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Mitscherling J, Sczakiel HL, Kiskemper-Nestorjuk O, Winterhalter S, Mundlos S, Bartzela T, Mensah MA. Whole genome sequencing in families with oligodontia. Oral Dis 2024; 30:3935-3950. [PMID: 38071191 DOI: 10.1111/odi.14816] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/22/2023] [Accepted: 11/10/2023] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVES Tooth agenesis (TA) is among the most common malformations in humans. Although several causative mutations have been described, the genetic cause often remains elusive. Here, we test whether whole genome sequencing (WGS) could bridge this diagnostic gap. METHODS In four families with TA, we assessed the dental phenotype using the Tooth Agenesis Code after intraoral examination and radiographic and photographic documentation. We performed WGS of index patients and subsequent segregation analysis. RESULTS We identified two variants of uncertain significance (a potential splice variant in PTH1R, and a 2.1 kb deletion abrogating a non-coding element in FGF7) and three pathogenic variants: a novel frameshift in the final exon of PITX2, a novel deletion in PAX9, and a known nonsense variant in WNT10A. Notably, the FGF7 variant was found in the patient, also featuring the WNT10A variant. While mutations in PITX2 are known to cause Axenfeld-Rieger syndrome 1 (ARS1) predominantly featuring ocular findings, accompanied by dental malformations, we found the PITX2 frameshift in a family with predominantly dental and varying ocular findings. CONCLUSION Severe TA predicts a genetic cause identifiable by WGS. Final exon PITX2 frameshifts can cause a predominantly dental form of ARS1.
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Affiliation(s)
- Janna Mitscherling
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Centrum 03 für Zahn-, Mund- und Kieferheilkunde, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Berlin, Germany
| | - Henrike L Sczakiel
- Institute of Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- BIH Biomedical Innovation Academy, Junior Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
- RG Development & Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Olga Kiskemper-Nestorjuk
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Centrum 03 für Zahn-, Mund- und Kieferheilkunde, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Berlin, Germany
| | - Sibylle Winterhalter
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Stefan Mundlos
- Institute of Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- RG Development & Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Charité - Centrum 03 für Zahn-, Mund- und Kieferheilkunde, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Berlin, Germany
- Department of Orthodontics, Technische Universität Dresden, Dresden, Germany
| | - Martin A Mensah
- Institute of Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- RG Development & Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
- BIH Biomedical Innovation Academy, Digital Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
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Manlove AE, Quintana EN, Cuellar LM, Linnebur AM. Benign Intraoral Soft Tissue Lesions in Children. Oral Maxillofac Surg Clin North Am 2024; 36:265-282. [PMID: 38395668 DOI: 10.1016/j.coms.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Benign intraoral soft tissue pathology in pediatric patients includes developmental, traumatic, inflammatory, and infectious lesions. Common pathology includes gingival cysts, mucoceles, fibromas, and parulis. Less common lesions include peripheral ossifying fibromas, congenital epulis of the newborn, and congenital mandibular duct atresia. Most of these lesions present at painless masses but can have significant effects on children and their caregivers. Although these lesions are generally harmless, evaluation and treatment is necessary for appropriate management and health of the child.
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Affiliation(s)
- Ashley E Manlove
- Carle Illinois College of Medicine, Carle Cleft and Craniofacial Team, Carle Foundation Hospital, Urbana, IL, USA.
