Costa Márcio Magno, Pennisi Pedro Rogério Camargos, de Oliveira Andréa Cristina Zacarias Martins, de Oliveira João Edson Carmo, Oliveira Gustavo Vilela, Moffa Eduardo Buozi, Paranhos Luiz Renato
Federal University of Uberlândia, School of Dentistry, Uberlândia, MG, Brazil.
Private Clinic, Uberlândia, Brazil.
Clin Cosmet Investig Dent. 2020 Apr 15;12:131-139. doi: 10.2147/CCIDE.S247614. eCollection 2020.
Pycnodysostosis (PYCD) is a rare autosomal recessive skeletal dysplasia arising from a change in the production of the cathepsin K enzyme and it is also known as Maroteaux-Lamy Syndrome. The main changes in the buccal and maxillofacial region are modifications of the facial bones (leading to the loss of the mandibular angle due to micrognathia), deep palate, premature and/or delayed tooth eruption, hypopneumatization of the maxillary sinuses, chin hypoplasia, hypercementosis, enamel hypoplasia, hyperdontia, incomplete dentin calcification, root hypoplasia, pulp chamber obliteration, and increased free functional space. This paper aims to report a case of a patient with PYCD, in which are highlighted the oral manifestations of this syndrome and present an option of oral rehabilitative treatment through a removable overdenture made on natural tooth of the patient. The technique of dental coating through overdenture is a simple, viable and conservative alternative for oral rehabilitation of patients with large maxillomandibular discrepancies, as in cases of pycnodysostosis, especially in the presence of increased free space - characteristic of patients with this syndrome. The result was quite satisfactory both aesthetically and functionally and provided a better life quality for the patient.
致密性骨发育不全(PYCD)是一种罕见的常染色体隐性遗传性骨骼发育不良,由组织蛋白酶K酶的产生变化引起,也被称为马罗-拉米综合征。口腔颌面部的主要变化包括面部骨骼改变(由于小颌畸形导致下颌角消失)、腭部深陷、牙齿过早萌出和/或萌出延迟、上颌窦气化不足、颏部发育不全、牙骨质增生、釉质发育不全、多生牙、牙本质钙化不全、牙根发育不全、髓腔闭塞以及游离功能间隙增加。本文旨在报告一例致密性骨发育不全患者的病例,突出该综合征的口腔表现,并提出通过患者天然牙制作可摘式覆盖义齿进行口腔修复治疗的方案。通过覆盖义齿进行牙体覆盖技术是一种简单、可行且保守的方法,可用于口腔颌面部差异较大的患者(如致密性骨发育不全病例)的口腔修复,特别是在存在游离间隙增加的情况下——这是该综合征患者的特征。结果在美学和功能方面都相当令人满意,为患者提供了更好的生活质量。