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Al-Zahrani MS, Alhassani AA, Zawawi KH. Clinical manifestations of gastrointestinal diseases in the oral cavity. Saudi Dent J 2021; 33:835-841. [PMID: 34938023 PMCID: PMC8665164 DOI: 10.1016/j.sdentj.2021.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/03/2021] [Accepted: 09/05/2021] [Indexed: 02/07/2023] Open
Abstract
Aim In this review, several gastrointestinal diseases that dentists may encounter in practice are highlighted and discussed. Materials and methods Using MEDLINE (PubMed), a comprehensive review of gastrointestinal diseases and their oral cavity manifestations was performed. Results Many gastrointestinal diseases present with oral symptoms that are detectable by dentists and dental hygienists. Often, oral manifestations of the disease may appear before systemic signs and symptoms. Managing patients with these conditions requires dentists to adjust their treatment and/or involve other health professionals. Conclusion Care must be taken when providing periodontal therapy or dental implants to patients suffering gastrointestinal diseases who are at high risk of bleeding, infection, or malnutrition, for example. Also, pharmacological therapy for these patients may need to be customized.
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Affiliation(s)
- Mohammad S Al-Zahrani
- Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ahmed A Alhassani
- Assistant Professor, Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Khalid H Zawawi
- Professor, Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabi
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2
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da Costa AAS, Tavares TS, Caldeira PC, Barcelos NS, de Aguiar MCF. Benign connective and soft-tissue neoplasms of the oral and maxillofacial region: Cross-sectional study of 1066 histopathological specimens. Head Neck 2020; 43:1202-1212. [PMID: 33340377 DOI: 10.1002/hed.26580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/11/2020] [Accepted: 12/08/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Benign connective and soft-tissue neoplasms (CSTNs) are unusual in the head and neck region. The aim of the present study was to evaluate the demographic and clinicopathological features of these neoplasms. METHODS A cross-sectional study was conducted of cases diagnosed as benign CSTNs, with data collected from biopsy records. The chi-square test was used. A p-value <0.05 was considered indicative of statistical significance. RESULTS Among the 38 119 specimens, 1066 (2.79%) were benign CSTNs: 369 fibroblastic/myofibroblastic, 250 adipocytic, 179 vascular, 130 neural, 94 osseous/cartilaginous, 19 muscular, and two fibrohistiocytic. Most patients were female (62.8%) and white-skinned (45.8%). Mean age was 42 years. The tongue (25.2%) was the most affected site for extraosseous neoplasms. CONCLUSION This study had the largest sample of benign oral and maxillofacial CSTNs. Although these tumors have similar clinical features, the characterization and differentiation detailed here may help clinicians with regards to the correct diagnosis.
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Affiliation(s)
| | - Thalita Soares Tavares
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Patrícia Carlos Caldeira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natália Santos Barcelos
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Larsson Wexell C, Bergenblock S, Kovács A. A Case Report on Gardner Syndrome With Dental Implant Treatment and a Long-Term Follow-Up. J Oral Maxillofac Surg 2019; 77:1617-1627. [PMID: 30959012 DOI: 10.1016/j.joms.2019.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 11/26/2022]
Abstract
A case of Gardner syndrome (GS) in a 37-year-old woman is presented in which rehabilitation with dental implant treatment was followed for 7 years. The course of diagnostics and treatment is followed through an overview of 45 tissue biopsy and cytology samples during a period of 30 years. The patient was diagnosed with GS after a routine review of an oral panoramic radiograph presenting with multiple osteomas and multiple unerupted supernumerary teeth. Biopsy results and surgical procedures with histopathologic diagnoses from 1986 to 2016 are presented. Histologic analysis of the sampled jawbone showed a picture similar to an osteoid osteoma. The installed implant was functionally stable, with no clinical or radiographic events observed at yearly visits, for 7 years. In 1991, benign tumors appeared; in 2014, multiple adenomas were found in the small intestine and rectum. This case report shows the potential for dental implant treatment in a patient with GS.