| | - Erik N Quintana
- Division of Oral and Maxillofacial Surgery, Carle Foundation Hospital, Urbana, IL, USA
| | - Leticia M Cuellar
- Division of Oral and Maxillofacial Surgery, Carle Foundation Hospital, Urbana, IL, USA
| | - Alexis M Linnebur
- Arnold Palmer Hospital for Children - Orlando Health, 207 W. Gore Street, 3Road Floor, Suite.302, Orlando, FL 32806, USA
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Kammerhofer G, Bogdan S, Vegh D, Ujpal M, Kiss D, Jakob NP, Fadgyas F, Szabo G, Nemeth Z. Solitary ameloblastic fibroma with impacted teeth: A case report. J Craniomaxillofac Surg 2024:S1010-5182(24)00193-8. [PMID: 38971652 DOI: 10.1016/j.jcms.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/19/2024] [Accepted: 06/08/2024] [Indexed: 07/08/2024] Open
Abstract
This case report aimed to describe a rare benign mandibular tumour and assess the outcomes of the most recent reviews, between January 2017 and August 2023. Presenting a detailed clinical case, this study advances our understanding of the diagnostic and therapeutic aspects, ultimately improving the management of similar cases in clinical practice. Orthopantomogram (OPG) revealed a well-defined unilocular radiolucency extending from the midline of the ramus and teeth 47 and 48 were submerged at the base of the mandible. In the presented case, a PLANMECA ROMEXIS PROMAX® three-dimensional (3D) maximum (MAX) cone-beam computed tomography (CBCT) device was used for the 3D examination. An intraoral approach was preferred and the tumour was removed in toto by creating a bone window using a W&H® Dentalwerk Bürmoos GmbH Piezomed piezoelectric device, and the bone plates were fixed with 4 MEDARTIS® microplates, with a primary flap closure. A PANORAMIC 1000, 3DHISTECH Ltd® device was employed for the histological investigation. Odontogenic tumours are rare and typically asymptomatic, often discovered incidentally during routine radiographic examinations. Most of these benign lesions heal well after complete excision and require long-term follow-up. Once diagnosed, ameloblastic fibroma (AF) should be treated immediately to avoid malignant transformation.
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Affiliation(s)
- Gabor Kammerhofer
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary.
| | - Sandor Bogdan
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary
| | - Daniel Vegh
- Department of Prosthodontics, Semmelweis University, 1088, Budapest, Hungary
| | - Marta Ujpal
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary
| | - Dorottya Kiss
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary
| | - Noemi Piroska Jakob
- Department of Pathology and Experimental Cancer Research, Semmelweis University, 1085, Budapest, Hungary
| | - Fanny Fadgyas
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary
| | - Gyorgy Szabo
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary
| | - Zsolt Nemeth
- Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University, 1088, Budapest, Hungary
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Jung Y, Oh KY, Han SS, Lee C. A rare case report of ameloblastic fibrodentinoma with imaging features in a pediatric patient. Imaging Sci Dent 2024; 54:207-210. [PMID: 38948190 PMCID: PMC11211030 DOI: 10.5624/isd.20230247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/29/2024] [Accepted: 03/08/2024] [Indexed: 07/02/2024] Open
Abstract
Ameloblastic fibrodentinoma (AFD) is a rare benign odontogenic tumor that resembles an ameloblastic fibroma with dysplastic dentin. This report presents a rare case of mandibular AFD with imaging features in a young patient. Panoramic radiography and computed tomography revealed a well-defined lesion with internal septa and calcified foci, causing inferior displacement of the adjacent molars as well as buccolingual cortical thinning and expansion of the posterior mandible. The lesion was surgically removed via mass excision, and the involved tooth was extracted under general anesthesia. During the 5-year follow-up period, no evidence of recurrence was observed. Radiologic features of AFD typically reveal a moderately to well-defined mixed lesion with varying degrees of radiopacity, reflecting the extent of dentin formation. Radiologists should consider AFD in the differential diagnosis when encountering a multilocular lesion with little dense radiopacity, particularly if it is associated with delayed eruption, impaction, or absence of involved teeth, on radiographic images of young patients.
