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脆性X综合征:遗传学方面及口腔学评估

Fragile-X syndrome: genetic aspects and stomatologic evaluations.

作者信息

Muzzi F, Santini F, Romanini G, Bartuli F N, Arcuri C

机构信息

"S. Giovanni Calibita" AFaR - Fatebenefratelli Hospital - Isola Tiberina, Rome, Italy.

出版信息

Oral Implantol (Rome). 2010 Jul;3(3):38-44. Epub 2011 Jan 13.

Abstract

AIM OF THE WORK

The fragile-X syndrome is the most common cause of inherited mental retardation and it is associated with the FMR1 gene on X chromosome. The origin of anatomic anomalies of maxillo-facial complex is still discussed in literature. The authors describe the syndrome and report a clinical case.

METHODS

Genetical and clinical aspects and the incidence of caries, periodontal disease and occlusal abrasion are reviewed. Occlusal conditions, particularly openbite and crossbite, are considered.

RESULTS

The incidence of fragile-X syndrome is 1: 2000 in males and 1:4000 in females, despite this the syndrome is diagnosed with a lot of difficulties yet, because of extreme variability of the phenomenological aspects. Patients often show severe mental retardation, linked to a peculiar profile of cognitive, behavioural, and emotional dysfunction and to distinctive anatomic features, which become more evident after puberty. Concerning oral characteristics, it doesn't seem to be a significant association between the syndrome and the incidence of caries or periodontal diseases, while an ogival shaped palate is peculiar.

CONCLUSIONS

Literature review suggests that when male patients with severe mental retardation without well-known cause are visited, the ipothesis of X-fragile syndrome should be considered. Even though the diagnostic hypothesis may arise from the observation of typical somatic features, the diagnosis can be confirmed only by genetical tests.

摘要

工作目的

脆性X综合征是遗传性智力迟钝最常见的病因,与X染色体上的FMR1基因相关。上颌面部复合体解剖异常的起源在文献中仍有讨论。作者描述了该综合征并报告了1例临床病例。

方法

回顾了遗传和临床方面以及龋齿、牙周病和牙合面磨损的发生率。考虑了牙合面情况,特别是开牙合和反牙合。

结果

脆性X综合征的发病率在男性中为1:2000,在女性中为1:4000,尽管如此,由于现象学方面的极端变异性,该综合征的诊断仍然存在很多困难。患者常表现出严重的智力迟钝,与认知、行为和情感功能障碍的特殊表现以及独特的解剖特征有关,这些在青春期后变得更加明显。关于口腔特征,该综合征与龋齿或牙周病的发生率之间似乎没有显著关联,而腭呈尖拱形是其特点。

结论

文献综述表明,当接诊原因不明的严重智力迟钝男性患者时,应考虑脆性X综合征的可能性。尽管诊断假设可能源于对典型躯体特征的观察,但诊断只能通过基因检测来证实。

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