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Sinada N, Wang CI. Fixed prosthodontic rehabilitation for an adolescent patient with ectodermal dysplasia using a fully digital workflow: Two-year follow-up. J Prosthet Dent 2024; 131:990-995. [PMID: 36577569 DOI: 10.1016/j.prosdent.2022.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 12/27/2022]
Abstract
Ectodermal dysplasia is a rare genetic disorder characterized by congenital abnormalities of tissues and structures of ectodermal origin, such as the hair, nails, skin, sweat glands, and teeth. Common dental characteristics include retained primary teeth, conical shaped incisors and canines, and hypodontia or oligodontia. Early prosthodontic intervention of young patients diagnosed with ectodermal dysplasia is essential as symptoms can have substantial esthetic, functional, and psychosocial impacts. This clinical report describes the fixed prosthodontic treatment of an adolescent patient with ectodermal dysplasia by using a fully digital workflow. Digital workflows streamlined the treatment process and allowed for esthetic, functional, and psychological improvements in an efficient manner.
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Herlin LK, Schmidt SAJ, Hermann XB, Rønholt K, Bygum A, Schuster A, Lei U, Mogensen M, Vinding GR, Djursby M, Hove H, Blechingberg J, Graversen L, Mogensen TH, Gjørup H, Langan SM, Sommerlund M. Prevalence and Patient Characteristics of Ectodermal Dysplasias in Denmark. JAMA Dermatol 2024; 160:502-510. [PMID: 38477886 PMCID: PMC10938247 DOI: 10.1001/jamadermatol.2024.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/09/2024] [Indexed: 03/14/2024]
Abstract
Importance Ectodermal dysplasias constitute a group of rare genetic disorders of the skin and skin appendages with hypodontia, hypotrichosis, and hypohidrosis as cardinal features. There is a lack of population-based research into the epidemiology of ectodermal dysplasias. Objective To establish a validated population-based cohort of patients with ectodermal dysplasia in Denmark and to assess the disease prevalence and patient characteristics. Design, Setting, and Participants This nationwide cohort study used individual-level registry data recorded across the Danish universal health care system to identify patients with ectodermal dysplasias from January 1, 1995, to August 25, 2021. A 3-level search of the Danish National Patient Registry and the Danish National Child Odontology Registry was conducted to identify patients with diagnosis codes indicative of ectodermal dysplasias; patients registered in the Danish RAREDIS Database, the Danish Database of Genodermatoses, and local databases were also added. The search results underwent diagnosis validation and review of clinical data using medical records. Of 844 patient records suggestive of ectodermal dysplasias, 791 patients (93.7%) had medical records available for review. Positive predictive values of the diagnosis coding were computed, birth prevalence was estimated, and patient characteristics were identified. Data analysis was performed from May 4 to December 22, 2023. Results The identified and validated study cohort included 396 patients (median [IQR] age at diagnosis, 13 [4-30] years, 246 females [62.1%]), of whom 319 had confirmed ectodermal dysplasias and 77 were likely cases. The combined positive predictive value (PPV) for ectodermal dysplasia-specific diagnosis codes was 67.0% (95% CI, 62.7%-71.0%). From 1995 to 2011, the estimated minimum birth prevalence per 100 000 live births was 14.5 (95% CI, 12.2-16.7) for all ectodermal dysplasias and 2.8 (95% CI, 1.8-3.8) for X-linked hypohidrotic ectodermal dysplasias. A molecular genetic diagnosis was available for 241 patients (61%), including EDA (n = 100), IKBKG (n = 55), WNT10A (n = 21), TRPS1 (n = 18), EDAR (n = 10), P63 (n = 9), GJB6 (n = 9), PORCN (n = 7), and other rare genetic variants. Conclusions and Relevance The findings of this nationwide cohort study indicate that the prevalence of ectodermal dysplasias was lower than previously reported. Furthermore, PPVs of the search algorithms emphasized the importance of diagnosis validation. The establishment of a large nationwide cohort of patients with ectodermal dysplasias, including detailed clinical and molecular data, is a unique resource for future research in ectodermal dysplasias.
