Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Eur J Orthod. 2021 Jan 29;43(1):36-44. doi: 10.1093/ejo/cjaa015.
Mutations in the fibroblast growth factor receptor 2 (FGFR2) gene are responsible for both Apert syndrome (AS) and Crouzon syndrome (CS). These diseases share phenotypic characteristics, including midfacial hypoplasia and premature fusion of the calvarial suture(s). Given the extensive range of craniofacial growth and developmental abnormalities, management of these patients requires a multidisciplinary approach. This study aimed to compare craniofacial, oral, and cervical morphological characteristics in Japanese orthodontic patients with AS or CS.
Lateral cephalograms, orthopantomograms, dental casts, medical interview records, facial photographs, and intraoral photographs of 7 AS patients and 12 CS patients on initial visits were used in this study. Cephalometric analyses were performed, and standard scores were calculated based on age- and sex-matched Japanese standard values.
Cephalometric analysis revealed that AS patients had significantly more severe maxillary hypoplasia in two dimensions and increased clockwise mandibular rotation. Additionally, cleft of the soft palate, anterior open bite, severe crowding in the maxillary dental arch, and congenitally missing teeth occurred more frequently among AS patients. Multiple fusions between cervical vertebrae C2, C3, C5, and C6 were observed in the AS patients.
Small sample size.
CONCLUSIONS/IMPLICATIONS: Our study shows that AS patients have more severe craniofacial and maxillofacial deformities than CS patients.
成纤维细胞生长因子受体 2 (FGFR2)基因突变可导致 Apert 综合征(AS)和 Crouzon 综合征(CS)。这些疾病具有相似的表型特征,包括面中部发育不良和颅骨缝过早融合。鉴于颅面生长和发育异常的广泛范围,这些患者的管理需要多学科方法。本研究旨在比较日本正畸患者中 AS 或 CS 的颅面、口腔和颈椎形态特征。
本研究使用了 7 例 AS 患者和 12 例 CS 患者初诊时的侧位头颅侧位片、全景片、牙模、医学访谈记录、面部照片和口腔内照片。进行了头影测量分析,并根据与年龄和性别匹配的日本标准值计算了标准分数。
头影测量分析显示,AS 患者的上颌骨在两个维度上的发育不良更为严重,并且下颌骨逆时针旋转更为明显。此外,AS 患者更常出现软腭裂、前牙开颌、上颌牙弓严重拥挤和先天性缺牙。AS 患者的颈椎 C2、C3、C5 和 C6 之间存在多处融合。
样本量小。
本研究表明,AS 患者的颅面和颌面畸形比 CS 患者更为严重。