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Affiliation(s)
- Cecilia Larsson Wexell
- Associate Professor and Senior Consultant in OMFS, Department of Oral and Maxillofacial Surgery, Skane University Hospital, Lund; Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Sibel Bergenblock
- Senior Consultant in Prosthodontics, Department of Prosthodontics, Public Dental Health Service, Sahlgrenska University Hospital-Mölndal, Mölndal, Sweden
| | - Anikó Kovács
- Associate Professor and Senior Consultant in General Pathology, Department of Clinical Pathology and Genetics, Sahlgrenska University Hospital, Gothenburg, Sweden
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4
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Loncarevic S, Brajkovic D, Popovic M, Gardasevic M, Sekulic M, Matejic S. The Surgical Management of Gardner Syndrome Manifestation in the Maxillofacial Region: A Case Report. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.1515/sjecr-2017-0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
ApstraktGardner syndrome is a rare autosomal-dominant genetic disorder, considered a variant of familial adenomatous polyposis. It is characterized by intestinal polyposis and various bone and soft-tissue tumors, including osteomas, epidermal and dermal cysts, lipomas and fibromas. Intestinal polyps have high potential to become malignant, and the screening of intestinal lesions is mandatory. Maxillofacial manifestations, such as jaw osteomas, odontomas, dental abnormalities and soft tissue tumors frequently precede the intestinal manifestations. Thus, maxillofacial surgeons and dental practitioners may have important role in early detection of Gardner syndrome. In this case report we present a 22 year old male patient who was reffered to maxillofacial surgeon due to osteoma of the mandible. After obtaining clinical and radiological examinations, as well as data from family history, Gardner syndrome was suspected, which was later confirmed after gastroenterological examination.
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Affiliation(s)
- Slobodan Loncarevic
- Department of dentistry , University of Kragujevac , Serbia , Faculty of medical sciences
- Clinic for Maxillofacial surgery, Military Medical Academy , Belgrade , Serbia
| | - Denis Brajkovic
- Department of dentistry , University of Kragujevac , Serbia , Faculty of medical sciences
| | - Milica Popovic
- Department of dentistry , University of Kragujevac , Serbia , Faculty of medical sciences
| | - Milka Gardasevic
- Clinic for Maxillofacial surgery, Military Medical Academy , Belgrade , Serbia
| | - Miona Sekulic
- Department of dentistry , University of Kragujevac , Serbia , Faculty of medical sciences
| | - Suzana Matejic
- Department of forensic medicine , University of Pristina , Serbia , Faculty of medicine situated in Kosovska Mitrovica , Kosovo , Srbija
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5
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Lv Z, Wang C, Wu L, Guo B, Zhang D, Zhang Y, Huang S, Ou M. Identification of a mutL‑homolog 1 mutation via whole‑exome sequencing in a Chinese family with Gardner syndrome. Mol Med Rep 2018; 18:987-992. [PMID: 29845239 DOI: 10.3892/mmr.2018.9063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 02/12/2018] [Indexed: 11/06/2022] Open
Abstract
Gardner syndrome (GS), a variant of familial adenomatous polyposis, is a rare genetic disorder with autosomal dominant inheritance, characterized by the presence of multiple intestinal polyps, multiple osteomas, dental abnormalities and soft tissue tumors. To date, only a few gene mutations have been demonstrated to be responsible for GS. To explore potential unknown mutations responsible for GS, the present study used whole‑exome sequencing of two affected individuals from a family with GS to identify a candidate mutation in mutL‑homolog (MLH)1. The two patients with GS were diagnosed based on a combination of clinical features, family history, physical examinations and cone‑beam computed tomographic imaging. Through whole‑genome sequencing, the present study subsequently identified a missense mutation in MLH1 (NM_000249.3:p.Tyr379Ser/c.1136A>C), which was further confirmed by Sanger sequencing. Furthermore, the amino acid residue p.Tyr379 was identified to be highly conserved among different species through sequence alignment with ClustalW2. In conclusion, the results identified for the first time a MLH1 missense mutation (NM_000249.3:p.Tyr379Ser/c.1136A>C) in a Chinese family with GS, thus broadening the range of mutated genes associated with GS. This highlights the value of whole‑exome sequencing in identifying disease mutations in a family.