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Affiliation(s)
- Laura Krogh Herlin
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Sigrun A. J. Schmidt
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Xenia Buus Hermann
- Center for Oral Health in Rare Diseases, Department of Maxillofacial Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten Rønholt
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Anette Bygum
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Annette Schuster
- Department of Dermatology, Odense University Hospital, Odense, Denmark
| | - Ulrikke Lei
- Department of Dermatology and Allergy, Copenhagen University Hospital Gentofte, Copenhagen, Denmark
| | - Mette Mogensen
- Department of Dermatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | | | - Malene Djursby
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hanne Hove
- Center for Rare Diseases, Department of Pediatrics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- RAREDIS Database, Section of Rare Diseases, Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jenny Blechingberg
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Lise Graversen
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Trine H. Mogensen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Gjørup
- Center for Oral Health in Rare Diseases, Department of Maxillofacial Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Sinéad M. Langan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mette Sommerlund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Blanchet I, Michel F, Tardieu C, Camoin A. Difficulties experienced by dentists and orthodontists regarding ethical issues when announcing the diagnosis of a rare oral disease: a qualitative study in Marseille, France. Eur Arch Paediatr Dent 2024; 25:169-179. [PMID: 38457081 DOI: 10.1007/s40368-024-00864-z] [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] [Received: 05/05/2023] [Accepted: 01/03/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE It is traditionally considered that breaking bad news to patients does not represent a cause for concern for dental professionals. However, there are situations where they will be confronted with this task, as in the case of rare dental diseases. Little information is available regarding the feelings of healthcare professionals on this subject. There are no qualitative studies that explore how a diagnosis of oligodontia is announced to patients by dentists and orthodontists. The aim of our study is to explore the difficulties and ethical issues experienced by dental health professionals when they have to announce a diagnosis of oligodontia to a patient and their family. METHODS This study relied on a qualitative research method using focus groups of dentists and orthodontists and a thematic analysis procedure. RESULTS The difficulties experienced could be summarised within five topics: organisational difficulties, difficulties with the management of dental treatment and with the administrative management associated with this anomaly, difficulties with the content of the announcement, and relational difficulties. These could be grouped in two categories: practical difficulties and ethical difficulties. CONCLUSION This survey allowed us to understand the difficulties encountered by dentists and orthodontists when announcing oligodontia. The participants felt uncomfortable with this task and were under stress. They reported difficulties in delivering the medical information and in adapting to the message. It is essential that dental professionals develop skills in medical communication.
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Affiliation(s)
- I Blanchet
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France.
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France.
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France.
| | - F Michel
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France
| | - C Tardieu
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France
| | - A Camoin
- APHM Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
- Medical and Paramedical Sciences Faculty, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005, Marseille, France
- ADES CNRS EFS, UMR 7268, Aix-Marseille University, 51 Bd Pierre Dramard, 13344, Marseille, France
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Dufresne H, Maincent O, Taieb C, Bodemer C, Hadj-Rabia S. The Ectodermal Dysplasias-Burden of Disease Score: Development and Validation of an Ectodermal Dysplasia Family/Parental Burden Score. Acta Derm Venereol 2023; 103:adv5203. [PMID: 37646348 PMCID: PMC10547059 DOI: 10.2340/actadv.v103.5203] [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] [Received: 10/22/2022] [Accepted: 05/17/2023] [Indexed: 09/01/2023] Open
Abstract
Ectodermal dysplasias are genetic conditions affecting the development and/or homeostasis of 2 or more ectodermal derivatives, including hair, teeth, nails, and certain glands. No tool is available to assess the burden of ectodermal dysplasias and its multidimensional impact on patients and their families. This study developed and validated a familial/parental 19-item burden questionnaire designed specifically for ectodermal dysplasias. Each group of questions was linked to 1 of the following dimensions: (i) Impact of the disease on social life and hobbies; (ii) Future prospects; (iii) Restraint of the disease on outdoor activities; (iv) Financial burden of the disease; (v) Acceptance of the disease. Cronbach's alpha was 0.91 for the entire Ectodermal Dysplasias-Burden of Disease (ED-BD) scale, confirming excellent internal coherence. Intradimensional coherences all demonstrated excellent reliability (α > 0.76). The ED-BD questionnaire was highly correlated with the Short Form-12 and Psychological General Well Being Index validated questionnaires. Cultural and linguistic validation in US English was conducted. Development and validation of the questionnaire was based on data from patients with the 2 main ectodermal dysplasias subtypes. This ED-BD questionnaire represents the first specific assessment tool for evaluating the familial/parental burden of ectodermal dysplasias.
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Affiliation(s)
- Helene Dufresne
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Filière Maladies Rares Dermatologiques (FIMARAD), ERN-Skin, Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France
| | - Oriane Maincent
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Filière Maladies Rares Dermatologiques (FIMARAD), ERN-Skin, Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France
| | - Charles Taieb
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Filière Maladies Rares Dermatologiques (FIMARAD), ERN-Skin, Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France
| | - Christine Bodemer
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Filière Maladies Rares Dermatologiques (FIMARAD), ERN-Skin, Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France
| | - Smail Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Filière Maladies Rares Dermatologiques (FIMARAD), ERN-Skin, Hôpital Universitaire Necker- Enfants Malades, Assistance Publique - Hôpitaux de Paris-Centre (AP-HP5), Paris, France.
