Special Care Dentistry Center, School of Dentistry, University of São Paulo, São Paulo, Brazil.
School of Dentistry, University of Santo Amaro, São Paulo, Brazil.
Spec Care Dentist. 2022 Mar;42(2):143-148. doi: 10.1111/scd.12645. Epub 2021 Sep 30.
The purpose of this study was to describe a detailed investigation of craniofacial and dental characteristics in a group of Brazilian Rubinstein-Taybi syndrome (RSTS) patients.
Thirteen RSTS patients treated in a special care dental clinic after 10 years were studied. Panoramic radiographs were obtained from all patients, and cephalometric analysis was performed in eight patients. Five male and eight white female patients with a median age of 11.7 years were analyzed. All the RSTS patients were mouth breathers and presented malocclusion, transverse hypoplastic maxilla, nine subjects (9/13; 69.2%) had posterior crossbite, and eight (61.53%) exhibited talon cusps. Most patients presented class II skeletal pattern and were brachycephalic. Regarding systemic disorders, one patient (7.69%) reported seizure episodes during childhood, and four patients (30.76%) presented heart valve disorders. All patients presented reduced attention span, low intolerance to dental interventions, impulsiveness, and irritability.
Since RSTS exhibits oral and skeletal changes, early dental treatment is essential for these patients. Dentists must be aware of medical problems related to heart disease and persist in conditioning techniques to obtain cooperation and avoid dental care under general anesthesia.
本研究旨在详细描述一组巴西 Rubinstein-Taybi 综合征(RSTS)患者的颅面和牙齿特征。
对在特殊护理牙科诊所接受治疗 10 年后的 13 例 RSTS 患者进行了研究。对所有患者均获得全景片,并对 8 例患者进行了头影测量分析。分析了 5 名男性和 8 名白人女性患者,平均年龄为 11.7 岁。所有 RSTS 患者均为口呼吸者,存在错牙合畸形、横向发育不全的上颌、9 例(9/13;69.2%)存在后牙反牙合,8 例(61.53%)存在尖牙嵴。大多数患者呈现出 II 类骨骼模式,呈短头畸形。关于全身疾病,1 例(7.69%)患者在儿童期报告有癫痫发作,4 例(30.76%)患者存在心脏瓣膜疾病。所有患者均存在注意力持续时间缩短、对牙科干预的耐受性低、冲动和易怒等问题。
由于 RSTS 表现出口腔和骨骼的改变,因此这些患者早期的牙科治疗至关重要。牙医必须了解与心脏病相关的医学问题,并坚持进行条件技术,以获得患者的合作,避免在全身麻醉下进行牙科护理。