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Affiliation(s)
- Zilan Lv
- Department of Laboratory Medicine, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing 400030, P.R. China
| | - Chuan Wang
- Department of Gastroenterology, Chongqing General Hospital, Chongqing 400014, P.R. China
| | - Lixiang Wu
- Department of Laboratory Medicine, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing 400030, P.R. China
| | - Bianqin Guo
- Department of Laboratory Medicine, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing 400030, P.R. China
| | - Darong Zhang
- Department of Laboratory Medicine, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing 400030, P.R. China
| | - Yang Zhang
- Department of Laboratory Medicine, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing 400030, P.R. China
| | - Shengxing Huang
- Medical Center of Stomatology, The Second Clinical Medical College, Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
| | - Minglin Ou
- Clinical Medical Research Center, The Second Clinical Medical College, Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong 518020, P.R. China
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7
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Koh KJ, Park HN, Kim KA. Gardner syndrome associated with multiple osteomas, intestinal polyposis, and epidermoid cysts. Imaging Sci Dent 2016; 46:267-272. [PMID: 28035305 PMCID: PMC5192025 DOI: 10.5624/isd.2016.46.4.267] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/05/2016] [Accepted: 09/03/2016] [Indexed: 01/06/2023] Open
Abstract
Gardner syndrome is known as a variant of familial adenomatous polyposis. This syndrome is characterized by multiple intestinal polyposes, osteomas, and epidermoid cysts. In addition, dental abnormalities include an increased frequency of multiple odontomas, as well as supernumerary and impacted teeth. The authors report the case of a 7-year-old male patient with Gardner syndrome. Radiographic findings revealed multiple osteomas in both sides of the maxilla, multiple diffuse enostoses in both jaws, and a complex odontoma in the left mandibular body. Two years later, multiple epidermoid cysts on the scalp were found. Since this patient was suspected to have Gardner syndrome, the authors recommended gastrointestinal endoscopy to check for intestinal polyposis. Gastrointestinal endoscopic examination revealed multiple polyposes in the upper gastrointestinal tract and fundus of the stomach. As a result, the final diagnosis was Gardner syndrome.
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Affiliation(s)
- Kwang-Joon Koh
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju-si, Republic of Korea
| | - Ha-Na Park
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju-si, Republic of Korea
| | - Kyoung-A Kim
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju-si, Republic of Korea
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8
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Ponti G, Tomasi A, Manfredini M, Pellacani G. Oral mucosal stigmata in hereditary-cancer syndromes: From germline mutations to distinctive clinical phenotypes and tailored therapies. Gene 2016; 582:23-32. [PMID: 26850131 DOI: 10.1016/j.gene.2016.01.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 01/25/2016] [Accepted: 01/30/2016] [Indexed: 12/18/2022]
Abstract
Numerous familial tumor syndromes are associated with distinctive oral mucosal findings, which may make possible an early diagnosis as an efficacious marker for the risk of developing visceral malignancies. In detail, Familial Adenomatous Polyposis (FAP), Gardner syndrome, Peutz-Jeghers syndrome, Cowden Syndrome, Gorlin Syndrome, Lynch/Muir-Torre Syndrome and Multiple Endocrine Neoplasia show specific lesions of the oral mucosa and other distinct clinical and molecular features. The common genetic background of the above mentioned syndromes involve germline mutations in tumor suppressor genes, such as APC, PTEN, PTCH1, STK11, RET, clearly implied in both ectodermal and mesodermal differentiation, being the oral mucosal and dental stigmata frequently associated in the specific clinical phenotypes. The oral and maxillofacial manifestations of these syndromes may become visible several years before the intestinal lesions, constituting a clinical marker that is predictive for the development of intestinal polyps and/or other visceral malignancies. A multidisciplinary approach is therefore necessary for both clinical diagnosis and management of the gene-carriers probands and their family members who have to be referred for genetic testing or have to be investigated for the presence of visceral cancers.