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5
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Aarts M, Mettenberger S, Bronkhorst EM, Ongkosuwito EM. Oral health-related Quality of Life in patients with Oligodontia: a FACE-Q assessment. J Dent 2023:104544. [PMID: 37178858 DOI: 10.1016/j.jdent.2023.104544] [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: 02/03/2023] [Revised: 05/06/2023] [Accepted: 05/10/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES The present study aimed to investigate the impact of oligodontia on appearance and on the functional and psychosocial aspects of oral health-related quality of life (OHrQoL) in patients aged 8-29 years. METHODS 62 patients with oligodontia that were registered at -REDACTED- were included. A control group included 127 patients that were referred for a first orthodontic consultation. Participants completed the FACE-Q Dental questionnaire. Regression analyses were performed to explore relationships between OHrQoL and patient-identified gender, age, the number of congenitally missing teeth, active orthodontic treatment, and previous orthodontic treatment. RESULTS The only clear significant difference between the oligodontia and control groups was that patients with oligodontia scored lower in the domain, 'eating and drinking' (p<0.001). It was found that, in oligodontia the greater the number of agenetic teeth, the more difficulties eating and drinking. In fact, the Rasch score was reduced by 1.00 (95% CI: 0.23-1.77; p=0.012) for each extra agenetic tooth. Older children scored significantly lower than younger ones on five out of nine scales: appearance of the face, smile, and jaws; social function; and psychological function. Females scored significantly lower than males on four scales: appearance of the face, appearance distress, social function, and psychological function. CONCLUSION These findings suggested that, when treating patients with oligodontia, the number of agenetic teeth, age, and gender should be taken into account. These factors could have negative effects on their self-assessment of appearance, their facial function, and their quality of life. CLINICAL SIGNIFICANCE The increased difficulty with eating and drinking associated with more agenetic teeth highlighted the importance of functional (re)habilitation.
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Affiliation(s)
- M Aarts
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - S Mettenberger
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, The Netherlands; Orthodontic Practice Dr. Hilligardt and Dr. Ellebracht, Sindelfingen, Germany
| | - E M Bronkhorst
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - E M Ongkosuwito
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, The Netherlands
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6
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The paediatric dentistry-restorative dentistry interface. Br Dent J 2022; 233:475-482. [PMID: 36151172 DOI: 10.1038/s41415-022-4983-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/15/2022] [Indexed: 11/09/2022]
Abstract
This paper examines the various contemporary clinical interfaces between paediatric dentistry and restorative dentistry for patients with both acquired and congenital abnormalities presenting to primary and secondary care. Dental trauma of the child or adolescent has long-standing implications on future oral health due to conditions such as ankylosis, pulp necrosis, coronal tissue loss or tooth loss, all of which provide significant challenges into adulthood. Similarly, congenital conditions, such as hypodontia and structural deficiencies or malformations, such as amelogenesis and dentinogenesis imperfecta, result in the need for collaborative, multi-speciality decision-making from a young age, creating a pathway for longitudinal multi-disciplinary team treatment planning.
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Gökdere S, Schneider H, Hehr U, Willen L, Schneider P, Maier-Wohlfart S. Functional and clinical analysis of five EDA variants associated with ectodermal dysplasia but with a hard-to-predict significance. Front Genet 2022; 13:934395. [PMID: 35923710 PMCID: PMC9339965 DOI: 10.3389/fgene.2022.934395] [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] [Received: 05/02/2022] [Accepted: 06/27/2022] [Indexed: 12/13/2022] Open
Abstract
Deficiency of ectodysplasin A1 (EDA1) due to variants of the gene EDA causes X-linked hypohidrotic ectodermal dysplasia (XLHED), a rare genetic condition characterized by abnormal development of ectodermal structures. XLHED is defined by the triad of hypotrichosis, hypo- or anhidrosis, and hypo- or anodontia. Anhidrosis may lead to life-threatening hyperthermia. A definite genetic diagnosis is, thus, important for the patients' management and amenability to a novel prenatal treatment option. Here, we describe five familial EDA variants segregating with the disease in three families, for which different prediction tools yielded discordant results with respect to their significance. Functional properties in vitro and levels of circulating serum EDA were compared with phenotypic data on skin, hair, eyes, teeth, and sweat glands. EDA1-Gly176Val, although associated with relevant hypohidrosis, still bound to the EDA receptor (EDAR). Subjects with EDA1-Pro389LeufsX27, -Ter392GlnfsX30, -Ser125Cys, and an EDA1 splice variant (c.924+7A > G) showed complete absence of pilocarpine-induced sweating. EDA1-Pro389LeufsX27 was incapable of binding to EDAR and undetectable in serum. EDA1-Ter392GlnfsX30, produced in much lower amounts than wild-type EDA1, could still bind to EDAR, and so did EDA1-Ser125Cys that was, however, undetectable in serum. The EDA splice variant c.924+7A > G resulted experimentally in a mix of wild-type EDA1 and EDA molecules truncated in the middle of the receptor-binding domain, with reduced EDA serum concentration. Thus, in vitro assays reflected the clinical phenotype in two of these difficult cases, but underestimated it in three others. Absence of circulating EDA seems to predict the full-blown phenotype of XLHED, while residual EDA levels may also be found in anhidrotic patients. This indicates that unborn subjects carrying variants of uncertain significance could benefit from an upcoming prenatal medical treatment even if circulating EDA levels or tests in vitro suggest residual EDA1 activity.
