Docimo Raffaella, Maturo Paolo, D'Auria Francesca, Grego Susanna, Costacurta Micaela, Perugia Cesare, Chiariello Luigi
Department of Experimental Medicine & Surgery, Pediatric Dentistry.
J Clin Diagn Res. 2013 Apr;7(4):700-3. doi: 10.7860/JCDR/2013/5656.2885. Epub 2013 Apr 1.
It is important to establish an early diagnosis of the Marfan Syndrome (MFS) for providing an adequate pharmacological or surgical therapy. Nevertheless, this diagnosis may be complex, given the multi-organic involvement of this disease.
In this work, we evaluated the oral phenotype in a group of paediatric patients with a clinical diagnosis of MFS, to quantify the association of the oro-facial defects with other systemic alterations.
Paediatric subjects who were aged, with a clinical diagnosis of MFS, were selected from our regional Marfan monitoring unit.
All the patients were subjected to Paediatric Dentistry examinations and a radiological screening with Panoramic and Cephalometric X-Rays. The aortic dilation (Aortic Z-score value), the hyperlaxity of the ligaments and scoliosis were evaluated by cardio-surgical and orthopaedics specialists.
The correlations between the oral and systemic alterations were analyzed by using the chi square test for the nominal variables.
We found a significant correlation of the Aortic Z - score with multiple oral defects which included retrognathia, malar hypoplasia, cross bite, oral respiration and an ogival palate. An association of the oral defects with hyperlaxity of the ligaments and scoliosis was also found. Thus, the data suggested that dentists should be more involved in a multidisciplinary approach, to provide an early MFS diagnosis in paediatric patients.
早期诊断马凡综合征(MFS)对于提供适当的药物或手术治疗至关重要。然而,鉴于该疾病的多器官受累,这种诊断可能很复杂。
在这项研究中,我们评估了一组临床诊断为MFS的儿科患者的口腔表型,以量化口腔面部缺陷与其他全身改变之间的关联。
从我们地区的马凡监测单位选取临床诊断为MFS的儿科患者。
所有患者均接受儿科牙科检查以及全景和头颅X线的放射学筛查。心脏外科和骨科专家评估主动脉扩张(主动脉Z评分值)、韧带过度松弛和脊柱侧弯情况。
对于名义变量,使用卡方检验分析口腔和全身改变之间的相关性。
我们发现主动脉Z评分与多种口腔缺陷显著相关,这些缺陷包括下颌后缩、颧骨发育不全、反咬合、口呼吸和尖腭。还发现口腔缺陷与韧带过度松弛和脊柱侧弯有关。因此,数据表明牙医应更多地参与多学科方法,以便在儿科患者中早期诊断MFS。