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Affiliation(s)
- Giovanni Ponti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Aldo Tomasi
- Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy
| | - Marco Manfredini
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
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9
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Multiple complex odontoma of the maxilla and the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:e11-6. [DOI: 10.1016/j.oooo.2015.02.488] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/17/2015] [Accepted: 02/20/2015] [Indexed: 12/11/2022]
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10
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Ramaglia L, Di Spigna G, Capece G, Sbordone C, Salzano S, Postiglione L. Differentiation, apoptosis, and GM-CSF receptor expression of human gingival fibroblasts on a titanium surface treated by a dual acid-etched procedure. Clin Oral Investig 2015; 19:2245-53. [PMID: 25895169 DOI: 10.1007/s00784-015-1469-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 04/03/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Analysis of the effects of titanium surface properties on the biological behavior of human gingival fibroblasts (HGFs). MATERIALS AND METHODS HGFs were in vitro cultured on a titanium surface modified by a dual acid-etched procedure and on a control machined surface. Cell adhesion, proliferation, apoptosis, production of certain extracellular matrix (ECM) proteins, and expression of granulocyte macrophage-colony stimulating factor receptor (GM-CSFR) were investigated using in each experiment a total of 18 samples for each titanium surface. RESULTS Cell attachment at 3 h of culture was statistically significantly higher on the etched surface. HGF growth increased on both surfaces during the entire experimental period and at day 14 of culture cell proliferation was statistically significantly higher on the treated surface than on the control. No statistically significant differences in percentage of apoptosis events were observed between the surfaces. ECM protein production increased progressively over time on both surfaces. A statistically significant deposition was observed at day 7 and 14 for collagen I and only at day 14 for fibronectin and tenascin, when compared to the baseline. GM-CSFR registered a positive expression on both surfaces, statistically significant at day 14 on the etched surface in comparison with the machined one. CONCLUSIONS Data showed that titanium surface microtopography modulates in vitro cell response and phenotypical expression of HGFs. The etched surface promoted a higher cell proliferation and differentiation improving the biological behavior of HGFs. CLINICAL RELEVANCE Results suggest a possible beneficial effect of surface etching modification on peri-implant biological integration and soft tissue healing which is critical for the formation of a biological seal around the neck of dental implants.
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Affiliation(s)
- Luca Ramaglia
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Gaetano Di Spigna
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
| | - Gabriele Capece
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Carolina Sbordone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - Salvatore Salzano
- Institute of Experimental Endocrinology and Oncology "G. Salvatore", National Council of Research (CNR), Naples, Italy
| | - Loredana Postiglione
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy
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11
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Subasioglu A, Savas S, Kucukyilmaz E, Kesim S, Yagci A, Dundar M. Genetic background of supernumerary teeth. Eur J Dent 2015; 9:153-158. [PMID: 25713500 PMCID: PMC4319293 DOI: 10.4103/1305-7456.149670] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Supernumerary teeth (ST) are odontostomatologic anomaly characterized by as the existence excessive number of teeth in relation to the normal dental formula. This condition is commonly seen with several congenital genetic disorders such as Gardner's syndrome, cleidocranial dysostosis and cleft lip and palate. Less common syndromes that are associated with ST are; Fabry Disease, Ellis-van Creveld syndrome, Nance-Horan syndrome, Rubinstein-Taybi Syndrome and Trico–Rhino–Phalangeal syndrome. ST can be an important component of a distinctive disorder and an important clue for early diagnosis. Certainly early detecting the abnormalities gives us to make correct management of the patient and also it is important for making well-informed decisions about long-term medical care and treatment. In this review, the genetic syndromes that are related with ST were discussed.