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Affiliation(s)
- Sare Gökdere
- Department of Pediatrics, Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
| | - Holm Schneider
- Department of Pediatrics, Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
| | - Ute Hehr
- Center for Human Genetics, Regensburg, Germany
| | - Laure Willen
- Department of Biochemistry, University of Lausanne, Lausanne, Switzerland
| | - Pascal Schneider
- Department of Biochemistry, University of Lausanne, Lausanne, Switzerland
| | - Sigrun Maier-Wohlfart
- Department of Pediatrics, Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
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8
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Leo B, Schneider H, Hammersen J. Reproductive decision-making by women with X-linked hypohidrotic ectodermal dysplasia. J Eur Acad Dermatol Venereol 2022; 36:1863-1870. [PMID: 35611639 DOI: 10.1111/jdv.18267] [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: 11/29/2021] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND In X-linked hypohidrotic ectodermal dysplasia (XLHED), ectodysplasin A1 (EDA1) deficiency results in malformation of hair, teeth, and sweat glands. Lack of sweating which can cause life-threatening hyperthermia is amenable to intrauterine therapy with recombinant EDA1. OBJECTIVES This study aimed at evaluating reproductive decision-making by women with XLHED and at clarifying the potential impact of a prenatal treatment option. METHODS In a retrospective cross-sectional analysis, a 75-item questionnaire filled in by 50 women with XLHED (age 19-49 years) was assessed. RESULTS 16 women (32%) prevented pregnancies because of the risk to pass on XLHED, 15 considered assisted reproduction for the same reason. Twelve women had a history of miscarriage, stillbirth or abortion, three women reported on previous abortion of affected fetuses. When imagining to be pregnant, all except one showed interest in prenatal diagnosis of XLHED and in the possibility of treatment before birth. In 13 out of 50 women (26%), XLHED if detected prenatally would have impact on the continuation of pregnancy. Among 35 mothers of at least one affected child, XLHED had rarely been diagnosed during the first pregnancy (17%) but regularly during subsequent pregnancies (77%). Becoming aware of the condition before birth had caused a moral conflict for 50% of these women. Subjects with an affected child less frequently considered assisted reproduction to prevent XLHED (p<0.05). In more than 66% of the women who reported an effect of XLHED on family planning, a prenatal treatment option for this disease would influence their decision-making. CONCLUSIONS Many pregnant XLHED carriers who seek prenatal diagnosis experience moral conflicts. A prenatal treatment option would have strong impact on reproductive decisions, underlining the importance of adequate professional counselling.
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Affiliation(s)
- B Leo
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany.,Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - H Schneider
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany.,Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - J Hammersen
- Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany.,Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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9
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Seremidi K, Markouli A, Agouropoulos A, Polychronakis N, Gizani S. Rehabilitation Considerations for Very Young Children with Severe Oligodontia due to Ectodermal Dysplasia: Report of Three Clinical Cases with a 2-Year Follow-Up. Case Rep Dent 2022; 2022:9925475. [PMID: 35360383 PMCID: PMC8964192 DOI: 10.1155/2022/9925475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/16/2022] [Accepted: 03/02/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Management of oligodontia can be complicated and requires multidiscipline care, involving a wide spectrum of interventions. The aim of this report is to describe the challenges of oral rehabilitation of three very young children with oligodontia. Report. Three preschool aged Caucasian males, diagnosed with ectodermal dysplasia, were treated with interim removable dentures in order to replace missing teeth, reclaim vertical dimension, and improve function and aesthetics. The main challenges faced were patient cooperation, dental and skeletal characteristics, and parental expectations. Two years post-treatment, both patients and parents reported excellent adaptation to prosthesis and satisfaction with aesthetics. Conclusion Rehabilitation of oligodontia may be challenging due to accompanying oral findings, dentofacial growth considerations, and behavioral issues. Establishment of good rapport between patients, parents, and clinician is the key for the success of the treatment even with the use of nonpharmacological behavioral management techniques.
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Affiliation(s)
- Kyriaki Seremidi
- Department of Pediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Antigoni Markouli
- Department of Pediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Andreas Agouropoulos
- Department of Pediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Nick Polychronakis
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Sotiria Gizani
- Department of Pediatric Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece
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10
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Crossan E, O'Connell AC. Parental perception on oral health-related quality of life and dental features of ectodermal dysplasia and isolated hypodontia in children. BMC Oral Health 2021; 21:510. [PMID: 34627220 PMCID: PMC8502392 DOI: 10.1186/s12903-021-01878-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/21/2021] [Indexed: 11/11/2022] Open
Abstract
Background Children missing 6 or more permanent teeth often present with complex dental care needs and significant impacts on their oral health related quality of life (OHRQoL). The most important facet in the overall care for these children is the child’s own experience, but parents primarily make the decisions regarding their child’s dental management. Understanding the parental perspective could have a positive impact on planning and provision of care for these patient groups in the future. The study compared the parental perspectives on OHRQoL impact and dental experience for children with ectodermal dysplasia (ED), severe isolated hypodontia (IH), and matched controls following assessment of their dental features.