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Affiliation(s)
- Youjin Jung
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Kyu-Young Oh
- Department of Oral Pathology, College of Dentistry, Dankook University, Cheonan, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
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Singh Sihmar S, Rathi S, Ramalingam K, Ramani P, Sethuraman S. Developing Odontoma in the Mandible of an Eight-Year-Old Boy. Cureus 2024; 16:e56230. [PMID: 38618463 PMCID: PMC11016319 DOI: 10.7759/cureus.56230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
Benign mixed odontogenic tumors have been repeatedly classified and reclassified over the past few decades. Odontoma is considered a hamartoma due to its slow growth and non-aggressive nature. We present an interesting case of developing odontoma in an eight-year-old boy. His complaint was a slow-growing swelling in the lower right back tooth region. Clinical examination revealed a carious deciduous second molar. The orthopantomogram revealed a well-defined radiolucency around the unerupted mandibular first premolar and impacted mandibular second premolar. Histopathology revealed an odontogenic epithelial lining overlying myxofibrous stroma with inflammatory cells and calcified structures with few odontogenic rests. Special staining methods including Van Gieson and modified Gallego stains led to the final diagnosis of a developing odontoma.
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Affiliation(s)
- Sandeep Singh Sihmar
- Oral Pathology, Daswani Dental College, Kota, IND
- Oral Pathology, Darshan Foundation, Bhiwani, IND
| | - Shalini Rathi
- Oral Medicine and Radiology, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, IND
- Oral Medicine and Radiology, Darshan Foundation, Bhiwani, IND
| | - Karthikeyan Ramalingam
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Pratibha Ramani
- Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Sathya Sethuraman
- Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Alhazmi YA. The Enigma Unveiled: Expansile Compound-complex Odontoma in the Anterior Maxilla of a Teenager. Int J Clin Pediatr Dent 2024; 17:82-85. [PMID: 38559850 PMCID: PMC10978505 DOI: 10.5005/jp-journals-10005-2735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Aim and objective The objective of this case report is to offer insight into an expansive compound-complex odontoma located in the anterior maxilla of a 15-year-old male. The focus is placed on the importance of early detection and the progressive comprehension of odontomas. Background Odontomas are common odontogenic lesions that are frequently discovered during examinations for delayed tooth eruption. There are two distinct classifications for odontomas-compound odontomas and complex odontomas. With its own each set of characteristics. A timely diagnosis is critical for avoiding complications. Case description A male individual aged 15 years exhibited an expansive compound-complex odontoma located in the anterior maxilla. The clinical examination showed delayed tooth eruption and asymptomatic swelling. The radiographic images showed a radiopaque mass with tooth-like structures and radiolucent borders affecting the surrounding dentition. A surgical excision procedure was conducted, followed by a subsequent histopathological examination confirming the diagnosis of compound-complex odontoma. The patient continued orthodontic treatment after a 1-year follow-up without recurrence. Clinical significance This case emphasizes the importance of regular dental exams in detecting odontomas early. This observation also highlights the growing understanding of odontomas as hamartomatous odontogenic malformations and the challenges of diagnosing them clinically. Additional molecular investigations are required to facilitate the classification and elucidation of genetic factors. How to cite this article Alhazmi YA. The Enigma Unveiled: Expansile Compound-complex Odontoma in the Anterior Maxilla of a Teenager. Int J Clin Pediatr Dent 2024;17(1):82-85.
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Affiliation(s)
- Yaser Ali Alhazmi
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Jazan University, Jazan, Saudi Arabia
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Berberi A, Aad G, Nassar M, Maalouf G, Nader N. Decompression of a Dentigerous Cyst Treatment in Mixed Dentition: A Case Report with 5 Years Follow-Up. Case Rep Dent 2023; 2023:8628326. [PMID: 38045018 PMCID: PMC10692702 DOI: 10.1155/2023/8628326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 12/05/2023] Open
Abstract
Among developmental odontogenic cysts, the dentigerous type is the second most prevailing one. It is a benign intraosseous lesion commonly affecting the mandibular region. Dentigerous cysts present a high prevalence in children as they can be caused by the eruption of permanent teeth or the infection of deciduous ones. The adopted treatment modalities include enucleation (cystectomy), marsupialization, and decompression. Decompression maintains communication between the cyst and the oral medium through a sutured fixed device, namely an acrylic stent or a pretrimmed disposable suction tube. In the mixed dentition, the extraction of the affected primary teeth and the decompression approach is recommended, especially since children and parents are more tolerant of conservative treatments. We report in this study, a case of a 9-year-old boy complaining of a painful swelling in the left mandibular region. Intraoral and radiological examination revealed an expansion of the buccal and lingual cortical plates associated with teeth #73, #74, and #75 and a well-limited, unilocular radiolucent image extending from the distal aspect of tooth #31 to the mesial aspect of tooth #36 involving the crowns of the unerupted teeth #33, #34, and #35. The preliminary diagnosis was in favor of a dentigerous cyst. The treatment was to extract the deciduous teeth and to use a sterile tube for decompression. The patient was followed up for 5 years, a complete remission of the cyst was observed and the teeth #33, #34, and #35 re-erupted normally on the mandibular arch.