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Affiliation(s)
- Aslı Subasioglu
- Department of Medical Genetics, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - Selcuk Savas
- Department of Pedodontics, Dentistry Faculty, Izmir Katip Celebi University, Izmir, Turkiye
| | - Ebru Kucukyilmaz
- Department of Pedodontics, Dentistry Faculty, Izmir Katip Celebi University, Izmir, Turkiye
| | - Servet Kesim
- Department of Periodontology, Faculty of Dentistry, Erciyes University, Kayseri, Turkiye
| | - Ahmet Yagci
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkiye
| | - Munis Dundar
- Department of Medical Genetics, Medical Faculty, Erciyes University, Kayseri, Turkiye
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12
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d’Incau E, Couture C, Crépeau N, Chenal F, Beauval C, Vanderstraete V, Maureille B. Determination and validation of criteria to define hypercementosis in two medieval samples from France (Sains-en-Gohelle, AD 7th–17th century; Jau-Dignac-et-Loirac, AD 7th–8th century). Arch Oral Biol 2015; 60:293-303. [DOI: 10.1016/j.archoralbio.2014.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 10/20/2014] [Accepted: 10/26/2014] [Indexed: 10/24/2022]
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Ragupathy K, Priyadharsini I, Sanjay P, Yuvaraj V, Balaji TS. Peripheral Osteoma of the Body of Mandible: A Case Report. J Maxillofac Oral Surg 2014; 14:1004-8. [PMID: 26604477 DOI: 10.1007/s12663-014-0710-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/19/2014] [Indexed: 11/24/2022] Open
Abstract
Osteoma is a slow growing benign tumor consisting of well differentiated compact or cancellous bone that increases in size by continuous growth. It can be of a central, peripheral, or extraskeletal type. The peripheral type arises from the periosteum and is rarely seen in mandible. Although completely curable with adequate surgical treatment, osteomas precede the clinical radiographic evidence of colonic polyposis/Gardner's syndrome. Therefore they may be sensitive markers for the disease. Recurrence of peripheral osteoma after surgical excision is extremely rare. However it is appropriate to provide both clinical and radiographic follow up after surgical excision of peripheral osteoma. This article describes the case of a 45 year old male who presented with painless swelling of the right body of mandible and resultant cosmetic facial disfigurement and functional impairment.
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Affiliation(s)
- Karthik Ragupathy
- Department of Dentistry, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Pondicherry, India
| | - Indira Priyadharsini
- Department of Dentistry, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Pondicherry, India
| | - P Sanjay
- Department of Dentistry, Sri Manakula Vinayagar Medical College and Hospital, Kalitheerthalkuppam, Pondicherry, India
| | - V Yuvaraj
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Cudallore Main Road, Pillaiyarkuppam, Pondicherry, 607402 India
| | - T S Balaji
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Sciences, Cudallore Main Road, Pillaiyarkuppam, Pondicherry, 607402 India
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Agrawal D, Newaskar V, Shrivastava S, Nayak PA. External manifestations of Gardner's syndrome as the presenting clinical entity. BMJ Case Rep 2014; 2014:bcr-2013-200293. [PMID: 25139912 DOI: 10.1136/bcr-2013-200293] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Gardner's syndrome is an autosomal dominant disease characterised by the presence of colonic polyposis, osteomas and a multitude of soft tissue tumours. Pathological features such as osteomas of the mandible, skull and facial skeleton are unaesthetic as well as incapacitating. We present the case of a 22-year-old man with pain and discharge from the left eye and a firm swelling in the left infraorbital region leading to proptosis of the left eye. A detailed examination of the patient led to the presence of a large osteoma in the left orbital region, multiple cystic lesion, corneal opacity and parapapillary atrophy in the left eye. Radiography revealed the presence of multiple unerupted supernumerary teeth and osteomas. Colonoscopic findings showed the presence of multiple polyps. Thus, external manifestations of the patient's facial region led to the establishment of the diagnosis of Gardner's syndrome. The importance of our case highlights the necessity of maintaining a high vigilance with regard to the occurrence of such an entity.