Design A cross-sectional study of 172 children (mean age: 12.4 years old) was conducted; 86 with severe hypodontia (≥ 6 missing teeth; ED: 29; IH: 57) and 86 age and gender matched controls. The Parental-Caregiver Perceptions Questionnaire (P-CPQ), Family Impact Scale (FIS) and a supplemental questionnaire were used to gather information on parental perceptions of OHRQoL and dental experiences, respectively. Clinical examinations were used to assess and compare the dental features between children with ED, IH and their respective controls. Results Higher scores (p < 0.05) were found in P-CPQ and FIS scores between the children with ED, IH and their respective controls. P-CPQ scores for males with ED had a moderate correlation with functional limitations (Rs = 0.576; p = 0.001*), oral symptoms (Rs = 0.444; p = 0.016*) and overall QoL (Rs = 0.499; p = 0.006*). The ED group reported earlier awareness of issues, the youngest attendance (3.24 years) and highest perceived number of appointments (“20 or more”; 58.6%). The mean number of missing teeth in the ED group was almost twice that of the IH group (ED: 20.17; IH: 10.68) and the median number of missing teeth (Radiographically: ED = 21; IH = 9; Clinically: ED = 11; IH = 6), was significantly greater in the ED group when compared to the IH group (p < 0.001*). Conclusion Parents of children with ED and IH perceive a greater impact on QoL, for both the child and their family. Children with ED need earlier intervention and more extensive treatment than children with IH and their controls.
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Affiliation(s)
- Emily Crossan
- Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Anne C O'Connell
- Dublin Dental University Hospital, Trinity College, Dublin, Ireland.
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11
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Neuropsychological Profile of an Adolescent Female With Ectodermal Dysplasia With Hypohidrosis. Cogn Behav Neurol 2021; 34:212-219. [PMID: 34473673 DOI: 10.1097/wnn.0000000000000281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 10/20/2020] [Indexed: 11/26/2022]
Abstract
The ectodermal dysplasias are a group of rare genetic disorders that are caused by abnormalities in cell and tissue development of the embryonic ectoderm. A paucity of research has systematically examined the cognitive, academic, and psychological phenotype of individuals with ectodermal dysplasia. We describe the neuropsychological profile of a female adolescent with ectodermal dysplasia with hypohidrosis. Using a battery of standardized tests, we assessed the adolescent's intellectual functioning, language processing, visuospatial and visuomotor functioning, perceptual reasoning, sensory-motor functioning, memory, executive functioning, academic functioning, emotional and behavioral functioning, and adaptive functioning. Results from the testing indicated that the adolescent possessed relative verbal strengths, with scores generally falling in the low average to average range. However, she exhibited severe deficits in visuospatial functioning, visuomotor construction/organization, visuomotor integration, visual memory, executive functioning, reading, and math. She also presented with symptoms of anxiety and depression but had relatively strong adaptive skills. Based on the testing results from our evaluation, the adolescent met the criteria for specific learning disorders with impairment in reading and math, generalized anxiety disorder, and major depressive disorder. To our knowledge, this is the first case report to comprehensively characterize the full neuropsychological and academic profile of an adolescent female with ectodermal dysplasia with hypohidrosis. Recommendations from the evaluation are presented to inform clinical practice with, and future research of, this population.
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Niekamp N, Kleinheinz J, Reissmann DR, Bohner L, Hanisch M. Subjective Oral Health-Related Quality of Life and Objective Oral Health in People with Ectodermal Dysplasia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010143. [PMID: 33379169 PMCID: PMC7796382 DOI: 10.3390/ijerph18010143] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/15/2020] [Accepted: 12/23/2020] [Indexed: 11/30/2022]
Abstract
Ectodermal dysplasia (ED) refers to a heterogeneous group of genetic diseases of the skin, skin appendages, and teeth. People with ED experience a poorer oral health-related quality of life (OHRQoL) compared to the general population. The aim of this study was to examine the OHRQoL of people with ED and to measure their objective physical oral health to confirm or disprove evidence of poorer oral health in this population. To determine OHRQoL, the German version of the 14-item Oral Health Impact Profile (OHIP-14G) was used. All the participants in the study were clinically examined, and the measured parameters were recorded using the Physical Oral Health Index (PhOX). In total, 10 male and 11 female participants, with an average age of 22.0 ± 9.0 years, were included in this study. The OHIP-14G summary score was 23.9 (±15.2) points (range: 0–56 points). The PhOX summary score was 61.2 (±5.1) points (range: 22–80 points). The findings indicated that both the OHRQoL and physical oral health of the participants were highly impaired and that their objective and subjective oral health were worse than those of the general population in Germany.