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Affiliation(s)
- Antoine Berberi
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Georges Aad
- Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Marise Nassar
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Gwenaëlle Maalouf
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Nabih Nader
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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Benign Pediatric Jawbone Lesions: A 10-Year Clinical and Radiological Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020335. [PMID: 36832466 PMCID: PMC9954982 DOI: 10.3390/children10020335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023]
Abstract
This study aimed at presenting a retrospective longitudinal analysis of the pediatric jaw lesions treated at the Oral and Maxillofacial Surgery Clinic in Cluj-Napoca, Romania, over a timeframe of ten years (2012 to 2022). The clinical and radiological characteristics of the jawbone lesions, the treatment outcome, and the recurrence incidence were described. All consecutive patients aged below 18 years, with histologically diagnosed odontogenic tumors (OTs), nonodontogenic tumors (non-OTs), or odontogenic cysts (OCs) were included. Age, dentition type, clinical symptoms, preoperative and postoperative radiological tests, histological diagnosis, treatment, and follow-up information one year following the diagnoses were all examined. Eighty-two cases were included. The ratio of men to women was 1.15:1, with the mandible predominating by 64.4%. Inflammatory radicular cysts predominated in 31.7% of cases. A total of 42.68% of the patients were asymptomatic. Enucleation was the most frequent surgical technique (45.1%), followed by cystectomies (28%) and marsupialization (14.6%). The overall recurrence rate was 7.3%; the most recurrent histopathological lesion was the odontogenic keratocyst. This study sheds new light on the clinical and radiological characteristics, treatment outcomes, and recurrence rate of juvenile jawbone lesions in children and adolescents. The diagnosis and treatment of jawbone lesions in children and adolescents can be enhanced with the use of epidemiological, clinical, and imagistic information.
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Ameloblastoma in a Three-Year-Old Child with Hurler Syndrome (Mucopolysaccharidosis Type I). REPORTS 2022. [DOI: 10.3390/reports5010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Mucopolysaccharidoses (MPS) are a family of genetic diseases associated with a deficiency of alpha-L iduronidase, which causes a lack of catabolism of glycosaminoglycans (GAGs). Therefore, the accumulation of GAGs determines a wide spectrum of symptoms, typically found in a few syndromes like Hurler syndrome (HS). Among other specific manifestations, craniofacial abnormalities are crucial for the characterization of this syndrome. Ameloblastoma is a rare, benign, slow-growing, odontogenic tumor usually located in the mandible. Clear risk factors for the development of ameloblastoma remain unknown, but black patients have a fivefold increased risk. Clinically, it is characterized by a painless, variable-sized jaw swelling. Although classified as a benign tumor, ameloblastoma often has a severe clinical outcome. The most common type of ameloblastoma is the solid/multicystic/conventional one. A computed tomography scan (CT) with and without contrast is the gold standard for evaluating this kind of neoplasia. Conservative or radical surgery is the mainstay of treatment. In this case report, we described an unusual clinical assessment of conventional ameloblastoma interesting the posterior left mandible of a 35-month-old child affected by HS. This case represented a suggestive challenge both from a diagnostic and a therapeutic point of view. The patient was disease-free at 2 years’ follow-up.
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