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Jensen ED, Smart G, Poirier BF, Sethi S. Molar-root incisor malformation - a systematic review of case reports and case series. BMC Oral Health 2023; 23:576. [PMID: 37596569 PMCID: PMC10439578 DOI: 10.1186/s12903-023-03275-6] [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: 10/25/2022] [Accepted: 07/31/2023] [Indexed: 08/20/2023] Open
Abstract
OBJECTIVES Molar-root incisor malformation (MRIM) is a seldom reported condition characterised by disturbances in root development of first permanent molars. This systematic review aimed to collate the clinical characteristics of individuals diagnosed with MRIM. MATERIALS AND METHODS A systematic search strategy using PubMed, Embase, Web of Science, and SCOPUS databases was performed through to March 2023. Inclusion criteria were case reports or case series including a diagnosis consistent with MRIM. Critical appraisal for all included studies utilised the Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series and collation of clinical characteristics was performed in JBI System for the Unified Management, Assessment and Review of Information program. RESULTS The search identified 157 studies from which 35 satisfied the inclusion criteria. After full-text review, a total of 23 papers described the MRIM dental anomaly and were included in this paper. A total of 130 reported cases were retrieved, with age ranging 3-32 years, and males affected 1.16:1 females. Presence of neurological conditions, premature birth history, medication, and surgery within first years of life were synthesised and described. CONCLUSIONS The aetiology of MRIM is yet to be determined but epigenetic changes from significant medical history in the first years of life are likely to influence the development of this root malformation. First permanent molars were most commonly affected, but clinicians should be aware that permanent central incisors, primary teeth and other permanent teeth may also be affected.
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Affiliation(s)
- Emilija D Jensen
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Gabrielle Smart
- Department of Paediatric Dentistry, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Brianna F Poirier
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Sneha Sethi
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Stănciulescu MC, Dorobantu FR, Boia ES, Popoiu MC, Cerbu S, Heredea R, Iacob ER, Cimpean AM, Caplar BD, Popoiu AV. "Face(s)" of a PHACE(S) Syndrome Patient before and after Therapy: Particular Case Report and Review of Literature. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121970. [PMID: 36553413 PMCID: PMC9776585 DOI: 10.3390/children9121970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
A rare, uncommon disorder called PHACE(S) (P-posterior fossa anomalies, H-hemangioma, A-arterial anomalies, C-cardiac anomalies, E-eye anomalies, and S-sternal cleft) of unknown etiology was rarely reported. Children are susceptible to developing PHACE(S) syndrome from the moment they are born. It may be challenging for a physician to appropriately diagnose and treat children with PHACE due to the multifaceted nature of the disease and the extensive range of consequences that may be associated with it. A one-month-old newborn girl was admitted to hospital with extensive, multiple facial infantile hemangiomas, ulceration of the lower lip hemangioma-like lesion, cardiovascular, sternal, and neurological concomitant malformations. Five days following the initial application of the medication, systemic treatment with propranolol and topical treatment with silver sulfadiazine produced their first noticeable benefits. The lip ulceration was mostly healed and facial hemangioma started to regress. The regression continued under therapy and this effect persists for 6 months since Propranolol therapy ended. No cardiovascular or neurological clinical events have been registered during follow-up. The present case has three peculiarities: (1) high number of facial hemangiomas; (2) presence of subependymal cyst not yet reported in the literature associated with PHACE syndrome; and (3) lack of cardiovascular events during therapy knowing that these events frequently appear in PHACE syndrome patients.
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Affiliation(s)
- Maria-Corina Stănciulescu
- Department XI/Pediatric Surgery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Emergency Hospital for Children Louis Turcanu, 300041 Timisoara, Romania
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
| | - Florica Ramona Dorobantu
- Department of Neonatology, Faculty of Medicine and Pharmacy, University of Oradea, 3700 Oradea, Romania
| | - Eugen Sorin Boia
- Department XI/Pediatric Surgery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Emergency Hospital for Children Louis Turcanu, 300041 Timisoara, Romania
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
| | - Marius-Călin Popoiu
- Department XI/Pediatric Surgery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Emergency Hospital for Children Louis Turcanu, 300041 Timisoara, Romania
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
| | - Simona Cerbu
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
- Department XV of Orthopaedics, Traumatology, Urology and Medical Imaging, Discipline of Radiology and Medical Imaging, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Rodica Heredea
- Emergency Hospital for Children Louis Turcanu, 300041 Timisoara, Romania
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
- Department V/Division of Clinical Practical Skills, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Emil Radu Iacob
- Department XI/Pediatric Surgery, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Emergency Hospital for Children Louis Turcanu, 300041 Timisoara, Romania
- Correspondence: (E.R.I.); (A.M.C.); Tel.: +40-720-060-955 (A.M.C.)