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Affiliation(s)
- Nils Niekamp
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W 30, D-48149 Münster, Germany; (N.N.); (J.K.); (L.B.)
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W 30, D-48149 Münster, Germany; (N.N.); (J.K.); (L.B.)
| | - Daniel R. Reissmann
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20251 Hamburg, Germany;
| | - Lauren Bohner
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W 30, D-48149 Münster, Germany; (N.N.); (J.K.); (L.B.)
| | - Marcel Hanisch
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W 30, D-48149 Münster, Germany; (N.N.); (J.K.); (L.B.)
- Correspondence: ; Tel.: +49-(0)2-51-83-4-70-02; Fax: +49-(0)2-51-83-4-71-84
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Liu Y, Tang C. Interdisciplinary treatment with implant-supported prostheses for an adolescent with ectodermal dysplasia: A clinical report. J Prosthet Dent 2019; 123:655-660. [PMID: 31753462 DOI: 10.1016/j.prosdent.2019.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 10/25/2022]
Abstract
This clinical report describes interdisciplinary treatments for a 17-year-old girl with ectodermal dysplasia. The treatment was initiated with orthodontic therapy. After the remaining primary teeth had been extracted, 6 implants were placed in the maxilla with bilateral sinus floor elevations, and 6 implants were placed in the mandible. Immediate restorations were provided. Definitive restorations included screw-retained partial dental prostheses and ceramic crowns.
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Affiliation(s)
- Yajing Liu
- Postgraduate student, Graduate Prosthodontics, Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, PR China; Postgraduate student, Department of Dental Implantology, Nanjing Medical University, Nanjing, PR China
| | - Chunbo Tang
- Professor, Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, PR China; Professor, Department of Dental Implantology, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, PR China.
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Rosing K, Christensen LB, Øzhayat EB. Associations between tooth loss, prostheses and self-reported oral health, general health, socioeconomic position and satisfaction with life. J Oral Rehabil 2019; 46:1047-1054. [PMID: 31206793 DOI: 10.1111/joor.12836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 06/07/2019] [Accepted: 06/09/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate whether the location of tooth loss and prosthesis are associated with self-reported oral health, general health, socioeconomic position and satisfaction with life. METHODS From the Copenhagen Aging and Midlife Biobank (CAMB) investigation, 1517 persons had their oral status ranked (full dentition, fixed prosthesis in the masticatory zone, tooth loss in the masticatory zone, fixed prosthesis in the aesthetic zone, removable prosthesis, tooth loss in the aesthetic zone). Self-reported oral health, general health, socioeconomic position and satisfaction with life were obtained. Information on gender, normative socioeconomic position, frequency of seeing a dentist, acute dental treatment within the last 5 years and general diseases was also recorded. RESULTS Patients with tooth loss in the aesthetic zone and removable prosthesis showed high odds ratios for reporting poor rather than good oral health compared to patients having a full dentition. Having a removable prosthesis was further associated with rating socioeconomic position as low rather than high (odds ratio = 27.7 [95% CI: 5.07; 151.6]) compared to a full dentition after controlling for normative socioeconomic position and gender. In the bivariate analyses, a tendency towards poorer general health and poorer satisfaction with life was found with worse oral status, meanwhile the multiple regression analyses did not show significant associations between oral status and general health and satisfaction with life. CONCLUSIONS Missing teeth and having prostheses are associated with worse self-reported oral health compared to having a full dentition. Removable dental prosthesis may be associated with a worse self-perception of socioeconomic status.
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Affiliation(s)
- Kasper Rosing
- Section of Community Dentistry, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Lisa Bøge Christensen
- Section of Community Dentistry, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Esben Boeskov Øzhayat
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
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Arai K. Tooth agenesis patterns in Japanese orthodontic patients with nonsyndromic oligodontia. Am J Orthod Dentofacial Orthop 2019; 156:238-247. [DOI: 10.1016/j.ajodo.2018.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 12/31/2022]
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Friedlander L, Berdal A, Boizeau P, Licht BA, Manière MC, Picard A, Azzis O, Vazquez MP, Alberti C, Molla MDLD. Oral health related quality of life of children and adolescents affected by rare orofacial diseases: a questionnaire-based cohort study. Orphanet J Rare Dis 2019; 14:124. [PMID: 31164137 PMCID: PMC6549379 DOI: 10.1186/s13023-019-1109-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 05/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare diseases affecting the teeth, the oral cavity and the face are numerous, each of them present specific characteristics, and is a life-long condition. The aim of the study was to assess the association between Oral health-related quality of life (OHRQoL), and demographic characteristics, clinical and dental factors, and psycho-social characteristics to investigate that oral symptoms are not the main factors underlying a decrease in OHRQoL. MATERIAL AND METHODS We conducted a national cohort study in French centres for rare diseases (RD) specialized in orofacial diseases. The inclusion criteria were: to have received care in RD centres over the last 5 years (2012-2017) and to have been between 6 and 17 years of age on September 1, 2017. Patients were invited to answer a questionnaire composed of socio-demographic, clinical and dental questions, psychosocial questions and then fill in the Child-OIDP Index. At the end of the questionnaire, a free space was left for the patient to add a verbatim comment to provide qualitative data. Thematic analysis was used to analyze the verbatim answers. RESULTS Complete data were available for 110 patients. The sample included 44.5% boys and 55.5% girls. Ages ranged from 6 to 17 years old and 68.2% were between 6 to 12 years old and 31.8% were between 13 and 17 years old. Factor associated with a lower OHRQoL were: being a girl (p = 0.03), renouncement to dental care for financial reasons (p = 0.01), having syndromic disease (p = 0.01), having a problem with tooth shape and color (p = 0.03), feeling isolated, alone and different from other children (p = 0.003 and p = 0.02). Qualitative analysis highlighted very little recourse to psychological care and patients reported great anxiety and fear about the future. CONCLUSION OHRQoL of children suffering from these diseases is impaired, especially from the psychosocial point of view but also from that of the course of treatment and access to care. There is a need to improve the legibility of care pathways and the financial coverage of treatments.
