PMC5573476_01
Positive thumb and wrist signs (positive wrist-Walker-Murdoch sign-the distal phalanx of the first and fifth
fingers of the hand overlap when surrounded around the opponent wrist and positive thumb-Steinberg sign-a flexed
thumb clutched within a clenched palm protrudes beyond the ulnar border of that hand)
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fig1
The patient had positive wrist (Walker-Murdoch sign: the distal phalanx of the first and fifth fingers of the hand overlap when surrounded around the opposite wrist) and positive thumb (Steinberg sign: a flexed thumb clutched within a clenched palm protrudes beyond the ulnar border of that hand) evidence (Figure 1).
Pretreatment clinical photographs showing profound caries and stains on teeth.
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fig2
Intraorally, the patient had a high arched palate, midline shift and class I malocclusion on the right side and class II malocclusion with posterior crossbite on the left side (Figure 2). Intraoral and extraoral photographs were taken and radiographic examination was done by using orthopantomograph and hand-wrist radiograph (Figure 2), Figure 3, Figure 4).  Two digit FDI numbering system was used for chart entry. She had black-stains in her teeth and mild gingivitis (Figure 2).
Panoramic radiography of the patient taken before dental treatment.
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fig3
Intraoral and extraoral photographs were taken and radiographic examination was done by using orthopantomograph and hand-wrist radiograph (Figure 2), Figure 3, Figure 4).  Two digit FDI numbering system was used for chart entry.
Hand-wrist radiograph.
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fig4
Intraoral and extraoral photographs were taken and radiographic examination was done by using orthopantomograph and hand-wrist radiograph (Figure 2), Figure 3, Figure 4).  Two digit FDI numbering system was used for chart entry.
Intraoral photographs taken after restorative treatment was completed.
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fig5
Clinical photographs were taken after restorative treatments were completed (Figure 5).