| | - Anca Maria Cimpean
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
- Department of Microscopic Morphology/Histology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Angiogenesis Research Center Timisoara, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (E.R.I.); (A.M.C.); Tel.: +40-720-060-955 (A.M.C.)
| | - Borislav Dusan Caplar
- Doctoral School in Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Anca Voichita Popoiu
- Emergency Hospital for Children Louis Turcanu, 300041 Timisoara, Romania
- Center of Expertise for Rare Vascular Disease in Children, Louis Turcanu Children Hospital, 300041 Timisoara, Romania
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Cotton CH, Ahluwalia J, Balkin DM, Frieden IJ, Haggstrom AN, Castelo-Soccio LA, Liy-Wong C, Pope E, Steiner JE, Siegel DH, Fernandez-Faith E, Morel KD, Lauren CT, Garzon MC, Mancini AJ, Chamlin SL, Tollefson MM, Liang MG, Delano S, Glick SA, Hogeling M, Barrio VR. Association of Demographic Factors and Infantile Hemangioma Characteristics With Risk of PHACE Syndrome. JAMA Dermatol 2021; 157:2781293. [PMID: 34132754 PMCID: PMC8209569 DOI: 10.1001/jamadermatol.2021.1901] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/21/2021] [Indexed: 11/14/2022]
Abstract
Importance A 2010 prospective study of 108 infants estimated the incidence of PHACE (posterior fossa malformations, hemangioma, arterial anomalies, cardiac defects, eye anomalies) syndrome to be 31% in children with facial infantile hemangiomas (IHs) of at least 22 cm2. There is little evidence regarding the associations among IH characteristics, demographic characteristics, and risk of PHACE syndrome. Objectives To evaluate demographic characteristics and comorbidities in a large cohort of patients at risk for PHACE syndrome and assess the clinical features of large head and neck IH that may be associated with a greater risk of a diagnosis of PHACE syndrome. Design, Setting, and Participants This multicenter, retrospective cohort study assessed all patients with a facial, head, and/or neck IH who were evaluated for PHACE syndrome from August 1, 2009, to December 31, 2014, at 13 pediatric dermatology referral centers across North America. Data analysis was performed from June 15, 2017, to February 29, 2020. Main Outcomes and Measures The main outcome was presence or absence of PHACE syndrome. Data included age at diagnosis, sex, patterns of IH presentation (including size, segment location, and depth), diagnostic procedures and results, and type and number of associated anomalies. Results A total of 238 patients (mean [SD] age, 2.96 [4.71] months; 184 [77.3%] female) were included in the analysis; 106 (44.5%) met the criteria for definite (n = 98) or possible (n = 8) PHACE syndrome. A stepwise linear regression model found that a surface area of 25 cm2 or greater (odds ratio [OR] 2.99; 95% CI, 1.49-6.02) and involvement of 3 or more locations (OR, 17.96; 95% CI, 6.10-52.85) to be statistically significant risk factors for PHACE syndrome. Involvement of the parotid gland (OR, 0.39; 95% CI, 0.18-0.85) and segment S2 (OR, 0.38; 95% CI, 0.16-0.91) was associated with a lower risk. Race and ethnicity may also be associated with PHACE syndrome risk, although more studies are needed. Conclusions and Relevance This cohort study further described factors associated with both a higher and lower risk of PHACE syndrome. The presence of multiple anatomical sites and large surface area were associated with greater risk, whereas S2 or parotid IHs were associated with lower, but still potential, risk. These findings can help in counseling families and decision-making regarding evaluation of infants with large head and neck IHs.