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Affiliation(s)
- Lisa Friedlander
- Sorbonne Paris Cité, INSERM, Laboratoire ECEVE UMR1123, Université Paris Diderot, Paris, France
- Centre de Reference, Maladies Orales et Dentaires Rares, Hopital Rothschild, APHP, Paris, France
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
| | - Ariane Berdal
- Centre de Reference, Maladies Orales et Dentaires Rares, Hopital Rothschild, APHP, Paris, France
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- Sorbonne Paris Cité, INSERM, Laboratoire de Physiopathologie Orale et Moléculaire, Université Paris Diderot, UMRS, 1138 Paris, France
| | - Priscilla Boizeau
- AP-HP, Unité d’Epidémiologie Clinique, Hôpital Robert Debré, Paris, France
- Sorbonne Paris-Cité, INSERM U1123 et CIC-EC 1426, Université Paris Diderot, Paris, France
| | - Brigitte Alliot Licht
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- Centre de Competence, Maladies orales et Dentaires Rares, CHU de Nantes, Nantes, France
| | - Marie-Cécile Manière
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- Centre de Référence, Maladies orales et dentaires rares, Pôle de Médecine et Chirurgie Bucco-dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Arnaud Picard
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- Centre de Référence des Fentes et Malformations Faciales, Hôpital Necker, AP-HP, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Olivier Azzis
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- Centre de Compétence des Fentes et Malformations Faciales, CHU de Rennes, Rennes, France
| | - Marie-Paule Vazquez
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- Centre de Référence des Fentes et Malformations Faciales, Hôpital Necker, AP-HP, Paris, France
- Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Corinne Alberti
- Sorbonne Paris Cité, INSERM, Laboratoire ECEVE UMR1123, Université Paris Diderot, Paris, France
- AP-HP, Unité d’Epidémiologie Clinique, Hôpital Robert Debré, Paris, France
- Sorbonne Paris-Cité, INSERM U1123 et CIC-EC 1426, Université Paris Diderot, Paris, France
| | - Muriel De La Dure Molla
- Centre de Reference, Maladies Orales et Dentaires Rares, Hopital Rothschild, APHP, Paris, France
- Filière de Santé Maladies Rares TETECOU, Malformations Rares de la tête, du cou et des dents, Hôpital Necker, Paris, France
- INSERM UMRS1163 Bases Moléculaires et Physiopathologiques des Ostéochondrodysplasies, Institut Imagine, Necker, Paris, France
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Saltnes SS, Geirdal AØ, Saeves R, Jensen JL, Nordgarden H. Experiences of daily life and oral rehabilitation in oligodontia - a qualitative study. Acta Odontol Scand 2019; 77:197-204. [PMID: 30646789 DOI: 10.1080/00016357.2018.1535137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Quantitative research indicate increased anxiety and poorer mental health related quality of life (QoL) in individuals with oligodontia (congenital absence of six or more teeth). The aim of this qualitative study was to complement and explore the individuals' experiences of life and oral rehabilitation, hopefully improving the care for these patients. MATERIAL AND METHODS Twelve participants (6 females, 6 males, aged 21-48) with oligodontia and experiences of comprehensive dental treatments, consented to participate in a semi-structured interview. The questions in the interview guide were based on previous research and clinical experience and included both open (i.e. how is your life?) and specific questions (i.e. do health care personnel know enough about your condition?). The interview transcripts were coded and analysed using a phenomenological method of analysis. The Regional Ethics Committee approved the study. RESULTS The following themes grew out of the data; 'feeling of being different', 'the burden of treatment', 'shared decision-making', 'treatment increases self-esteem' and 'use of coping strategies'. Psychological distress and reduced QoL seemed to be related to negative aspects of the themes, which covered unacceptable aesthetics, reduced orofacial function, the long-term process of oral rehabilitation, and negative experiences with healthcare services. The informants used problem focused and emotionally focused strategies to meet these challenges. Finalizing oral rehabilitation and shared decision making were positive aspects of the themes. CONCLUSION All themes expressed by the participants were of importance for experienced QoL and psychological distress, and should be acknowledged by health care personnel when planning and performing treatment.
