Karlak Victoria, Jankowski Jakub, Kolasińska Julia, Nijakowski Kacper
University Centre of Dentistry and Specialised Medicine, 60-812 Poznan, Poland.
Student's Scientific Group in Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland.
Case Rep Dent. 2023 Sep 22;2023:2478465. doi: 10.1155/2023/2478465. eCollection 2023.
Kleefstra syndrome (KS) is a rare genetic disorder (prevalence < 1/1 000 000) characterised by autistic spectrum disorder (ASD), childhood hypotonia, and seizures. A typical facial appearance includes microcephaly, arched eyebrows, synophrism, hypertelorism, a short nose, midface hypoplasia, prognathism, and tongue protrusion. This case report presents a 19-year-old female with KS from a dentist's perspective. The patient demonstrates limited mouth opening with a slight deviation of the mandible on the left side. The mandibular prognathism and anterior open bite are visible. A generalised inflammatory gingival enlargement is most likely a response to local irritants like plaque and calculus but is enhanced by the patient's mouth breathing habit. Also, the tongue is unusually large-macroglossia. Dental anomalies were diagnosed by digital panoramic radiograph, including dilaceration of the maxillary left second premolar and taurodontism. The patient was qualified to be treated under general anaesthesia with multiple extractions, restorations, hygienisation procedures, and tooth remineralisation. This individual should also be considered for orthodontic treatment and an eventual tongue reduction procedure. In the case of KS, multidisciplinary cooperation as well as frequent dental check-ups with fluoride prophylaxis are recommended. Unfortunately, dental treatment is still not an integral part of taking care of disabled children and youth with rare diseases.
克莱夫斯特拉综合征(KS)是一种罕见的遗传性疾病(患病率<1/1,000,000),其特征为自闭症谱系障碍(ASD)、儿童期肌张力减退和癫痫发作。典型的面部特征包括小头畸形、拱形眉毛、皱眉、眼距过宽、短鼻、面中部发育不全、下颌前突和伸舌。本病例报告从牙医的角度介绍了一名19岁的KS女性患者。患者表现为张口受限,下颌向左侧轻度偏斜。下颌前突和前牙开合可见。广泛性炎症性牙龈增生很可能是对牙菌斑和牙结石等局部刺激物的反应,但患者的口呼吸习惯加剧了这种情况。此外,舌头异常大——巨舌症。通过数字化全景X线片诊断出牙列异常,包括上颌左侧第二前磨牙牙根弯曲和牛牙症。该患者符合在全身麻醉下进行多次拔牙、修复、洁治程序和牙齿再矿化治疗的条件。该患者还应考虑进行正畸治疗以及最终的缩舌手术。对于KS患者,建议多学科合作以及频繁进行牙科检查并进行氟化物预防。不幸的是,牙科治疗仍然不是照顾患有罕见疾病的残疾儿童和青少年的一个组成部分。