaling and root planing of the teeth, gingival excision surgeries, and conversion from cyclosporin to tacrolimus.
  
  
  RESULTS
  Gingival enlargement and inflammation had completely disappeared after nonsurgical treatment for the maxilla and after surgical treatment for the mandible. The green coloration of the teeth was masked using composite restorations.
  
  
  CONCLUSIONS
  This case report indicates that a patient's quality of life can be improved by a team approach combining pharmacologic and dental therapies.
authors.affiliation: Department of Periodontology, Service of Odontology, Garancière Rothschild Hospital, Paris 7-Denis Diderot University, UFR of Odontology, 5 Rue Garancière, Paris, France. helene.range@gmail.com
authors.forename: Hélène
authors.initials: H
authors.lastname: Rangé
authors.forename: Sophie
authors.initials: S
authors.lastname: Camy
authors.forename: Joseph
authors.initials: J
authors.lastname: Cohen
authors.forename: Pierre
authors.initials: P
authors.lastname: Colon
authors.forename: Philippe
authors.initials: P
authors.lastname: Bouchard
mesh_terms: D000293:Adolescent; D001656:Biliary Atresia / Q000150:complications* / Q000601:surgery; D017742:Dental Care for Chronically Ill; D003801:Dental Veneers; D005886:Gingival Hypertrophy / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications / Q000209:etiology / Q000601:surgery; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation; D008297:Male; D011788:Quality of Life; D014075:Tooth Discoloration / Q000209:etiology* / Q000534:rehabilitation
chemical_list: D007166:Immunosuppressive Agents