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Affiliation(s)
- Solfrid Sørgjerd Saltnes
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
- TAKO-centre Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Amy Østertun Geirdal
- Department of Social Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
| | | | - Janicke Liaaen Jensen
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Deo K, Sharma YK, Shah B, Kothari P, Chavan D, Sitaniya S, Gupta A. Improvement in the Quality of Life of a Patient of Ectodermal Dysplasia with Reconstructive Surgeries. J Cutan Aesthet Surg 2019; 12:244-247. [PMID: 32001971 PMCID: PMC6967165 DOI: 10.4103/jcas.jcas_17_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ectodermal dysplasias are a complex group of heterogenous, heritable disorders entailing two or more developmental abnormalities in ectodermal structures, such as hair, teeth, nails, and/or sweat glands. The most common subtype of these disorders is X-linked hypohidrotic that significantly impairs the quality of life of its sufferers. A 15-year-old boy, who sought the treatment for protuberant lips, saddle nose, dental anomalies, fine sparse hair, decreased sweating, intolerance to heat and photosensitivity, experienced dramatic improvement in his quality of life and confidence with aesthetic correction comprising autologous fat grafting, rhinoplasty, lip reduction, microblading and comprehensive prosthodontic and orthodontic treatments undertaken in collaboration with dental and plastic surgery departments and expert psychological counseling.
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Affiliation(s)
- Kirti Deo
- Department of Dermatology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Yugal K Sharma
- Department of Dermatology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Bhavika Shah
- Department of Dermatology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Preeti Kothari
- Department of Dermatology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Dhanraj Chavan
- Department of Dermatology, Krishna Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Sakshi Sitaniya
- Department of Dermatology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
| | - Aayush Gupta
- Department of Dermatology, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra, India
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Hammersen J, Wohlfart S, Goecke TW, Köninger A, Stepan H, Gallinat R, Morris S, Bücher K, Clarke A, Wünsche S, Beckmann MW, Schneider H, Faschingbauer F. Reliability of prenatal detection of X-linked hypohidrotic ectodermal dysplasia by tooth germ sonography. Prenat Diagn 2018; 39:796-805. [PMID: 30394555 DOI: 10.1002/pd.5384] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 10/11/2018] [Accepted: 10/19/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE In X-linked hypohidrotic ectodermal dysplasia (XLHED), dysfunction of ectodysplasin A1 (EDA1) due to EDA mutations results in malformation of hair, teeth, and sweat glands. Hypohidrosis, which can cause life-threatening hyperthermia, is amenable to intrauterine therapy with recombinant EDA1. This study aimed at evaluating tooth germ sonography as a noninvasive means to identify affected fetuses in pregnant carrier women. METHODS Sonography, performed at 10 study sites between gestational weeks 18 and 28, led to the diagnosis of XLHED if fewer than six tooth germs were detected in mandible or maxilla. The assessment was verified postnatally by EDA sequencing and/or clinical findings. Estimated fetal weights and postnatal weight gain of boys with XLHED were assessed using appropriate growth charts. RESULTS In 19 of 38 sonographic examinations (23 male and 13 female fetuses), XLHED was detected prenatally. The prenatal diagnosis proved to be correct in 37 cases; one affected male fetus was missed. Specificity and positive predictive value were both 100%. Tooth counts obtained by clinical examination corresponded well with findings on panoramic radiographs. We observed no weight deficits of subjects with XLHED in utero but occasionally during infancy. CONCLUSION Tooth germ sonography is highly specific and reliable in detecting XLHED prenatally.
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Affiliation(s)
- Johanna Hammersen
- Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
| | - Sigrun Wohlfart
- Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
| | - Tamme W Goecke
- Department of Gynecology and Obstetrics, RWTH Aachen, Aachen, Germany
| | - Angela Köninger
- Department of Gynecology and Obstetrics, University of Duisburg-Essen, Essen, Germany
| | - Holger Stepan
- Department of Obstetrics, University Hospital Leipzig, Leipzig, Germany
| | - Ralph Gallinat
- Frauenärztliche Gemeinschaftspraxis Günzburg-Ichenhausen, Günzburg, Germany
| | - Susan Morris
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Katharina Bücher
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Angus Clarke
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK.,Institute of Medical Genetics, School of Medicine, Cardiff University, Cardiff, UK
| | - Stephanie Wünsche
- Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
| | - Matthias W Beckmann
- Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
| | - Holm Schneider
- Center for Ectodermal Dysplasias, University Hospital Erlangen, Erlangen, Germany
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