Extreme oral manifestations in a Marfan-type syndrome

Full-Mouth Rehabilitation With Implant-Prosthesis in Marfan Syndrome Patient: Clinical Report and Literature Review

The purpose of this case report is to present implant-retained maxillary and mandibular complete overdentures in a patient with Marfan syndrome. The patient initially presented with generalized periodontitis (stage IV, grade C). Due to the progressive nature of periodontal disease, the patient elected to have implant-retained maxillary and mandibular complete dentures. Bilateral maxillary sinus augmentation was performed 6 months before full-mouth extraction, alveoloplasty, and immediate implant placement. Maxillary and mandibular immediate overdentures were delivered. After 4 months of healing, the final overdenture was fabricated. The patient was seen regularly throughout the healing process for peri-implant maintenance. Soft-tissue grafts were completed to increase the thickness of the mucosa around the implants. The patient has been followed for 2 years and is functioning well without major complications. For patients with Marfan syndrome, implant-retained prostheses are a viable treatment option in the presence of a failing dentition.

Problems in the orofacial region associated with Ehlers-Danlos and Marfan syndromes: a case series

Ehlers-Danlos syndrome (EDS) and Marfan syndrome (MFS) are characterised by hypermobility of joints and cardiovascular morbidity, and typical orofacial signs and symptoms are associated with both. Basic knowledge of these should prevent late-stage diagnosis and enable adequate management. This case series comprises all EDS and MFS patients who consulted the Department of Oral and Maxillofacial Surgery at University Hospitals Leuven between 2005 and 2017. Thirty patients had EDS or MFS, and in seven the diagnosis was made based on temporomandibular dysfunction or craniofacial dysmorphism. Non-facial symptoms led to diagnosis in the remaining patients. Twenty-five interventions were followed by two infections and one haemorrhage. One patient developed trismus. No major complications were reported. The complications we observed did not seem to differ from those often seen in patients who did not have EDS or MFS, possibly as a result of our strictly applied precautions and postoperative instructions. However, our study of relevant publications shows that patients with EDS and MFS are a vulnerable group.

Orthodontic Treatment and Long-Term Management of a Patient with Marfan Syndrome

Marfan syndrome (MFS) is caused by abnormal systemic connective tissue. The main clinical manifestations include long limbs, long slender fingers, lens subluxation, abnormal cardiac valves, and aortic aneurysm. We report the case of an 11-year-old patient with MFS who underwent orthodontic treatment and was followed up until the age of 25 years. We found no significant differences in tooth movement between the patient with MFS and healthy subjects. However, because patients with MFS show characteristic facial growth and an increased risk of developing systemic comorbidities, their dental status requires careful observation over time.

Odontomas and supernumerary teeth: is there a common origin?

The aim of the present work is to analyze all scientific evidence to verify whether similarities supporting a unified explanation for odontomas and supernumerary teeth exist. A literature search was first conducted for epidemiologic studies indexed by PubMed, to verify their worldwide incidence. The analysis of the literature data shows some interesting similarities between odontomas and supernumerary teeth concerning their topographic distribution and pathologic manifestations. There is also some indication of common genetic and immuno-histochemical factors. Although from a nosological point of view, odontomas and supernumeraries are classified as distinct entities, they seem to be the expression of the same pathologic process, either malformative or hamartomatous.

[Extra-oral signs to look for in patients exhibiting oral warning signs of genetic diseases]

This article is aimed at defining guidelines for dental surgeons to manage patients with warning signs of rare genetic diseases. Anomalies of tooth development may occur as an isolated condition or in association with other symptoms in syndromes. In many cases, dental anomalies may be the first manifestations of a genetic disease. The dentist can contribute to the diagnosis, and hence to an early treatment of this syndrome. When one or more dental anomalies are found, practitioners should refer patients to a genetic clinic or a specialized reference center to diagnose genetic diseases. Therefore, we provide, for the first time, a table of extra-oral signs that dental surgeons can look for in patients exhibiting heritable dental developmental anomalies.

Marfan syndrome: a review of the literature and case report

Marfan syndrome (MFS) is a connective tissue disorder of variable inheritance that affects multiple organ systems. Cardiovascular, ocular, and skeletal abnormalities are cardinal features of the syndrome. Orofacially, MFS patients typically exhibit skeletal class II malocclusion, dolichofacial growth pattern, mandibular retrognathia, malar hypoplasia, high arched palate, dental crowding, and root anomalies. The purpose of this paper is to provide a review of the literature, as well as describe an 11-year-old female with MFS diagnosed at the age of 10.5 years. This report emphasizes the orofacial findings in MFS and highlights particularities of dental treatment when social deficits and intellectual disabilities are also implicated.