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Affiliation(s)
- Deepak Agrawal
- Department of Oral Surgery, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Vilas Newaskar
- Department of Oral Surgery, Government College of Dentistry, Indore, Madhya Pradesh, India
| | - Sanket Shrivastava
- Department of Oral Surgery, Government College of Dentistry, Indore, Madhya Pradesh, India
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Klein OD, Oberoi S, Huysseune A, Hovorakova M, Peterka M, Peterkova R. Developmental disorders of the dentition: an update. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2013; 163C:318-32. [PMID: 24124058 DOI: 10.1002/ajmg.c.31382] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Dental anomalies are common congenital malformations that can occur either as isolated findings or as part of a syndrome. This review focuses on genetic causes of abnormal tooth development and the implications of these abnormalities for clinical care. As an introduction, we describe general insights into the genetics of tooth development obtained from mouse and zebrafish models. This is followed by a discussion of isolated as well as syndromic tooth agenesis, including Van der Woude syndrome (VWS), ectodermal dysplasias (EDs), oral-facial-digital (OFD) syndrome type I, Rieger syndrome, holoprosencephaly, and tooth anomalies associated with cleft lip and palate. Next, we review delayed formation and eruption of teeth, as well as abnormalities in tooth size, shape, and form. Finally, isolated and syndromic causes of supernumerary teeth are considered, including cleidocranial dysplasia and Gardner syndrome.
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Cristofaro MG, Giudice A, Amantea M, Riccelli U, Giudice M. Gardner's syndrome: a clinical and genetic study of a family. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 115:e1-6. [PMID: 23453033 DOI: 10.1016/j.oooo.2011.10.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 09/29/2011] [Accepted: 10/04/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Gardner syndrome (GS) is an autosomal dominant genetic disorder with almost complete penetrance (80%) and variable expression. GS is a variant of familial adenomatous polyposis and characterized by extracolonic manifestations including osteomas and soft tissue tumors (desmoid tumors, epidermoid cysts). We describe clinical and surgical approaches in a family in which the genetic disorder was diagnosed in 3 generations. STUDY DESIGN The studied family underwent clinical history and instrumental and genomic studies. Two members of this family, affected with GS, underwent surgery for skeletal osteomas. RESULTS The patients that we treated with clinical-instrumental monitoring for a period of 5 years had no major disturbances of the stomatognathic system and no clinical signs of pathology of the gastrointestinal tract, eyes, or endocrine systems. CONCLUSIONS The orofacial complex disorders are exclusively functional and esthetic, concerning primarily the stomatognathic system. We had no cases of malignant transformation of osteomatosis lesions. Clinical sequelae are manly facial eumorphy and occlusion problems of the temporomandibular joint.
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Cankaya AB, Erdem MA, Isler SC, Cifter M, Olgac V, Kasapoglu C, Oral CK. Oral and maxillofacial considerations in Gardner's Syndrome. Int J Med Sci 2012; 9:137-41. [PMID: 22253560 PMCID: PMC3258555 DOI: 10.7150/ijms.3989] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 01/02/2012] [Indexed: 11/25/2022] Open
Abstract
Gardner's Syndrome is a variant of familial adenomatosis polyposis (FAP) with a triad consisting of polyps of the colon, multiple osteomas and surface tumors of soft and hard tissue. The intestinal polyps have a %100 risk of undergoing malignant transformation, therefore early identification of this disease is very important. There are several symptoms of Gardner's syndrome in the oral and maxillofacial surgery, which can be discovered during routine dental examination. We report a case of a 25-year old male patient with Gardner's syndrome who has not any intestinal polyps but osteomas in the mandible and jaw deformalities.
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Kalady MF, Church JM. Monitoring and Management of Desmoids and Other Extracolonic Manifestations in Familial Adenomatous Polyposis. SEMINARS IN COLON AND RECTAL SURGERY 2011. [DOI: 10.1053/j.scrs.2010.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wang XP, Fan J. Molecular genetics of supernumerary tooth formation. Genesis 2011; 49:261-77. [PMID: 21309064 DOI: 10.1002/dvg.20715] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 01/02/2011] [Accepted: 01/06/2011] [Indexed: 01/07/2023]
Abstract
Despite advances in the knowledge of tooth morphogenesis and differentiation, relatively little is known about the aetiology and molecular mechanisms underlying supernumerary tooth formation. A small number of supernumerary teeth may be a common developmental dental anomaly, while multiple supernumerary teeth usually have a genetic component and they are sometimes thought to represent a partial third dentition in humans. Mice, which are commonly used for studying tooth development, only exhibit one dentition, with very few mouse models exhibiting supernumerary teeth similar to those in humans. Inactivation of Apc or forced activation of Wnt/β(catenin signalling results in multiple supernumerary tooth formation in both humans and in mice, but the key genes in these pathways are not very clear. Analysis of other model systems with continuous tooth replacement or secondary tooth formation, such as fish, snake, lizard, and ferret, is providing insights into the molecular and cellular mechanisms underlying succesional tooth development, and will assist in the studies on supernumerary tooth formation in humans. This information, together with the advances in stem cell biology and tissue engineering, will pave ways for the tooth regeneration and tooth bioengineering.
