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Harizanova Z, Popova F, Peycheva M. A unique case report of mulberry second molar in a non-syphilitic patient. Medicine (Baltimore) 2024; 103:e39127. [PMID: 39058872 PMCID: PMC11272299 DOI: 10.1097/md.0000000000039127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
RATIONALE The common embryologic neural origin of the ectoderm includes the epidermal layer of the skin and the amelodentinal components of the teeth which can result in numerous diseases damaging both skin and dentition. Three main dental abnormalities were described as a consequence of congenital syphilis: Hutchinson incisors, bud molars, and mulberry molars which usually affect all permanent first molars. PATIENT CONCERNS As far as we know, this case is the first reported for mulberry second molar in a non-syphilitic patient. Ten projections globular in shape were presented on the occlusal surface of the second mandibular molar. DIAGNOSES The findings were characteristic for mulberry molars and therefore diagnosed as mulberry molars. INTERVENTIONS AND OUTCOMES No prosthetic treatment was conducted, just topical fluoride application was performed, and periodic observations were scheduled. LESSONS It is recommended that gynecologists and pediatricians should be provided with additional information about the local and systemic factors that can lead to developmental diseases of the teeth.
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Affiliation(s)
- Zdravka Harizanova
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria
| | - Ferihan Popova
- Department of Anatomy, Histology and Embryology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria
| | - Marieta Peycheva
- Department of Neurology, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria
- Research Institute, Faculty of Medicine, Medical University-Plovdiv, Plovdiv, Bulgaria
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Shah SAY, Hassan WU, Sajjad W, Shabbir UB, Raza A. A Rare Case of Hypohidrotic Ectodermal Dysplasia in a Seven-Year-Old Child. Cureus 2022; 14:e24300. [PMID: 35602783 PMCID: PMC9121332 DOI: 10.7759/cureus.24300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/05/2022] Open
Abstract
Ectodermal dysplasias (EDs) encompass a large group of inherited disorders that affects two or more ectodermally derived structures. Hair, sweat glands, teeth, and nails are the most common ectodermal derivates affected. Other ectodermal structures that may be affected are ears, eyes, lips, and mucous membranes of the mouth or nose. During embryonic development, the ectoderm forms the outermost layer of the primary germ layers that give rise to the several structures that are commonly affected in ED. Therefore, ED manifests differently among patients, depending on the abnormality's combination and severity. Out of 150 distinctive syndromes, the most common syndromes within this group are hypohidrotic (defective sweat glands) and hidrotic (normal sweat glands). In addition, different types of inheritance patterns are found in ED; X-linked inheritance is by far the most common mode of inheritance. We present here the clinical case of hypohidrotic (anhidrotic) ED in a seven-year-old boy.
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Affiliation(s)
| | | | - Waseem Sajjad
- Internal Medicine, Nishtar Medical University, Multan, PAK
| | | | - Ali Raza
- Internal Medicine, Nishtar Medical University, Multan, PAK
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Mascolo A, Boschetti E, Flanagan D. An ectodermal dysplasia patient treated with a small diameter implant supporting a single crown. Clin Cosmet Investig Dent 2018; 10:171-177. [PMID: 30127647 PMCID: PMC6089102 DOI: 10.2147/ccide.s170670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ectodermal dysplasia (EDD) is a developmental disorder that affects the skin, hair, and teeth among other organs generated in the ectoderm. Dental implants have been used to successfully treat partial edentulism in EDD patients, but the success rate is much lower for these patients. The report herein is a successful case of a single mini, small diameter, implant used to support a single crown of a mandibular right second premolar. A review of implant treatment in EDD patients is included.
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Affiliation(s)
- Andrea Mascolo
- European Institute for Medical Studies, H.E.I. Graduate School, Malta
| | - Elio Boschetti
- European Institute for Medical Studies, H.E.I. Graduate School, Malta
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Wilder EG, Frieder J, Sulhan S, Michel P, Cizenski JD, Wright JM, Menter MA. Spectrum of orocutaneous disease associations: Genodermatoses and inflammatory conditions. J Am Acad Dermatol 2017; 77:809-830. [PMID: 29029902 DOI: 10.1016/j.jaad.2017.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 02/01/2017] [Accepted: 02/08/2017] [Indexed: 12/18/2022]
Abstract
The oral cavity and cutaneous organ systems share a close embryologic origin. Therefore, there are numerous dermatologic conditions presenting with concomitant oral findings of which the dermatologist must be aware. The second article in this continuing medical education series reviews inflammatory orocutaneous conditions and a number of genodermatoses. It is essential for dermatologists to be familiar with oral cavity manifestations associated with dermatologic diseases for prompt diagnosis, management, and appropriate referral to stomatology and dentistry.
