Department of Orthodontics, University Hospital of Würzburg, Würzburg, Germany.
KOÇ University School of Medicine (KUSoM) Medical Genetics Department, Topkapi Zeytinburnu, Istanbul, Turkey.
Am J Med Genet A. 2020 Jul;182(7):1681-1689. doi: 10.1002/ajmg.a.61610. Epub 2020 Jun 2.
Fraser syndrome (FS) is a rare autosomal recessive multiple congenital malformation syndrome characterized by cryptophthalmos, cutaneous syndactyly, renal agenesis, ambiguous genitalia, and laryngotracheal anomalies. It is caused by biallelic mutations of FRAS1, FREM2, and GRIP1 genes, encoding components of a protein complex that mediates embryonic epithelial-mesenchymal interactions. Anecdotal reports have described abnormal orodental findings in FS, but no study has as yet addressed the orodental findings of FS systematically. We reviewed dental radiographs of 10 unrelated patients with FS of different genetic etiologies. Dental anomalies were present in all patients with FS and included hypodontia, dental crowding, medial diastema, and retained teeth. A very consistent pattern of shortened dental roots of most permanent teeth as well as altered length/width ratio with shortened dental crowns of upper incisors was also identified. These findings suggest that the FRAS1-FREM complex mediates critical mesenchymal-epithelial interactions during dental crown and root development. The orodental findings of FS reported herein represent a previously underestimated manifestation of the disorder with significant impact on orodental health for affected individuals. Integration of dentists and orthodontists into the multidisciplinary team for management of FS is therefore recommended.
弗雷泽综合征(FS)是一种罕见的常染色体隐性多系统先天畸形综合征,其特征为先天性独眼、皮肤并指(趾)畸形、肾发育不全、生殖器性别不清和喉气管异常。它由 FRAS1、FREM2 和 GRIP1 基因的双等位基因突变引起,这些基因编码参与胚胎上皮-间充质相互作用的蛋白复合物的组成部分。有报道描述了 FS 患者的口腔牙齿异常,但尚无研究系统地研究 FS 的口腔牙齿表现。我们回顾了 10 名不同遗传病因的 FS 患者的牙科 X 光片。所有 FS 患者均存在牙齿异常,包括缺牙、牙齿拥挤、中隔间隙和滞留牙。还发现大多数恒牙的牙根明显缩短,以及上颌切牙的牙冠长度/宽度比改变且牙冠缩短的非常一致的模式。这些发现表明,FRAS1-FREM 复合物在牙冠和牙根发育过程中介导了关键的间质-上皮相互作用。本文报道的 FS 的口腔牙齿表现代表了该疾病以前被低估的一种表现,对受影响个体的口腔牙齿健康有重大影响。因此,建议将牙医和正畸医生纳入 FS 的多学科管理团队中。
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