Chen Ben, Li Ling-Xia, Zhou Li-Li
Department of Oral Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China.
Department of Generality, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China.
World J Clin Cases. 2021 Aug 26;9(24):7269-7278. doi: 10.12998/wjcc.v9.i24.7269.
Moebius syndrome (MBS) is a nonprogressive and rare congenital neuromuscular disorder involving the facial nerve and abductor nerve; it mainly manifests as facial paralysis and eye strabismus paralytic symptoms. Tissues in the oral cavity are also compromised, characterized by microstomia, micrognathia, tongue malformation, cleft lip, high arched palate or cleft palate, bifid uvula, and dental malocclusion. Therefore, dentistry plays a fundamental and crucial role in caring for these individuals. However, there is limited available data on MBS treatment, particularly regarding dental management.
This case report presents dental treatment of a 21-year-old man with MBS and discusses crucial interactions among oral complications of MBS. In this case, the patient was clinically characterized by congenital neuromuscular disorder, occlusal disorders, and tooth and gum problems. It is noteworthy that the patient presented early eruption of deciduous teeth 2 mo after birth, which has not been reported in other MBS cases and suggests a potentially new clinical manifestation of this syndrome. It is important to note that MBS cannot be cured, and oral manifestations of this syndrome can be managed by a multidisciplinary health care team that helps the patient maintain oral hygiene and dental health. After a series of oral treatments, no obvious poor oral hygiene, swollen gums, or abnormal imaging results were observed after 2 years of follow-up.
This case addressed the oral clinical manifestations of MBS and difficulties experienced during dental management, and suggested early tooth eruption as a potentially new clinical manifestation of this syndrome. Knowledge of the loop-mediated association among oral complications of this syndrome is essential to perfecting treatments.
莫比乌斯综合征(MBS)是一种非进行性的罕见先天性神经肌肉疾病,累及面神经和展神经;主要表现为面瘫和麻痹性斜视症状。口腔组织也会受到影响,表现为小口畸形、小颌畸形、舌畸形、唇裂、高拱腭或腭裂、悬雍垂裂和牙列不齐。因此,牙科在照顾这些患者方面发挥着基础性和关键作用。然而,关于MBS治疗的可用数据有限,尤其是在牙科管理方面。
本病例报告介绍了一名21岁MBS男性患者的牙科治疗,并讨论了MBS口腔并发症之间的关键相互作用。在该病例中,患者的临床特征为先天性神经肌肉疾病、咬合紊乱以及牙齿和牙龈问题。值得注意的是,该患者出生后2个月乳牙早萌,这在其他MBS病例中未见报道,提示该综合征可能有新的临床表现。需要注意的是,MBS无法治愈,该综合征的口腔表现可由多学科医疗团队进行管理,以帮助患者保持口腔卫生和牙齿健康。经过一系列口腔治疗后,随访2年未观察到明显的口腔卫生不良、牙龈肿胀或异常影像学结果。
本病例阐述了MBS的口腔临床表现及牙科管理中遇到的困难,并提示乳牙早萌可能是该综合征的一种新的临床表现。了解该综合征口腔并发症之间的环介导关联对于完善治疗至关重要。