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Affiliation(s)
- Elizabeth G Wilder
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - Jillian Frieder
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - Suraj Sulhan
- Texas A&M Health Science Center College of Medicine, Bryan, Texas
| | - Pablo Michel
- Baylor Institute for Immunology Research, Dallas, Texas
| | - Jeffrey D Cizenski
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas
| | - John M Wright
- Texas A&M University College of Dentistry, Dallas, Texas
| | - M Alan Menter
- Division of Dermatology, Baylor University Medical Center, Dallas, Texas.
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Ioannou S, Sassani S, Henneberg M, Henneberg RJ. Diagnosing congenital syphilis using Hutchinson's method: Differentiating between syphilitic, mercurial, and syphilitic-mercurial dental defects. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2015; 159:617-29. [PMID: 26696588 DOI: 10.1002/ajpa.22924] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 11/27/2015] [Accepted: 12/03/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVES This study focuses on the dental abnormalities observed by Sir Jonathan Hutchinson, Henry Moon and Alfred Fournier in patients with congenital syphilis and in those treated with mercury, in order to define alterations in dental morphology attributable to each of these causes. These definitions are applied to reported paleopathological cases, exploring various etiologies behind the defects, in order to aid in the diagnosis of congenital syphilis. METHODS Original works were examined for descriptions of dental abnormalities in congenital syphilis and in mercurial treatments. These descriptions were compared with dentitions of paleopathological cases (n = 4) demonstrating abnormalities attributed to congenital syphilis. RESULTS Distinct morphological differences were recognized between congenital syphilitic teeth and teeth affected by mercury. Mercury produces a pronounced deficiency in enamel of incisors, canines and first permanent molars that become rugged and pitted, and of dirty grey honeycombed appearance. Mercury-induced dental changes are evident in three out of four cases studied here. In one case, only syphilitic changes were present. DISCUSSION Dental changes in congenital syphilis range from no visible signs to those beyond the classical models of Hutchinson, Moon and Fournier. Treatment of neonates and infants with mercury produces additional changes. Signs of disease and treatment with mercury on teeth may occur together; permanent incisors, first molars and canines, are typically affected, premolars and second/third molars are usually spared. Signs of treatment with mercury might be the only evidence of the occurrence of the disease as mercury was rarely used to treat other diseases.
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Affiliation(s)
- Stella Ioannou
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, South Australia 5005, Australia
| | - Sadaf Sassani
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, South Australia 5005, Australia
| | - Maciej Henneberg
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, South Australia 5005, Australia
| | - Renata J Henneberg
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, South Australia 5005, Australia
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Rakowska A, Górska R, Rudnicka L, Zadurska M. Trichoscopic Hair Evaluation in Patients with Ectodermal Dysplasia. J Pediatr 2015; 167:193-5. [PMID: 25935816 DOI: 10.1016/j.jpeds.2015.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Revised: 03/02/2015] [Accepted: 04/01/2015] [Indexed: 12/31/2022]
Abstract
Hair abnormalities in ectodermal dysplasia may be difficult to identify. Among 16 patients with ectodermal dysplasia trichoscopy (hair dermoscopy) revealed predominance of pilosebaceous units with 1 hair (69%), abnormalities of hair shaft pigmentation (gray hair with single dark hairs, 56%), pili torti, trichothiodystrophy, trichorrhexis nodosa, and rarely, cicatricial alopecia.
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Affiliation(s)
- Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.
| | - Renata Górska
- Department of Periodontology and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland; Department of Neuropeptides, Polish Academy of Sciences, Warsaw, Poland
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Affiliation(s)
- Vagish Kumar L Shanbhag
- Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya University, Mangalore, Karnataka, India
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Diagnosis of Mercurial Teeth in a Possible Case of Congenital Syphilis and Tuberculosis in a 19th Century Child Skeleton. ACTA ACUST UNITED AC 2015. [DOI: 10.1155/2015/103842] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Without the presence of “caries sicca,” “sabre shins,” and nodes/expansion of the long bones with superficial cavitation, differential diagnosis of venereal syphilis and tuberculosis (TB) may be difficult as various infections produce similar responses. However, congenital syphilis has distinctive features facilitating a diagnosis. A case study of remains of a juvenile European settler (probably male, 8–10 years old) (B70) buried in the 19th century and excavated in 2000 from the cemetery of the Anglican Church of St. Marys in South Australia is presented. B70 demonstrated that the two diseases might have been present in the same individual, congenital syphilis and TB. Widespread destruction of vertebral bodies and kyphosis-related rib deformations indicate advanced TB. Severe dental hypoplasia is limited to permanent incisors and first molars; there is pitting on the palate, periosteal reaction on the skull vault, and thinned clavicles. Dental signs are not limited to “screwdriver” central incisors and mulberry molars. Apical portions of the crowns of permanent upper, lower, central, and lateral incisors have multiple hypoplastic-disorganized defects; deciduous canines have severely hypoplastic crowns while possibly hypoplastic occlusal surfaces of lower deciduous second molars are largely destroyed by extensive caries. These dental abnormalities resemble teeth affected by mercurial treatment in congenital syphilitic patients as described by Hutchinson.
