A new syndrome of symphalangism, multiple frenula, postaxial polydactyly, dysplastic ears, dental anomalies, and exclusion of NOG and GDF5

Clinical and molecular heterogeneity of syndromic hypothalamic hamartoma

Two children are presented who have a distinct syndrome of multiple buccolingual frenula, a stiff and short fifth finger with small nails, a hypothalamic hamartoma, mild to moderate neurological impairment, and mild endocrinological symptoms. No variant assessed to be pathogenic or likely pathogenic was detected in the GLI3 gene in either child. This syndrome appears to be distinct from the inherited Pallister-Hall syndrome associated with GLI3 variants, which is characterized by hypothalamic hamartoma, mesoaxial polydactyly, and other anomalies. In the individuals described here, manifestations outside of the central nervous system were milder and the mesoaxial polydactyly, which is common in individuals with Pallister-Hall syndrome, was absent. Instead, these children had multiple buccolingual frenula together with the unusual appearance of the fifth digit. It remains unclear whether these two individuals represent a separate nosologic entity or if they represent a milder manifestation of one of the more severe syndromes associated with a hypothalamic hamartoma.

Concepts for the treatment of adolescent patients with missing permanent teeth

INTRODUCTION

Missing permanent teeth is observed with syndromes or is frequently hereditarily propagated in families. The treatment of these patients is a multi-task of specialists of oral surgery, orthodontics and prosthodontics.

DISCUSSION

Despite functional and aesthetic considerations, the main problem of all treatment is that it had to be performed in a growing child. This article discusses the conventional and implant-driven concepts to treat patients from childhood to adolescence with selective or multiple missing permanent teeth.