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Affiliation(s)
- Xiu-Ping Wang
- Department of Developmental Biology, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115, USA.
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The surgical management of oral and maxillofacial manifestations of Gardner syndrome. J Oral Maxillofac Surg 2010; 68:2549-54. [PMID: 20594634 DOI: 10.1016/j.joms.2009.09.084] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Revised: 08/01/2009] [Accepted: 09/23/2009] [Indexed: 11/23/2022]
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Lee BD, Lee W, Oh SH, Min SK, Kim EC. A case report of Gardner syndrome with hereditary widespread osteomatous jaw lesions. ACTA ACUST UNITED AC 2009; 107:e68-72. [PMID: 19157925 DOI: 10.1016/j.tripleo.2008.10.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 07/24/2008] [Accepted: 10/21/2008] [Indexed: 11/19/2022]
Abstract
Gardner syndrome (GS) is an abnormality of familial adenomatous polyposis accompanied by characteristic jaw lesions. Gardner syndrome intestinal polyps have a 100% risk of undergoing malignant transformation; consequently, early identification and surgical intervention of the disease are important to prolong the life of the patient. We present a case of GS in a 55-year-old woman. Familial adenomatous polyposis, osteomatous jaw and ocular lesions, several dental abnormalities, and an abdominal desmoid tumor are the characteristic features of this case. This case demonstrates the presence of unusual, widespread, hereditary, osteomatous jaw lesions that caused diagnostic confusion with familial gigantiform cementoma.
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Affiliation(s)
- Byung Do Lee
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan City, Korea.
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Groen EJ, Roos A, Muntinghe FL, Enting RH, de Vries J, Kleibeuker JH, Witjes MJH, Links TP, van Beek AP. Extra-intestinal manifestations of familial adenomatous polyposis. Ann Surg Oncol 2008; 15:2439-50. [PMID: 18612695 PMCID: PMC2518080 DOI: 10.1245/s10434-008-9981-3] [Citation(s) in RCA: 153] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Revised: 05/07/2008] [Accepted: 05/08/2008] [Indexed: 12/20/2022]
Abstract
Familial adenomatous polyposis (FAP) is an autosomal dominantly inherited disorder, which results from a germ line mutation in the APC (adenomatous polyposis coli) gene. FAP is characterized by the formation of hundreds to thousands of colorectal adenomatous polyps. Although the development of colorectal cancer stands out as the most prevalent complication, FAP is a multisystem disorder of growth. This means, it is comparable to other diseases such as the MEN syndromes, Von Hippel-Lindau disease and neurofibromatosis. However, the incidence of many of its clinical features is much lower. Therefore, a specialized multidisciplinary approach to optimize health care-common for other disorders-is not usually taken for FAP patients. Thus, clinicians that care for and counsel members of high-risk families should have familiarity with all the extra-intestinal manifestations of this syndrome. FAP-related complications, for which medical attention is essential, are not rare and their estimated lifetime risk presumably exceeds 30%. Affected individuals can develop thyroid and pancreatic cancer, hepatoblastomas, CNS tumors (especially medulloblastomas), and various benign tumors such as adrenal adenomas, osteomas, desmoid tumors and dental abnormalities. Due to improved longevity, as a result of better prevention of colorectal cancer, the risk of these clinical problems will further increase. We present a clinical overview of extra-intestinal manifestations, including management and treatment options for the FAP syndrome. Furthermore, we provide recommendations for surveillance of FAP complications based on available literature.
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Affiliation(s)
- Emma J Groen
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, De Brug 4.069, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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