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Abstract
BACKGROUND There are about 10,000 monogenic diseases and around 30% demonstrate alterations in the skin and its appendages. As there are so many genetic different skin diseases, clear diagnosis is often very difficult. AIM The goal of this review is to give the clinicians some key features on nails and teeth which might help to identify rare genodermatoses. DISCUSSION In the daily work genodermatoses manifest more commonly as incomplete or oligosymptomatic syndromes than as complete symptom complexes. To diagnose a rare disorder in such situations, a knowledge of key features which are characteristic for a genodermatoses is essential, so that a diagnosis can be advanced and the underlying gene defect identified. Changes in nails and teeth sometimes may be useful as diagnostic key features. Both structures originate from ectoderm and therefore they often appear in combination in diseases with major ectodermal malformations. Enamel defects resembling the lines of Blaschko are highly suggestive for focal dermal hypoplasia, even if other important signs and symptoms are missing. Enamel defects combined with gingival fibromas are highly suggestive for tuberous sclerosis. On the other side, triangular lunulae with malformation and dystrophy of the nail plate suggests nail-patella syndrome.
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Affiliation(s)
- P Itin
- Dermatologie Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz,
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Seow WK. Developmental defects of enamel and dentine: challenges for basic science research and clinical management. Aust Dent J 2013; 59 Suppl 1:143-54. [PMID: 24164394 DOI: 10.1111/adj.12104] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abnormalities of enamel and dentine are caused by a variety of interacting factors ranging from genetic defects to environmental insults. The genetic changes associated with some types of enamel and dentine defects have been mapped, and many environmental influences, including medical illnesses that can damage enamel and dentine have been identified. Developmental enamel defects may present as enamel hypoplasia or hypomineralization while dentine defects frequently demonstrate aberrant calcifications and abnormalities of the dentine-pulp complex. Clinically, developmental enamel defects often present with problems of discolouration and aesthetics, tooth sensitivity, and susceptibility to caries, wear and erosion. In contrast, dentine defects are a risk for endodontic complications resulting from dentine hypomineralization and pulpal abnormalities. The main goals of managing developmental abnormalities of enamel and dentine are early diagnosis and improvement of appearance and function by preserving the dentition and preventing complications. However, despite major advances in scientific knowledge regarding the causes of enamel and dentine defects, further research is required in order to translate the knowledge gained in the basic sciences research to accurate clinical diagnosis and successful treatment of the defects.
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Affiliation(s)
- W K Seow
- Centre for Paediatric Dentistry, School of Dentistry, The University of Queensland, Brisbane, Australia
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MATOS VÍTORM, SANTOS ANALUÍSA. Leprogenic odontodysplasia: new evidence from the St. Jørgen’s medieval leprosarium cemetery (Odense, Denmark). ANTHROPOL SCI 2013. [DOI: 10.1537/ase.121112] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- VÍTOR M.J. MATOS
- CIAS (Research Centre for Anthropology and Health) and Department of Life Sciences, University of Coimbra, Coimbra
| | - ANA LUÍSA SANTOS
- CIAS (Research Centre for Anthropology and Health) and Department of Life Sciences, University of Coimbra, Coimbra
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Abstract
Ectodermal dysplasias (ED) are a group of inherited disorders characterized by dysplasia of structures of ectodermal origin, clinically classified into hypohidrotic and hidrotic forms. A 21-year-old female presented with history of hypohidrosis, thinning of scalp and eyebrow hair, xerotic skin, and periorbital and perioral wrinkling. There was hypodontia and peg-shaped teeth on intraoral examination. Routine investigations were normal, orthopantomogram revealed absence of multiple teeth with peg-shaped teeth. Histopathological examination showed thinned epidermis and reduction in the number of eccrine units. Thus, the diagnosis was confirmed as Hypohidrotic ED.
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Affiliation(s)
- Manish Bansal
- Department of Dermatology and Venereology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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Abstract
Skin and teeth not only share several characteristics in their development but also have a similar ontogenetic origin from the ectoderm. Thus, numerous congenital diseases, such as genetic, infectious, inflammatory, and immune disorders affect both skin and teeth. Particularly skin diseases are often identified by the synopsis of systemic symptoms. The understanding and appreciation of dental abnormalities guides dermatologists in the diagnosis and identification of syndromes as well as in finding an optimal therapy.
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