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青少年患者多发性额外牙和埋伏牙的治疗及遗传学分析。

Treatment and genetic analysis of multiple supernumerary and impacted teeth in an adolescent patient.

机构信息

Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, No. 98, Xiwu Road, Xincheng District, Xi'an, Shaanxi, 710004, PR China.

Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, PR China.

出版信息

BMC Oral Health. 2024 Jul 14;24(1):790. doi: 10.1186/s12903-024-04573-3.

Abstract

BACKGROUND

Multiple supernumerary teeth, combined with numerous impacted teeth, can lead to various malocclusions, posing significant treatment challenges. While certain genes associated with syndromic cases of multiple supernumerary and impacted teeth have been identified, the etiologies of non-syndromic cases still largely remain elusive.

CASE PRESENTATION

Here, we report a treatment of a 12-year-old boy who presented with 10 supernumerary teeth and 6 impacted teeth, accompanied by a genetic analysis to explore the underlying etiology. During the treatment, fifteen teeth were extracted, and various skilled techniques, including the closed-eruption technique and the application of by-pass arches, were utilized. Post-treatment, traction was successful for all the impacted teeth, without any tooth mobility or reduction in gingival height. Space closure, well-aligned teeth, and excellent functional occlusion were achieved. Furthermore, comprehensive genetic analysis was conducted through whole-exome sequencing on the patient and his parents, which revealed a potential link between the patient's numerous supernumerary teeth and abnormal mineralization. Notably, the p.Ser496Pro variant in the TCF7L2 gene was identified as a potential candidate variant in this patient.

CONCLUSIONS

Overall, our findings not only report the treatment of a rare case involving multiple supernumerary and impacted teeth but also offer valuable insights into the molecular basis of supernumerary teeth.

摘要

背景

多发性额外牙,结合多发性阻生牙,可导致各种错颌畸形,治疗极具挑战。虽然已经确定了某些与多发性额外牙和阻生牙综合征病例相关的基因,但非综合征病例的病因仍很大程度上难以捉摸。

病例介绍

本研究报告了一名 12 岁男孩的治疗情况,该男孩患有 10 颗额外牙和 6 颗阻生牙,并进行了基因分析以探讨潜在病因。在治疗过程中,共拔除了 15 颗牙齿,并应用了各种熟练的技术,包括封闭萌出技术和旁路弓的应用。治疗后,所有阻生牙都成功牵引,没有任何牙齿松动或牙龈高度降低。实现了间隙关闭、牙齿排列整齐和良好的功能咬合。此外,通过对患者及其父母进行全外显子组测序进行了全面的基因分析,发现患者多发性额外牙与异常矿化之间存在潜在联系。值得注意的是,TCF7L2 基因中的 p.Ser496Pro 变异被确定为该患者的潜在候选变异。

结论

总体而言,我们的研究结果不仅报告了一例罕见的多发性额外牙和阻生牙的治疗情况,还为额外牙的分子基础提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a530/11246580/e4fa1e85ab1b/12903_2024_4573_Fig1_HTML.jpg

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