Liu Anqi, Wu Meiling, Guo Xiaohe, Guo Hao, Zhou Zhifei, Wei Kewen, Xuan Kun
State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, School of Stomatology Department of Dentistry, Hospital of Tangdu, Fourth Military Medical University, Xi'an, Shaanxi Province, China.
Medicine (Baltimore). 2017 Feb;96(5):e6014. doi: 10.1097/MD.0000000000006014.
Otodental syndrome is a rare autosomal-dominant disease characterized by globodontia, associated with sensorineural, high-frequency hearing loss. Here, we describe the clinical, pathological, and genetic evaluations of a 9-year-old girl with otodental syndrome and multiple complex odontoma.The patient presented with a draining sinus tract in her left cheek, globodontia, and hearing loss. The odontomas which caused the cutaneous sinus tracts were extracted because of the odontogenic infection. The extracted odontoma and primary tooth was studied by micro-CT and further observed histopathologically. The micro-CT findings revealed that the primary tooth had three crowns with two separated pulp chambers, and their root canals were partially fused. The histological findings showed abnormal morphologies of odontoblasts and dentin, hyperplasia of enamel, and malformation of odontogenic epithelium. Furthermore, DNA sequencing and analyze of deafness associated gene GJB2, GJB3, and PDS had not revealed any SNP or mutation; but exon 3 of the causative gene FGF3 could not be amplified, which may be associated with the microdeletion at chromosome 11q13.3. Three month after surgery, the patient was found to be asymptomatic and even the evidence of the extra-oral sinus had disappeared.The dental abnormality of otodental syndrome included congenital missing teeth, globodontia, and multiple complex odontoma. Globodontia exhibited characteristic features of fusion teeth. In addition, gene FGF3 haploinsufficiency was likely to be the cause of otodental syndrome. The report provides some new information in the field of otodental syndrome, which would make dentists more familiar with this disease.
耳牙综合征是一种罕见的常染色体显性疾病,其特征为巨牙症,并伴有感音神经性高频听力损失。在此,我们描述了一名患有耳牙综合征和多发性复合牙瘤的9岁女孩的临床、病理和基因评估情况。该患者左侧脸颊有一个引流窦道、巨牙症和听力损失。由于牙源性感染,将导致皮肤窦道的牙瘤摘除。对摘除的牙瘤和乳牙进行了显微CT研究,并进一步进行了组织病理学观察。显微CT结果显示,乳牙有三个牙冠,两个牙髓腔分离,根管部分融合。组织学结果显示成牙本质细胞和牙本质形态异常、釉质增生以及牙源性上皮畸形。此外,对耳聋相关基因GJB2、GJB3和PDS进行DNA测序和分析未发现任何单核苷酸多态性或突变;但致病基因FGF3的第3外显子无法扩增,这可能与11q13.3染色体微缺失有关。手术后三个月,发现该患者无症状,甚至口外窦道的迹象也已消失。耳牙综合征的牙齿异常包括先天性缺牙、巨牙症和多发性复合牙瘤。巨牙症表现出融合牙的特征。此外,基因FGF3单倍体不足可能是耳牙综合征的病因。该报告为耳牙综合征领域提供了一些新信息,这将使牙医对这种疾病更加熟悉。