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Affiliation(s)
- Colleen H. Cotton
- Division of Dermatology, University of Arizona, Tucson
- now with Departments of Dermatology and Pediatrics, Medical University of South Carolina, Charleston
| | | | - Daniel M. Balkin
- Department of Plastic & Oral Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ilona J. Frieden
- Department of Dermatology, School of Medicine, University of California, San Francisco
| | - Anita N. Haggstrom
- Department of Dermatology, Indiana University School of Medicine, Indianapolis
| | | | - Carmen Liy-Wong
- Section of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Elena Pope
- Section of Pediatric Dermatology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Jack E. Steiner
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Dawn H. Siegel
- Department of Dermatology, Medical College of Wisconsin, Milwaukee
| | - Esteban Fernandez-Faith
- Division of Dermatology, Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
| | - Kimberly D. Morel
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Christine T. Lauren
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Maria C. Garzon
- Department of Dermatology, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
- Department of Pediatrics, Columbia University Irving Medical Center and New York Presbyterian Hospital, New York
| | - Anthony J. Mancini
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Sarah L. Chamlin
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Megha M. Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Department of Pediatrics, Mayo Clinic, Rochester, Minnesota
| | - Marilyn G. Liang
- Department of Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sophia Delano
- Department of Dermatology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sharon A. Glick
- Departments of Dermatology and Pediatrics, Kings County Medical Center, Brooklyn, New York
| | - Marcia Hogeling
- Division of Dermatology, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Victoria R. Barrio
- Department of Dermatology, University of California, San Diego, Rady Children's Hospital, San Diego
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Vargo RJ, Reddy R, Da Costa WB, Mugayar LRF, Islam MN, Potluri A. Molar-incisor malformation: Eight new cases and a review of the literature. Int J Paediatr Dent 2020; 30:216-224. [PMID: 31677309 DOI: 10.1111/ipd.12592] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Molar-incisor malformation (MIM) is a recently described dental abnormality. While MIM mimics dentin dysplasia, it presents in a localized pattern. Furthermore, it is speculated that MIM is caused by significant early-life medical history. AIM The purpose of this study is to present a series of MIM cases and compare the findings with the literature. DESIGN An extensive search of all published cases of MIM in the English-language literature was conducted. Additionally, an institutional review board-approved retrospective search was performed within the University of Florida oral pathology biopsy service archives. Radiographic consultation cases were also included. Cases lacking radiographs were excluded. RESULTS Seventy-nine cases were identified in the literature, and eight cases were identified in our retrospective search. All but one case involved the permanent first molars. The average age at diagnosis was 9 years. Many patients reported significant early-life medical histories. CONCLUSIONS MIM usually affects the permanent first molars and may be linked to early-life medical conditions or interventions. Oral healthcare providers, especially paediatric dentists, should be aware of MIM to avoid misdiagnosing it as dentin dysplasia. Long-term follow-up studies with thorough medical history documentation are essential to understand the pathogenesis and aetiology and to create treatment guidelines.
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Affiliation(s)
- Richard J Vargo
- Oral and Maxillofacial Pathology Specialty Care Unit, A.T. Still University - Missouri School of Dentistry & Oral Health, St. Louis, MO, USA
| | - Rekha Reddy
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Walmir B Da Costa
- Department of Pediatric Dentistry, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Leda R F Mugayar
- Department of Pediatric Dentistry, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Mohammed N Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA
| | - Anitha Potluri
- Department of Diagnostic Sciences, University of Pittsburgh, School of Dental Medicine, Pittsburgh, PA, USA
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Two Cases of Oculofaciocardiodental (OFCD) Syndrome due to X-Linked BCOR Mutations Presenting with Infantile Hemangiomas: Phenotypic Overlap with PHACE Syndrome. Case Rep Genet 2020; 2019:9382640. [PMID: 31956451 PMCID: PMC6949664 DOI: 10.1155/2019/9382640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/07/2019] [Indexed: 01/16/2023] Open
Abstract
Background Oculofaciocardiodental (OFCD) syndrome is due to mutations in BCOR (BCL-6 corepressor). OFCD has phenotypic overlaps with PHACE syndrome (Posterior fossa anomalies, Hemangioma, Arterial anomalies, Cardiac defects, Eye anomalies). Infantile hemangiomas are a key diagnostic criterion for PHACE, but not for OFCD. A previous study reported two cases of infantile hemangiomas in OFCD, but the authors could not exclude chance association. Case Presentation We describe two novel cases of female patients (one initially diagnosed with PHACE syndrome), both of whom had infantile hemangiomas. Ophthalmological findings were consistent with oculofaciocardiodental (OFCD) syndrome. Upon genetic testing, these two females were determined to have X-linked BCOR mutations confirming OFCD syndrome diagnoses. Conclusion These case reports add support to the hypothesis that infantile hemangiomas may be a feature of OFCD. BCOR may potentially be within a pathway of genes involved in PHACE syndrome and/or in infantile hemangioma formation.
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