1
|
Yavuz Y, Akleyin E, Akdağ MZ, Çolak M, Doğan MS, Kotanlı S. Clinical and radiological findings, SEM analysis and evaluation of caries risk in ectodermal dysplasia cases. BIOTECHNOL BIOTEC EQ 2022. [DOI: 10.1080/13102818.2022.2061374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Yasemin Yavuz
- Department of Restorative Dentistry, Faculty of Dentistry, Harran University, Sanlıurfa, Turkey
| | - Ebru Akleyin
- Department of Pediatric Dentistry, Faculty of Dentistry, Dicle University, Diyarbakır, Turkey
| | - Mehmet Zülküf Akdağ
- Department of Biophysics, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Mehmet Çolak
- Department of Chemistry, Faculty of Science, Dicle University, Diyarbakır, Turkey
| | - Mehmet Sinan Doğan
- Department of Pediatric Dentistry, Faculty of Dentistry, Harran University, Sanlıurfa, Turkey
| | - Sedef Kotanlı
- Department of Maxillo Facial Radiology, Faculty of Dentistry, Harran University, Sanlıurfa, Turkey
| |
Collapse
|
2
|
Schneider SA, Gateno J, Coppelson KB, English JD, Xia JJ. Validity of Medical Insurance Guidelines for Orthognathic Surgery. J Oral Maxillofac Surg 2021; 79:672-684. [PMID: 33338420 PMCID: PMC7925386 DOI: 10.1016/j.joms.2020.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/26/2020] [Accepted: 11/12/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to assess the validity of the medical insurance guidelines for orthognathic surgery used by the major American medical insurance companies. MATERIALS AND METHODS This study assessed the validity of the medical insurance guidelines for orthognathic surgery used by Aetna, Anthem Blue Cross Blue Shield (BCBS), Cigna, Humana, and UnitedHealthcare (UHC). To evaluate the validity, we calculated the approval and denial rates of the 5 guidelines when we used them to assess the medical necessity for a control group of carefully selected patients. Patients were included in the control group if they met the criteria of a "prudent provider," crafted for this study. All rejected cases were analyzed to determine the root cause of the denials. The validity of the guidelines was also ascertained by determining their completeness and correctness. RESULTS The current study proves that no insurance guideline is in agreement with the criteria of a "prudent provider." When applied to carefully chosen patients, the requirements of BCBS, Aetna, Humana, and Cigna produce modest rejection rates of 6 to 12%. UHC is an outlier. Its guideline rejects 86% of patients, a rate about 7 times higher than its peers. Insurance guidelines disqualified patients for 3 different reasons: 1) no significant jaw deformity, 2) no demonstrable health impairment, and 3) the etiology of the condition is not a covered benefit. Additional evaluations demonstrate that the private insurance guidelines are incomplete, and at times, incorrect. CONCLUSIONS This study shows that the medical insurance guidelines for orthognathic surgery used by the major American medical insurance plans need revision. The most consequential flaw was considering etiology in judging medical necessity. Fortunately, only one company adopted this policy. Moreover, all guidelines have omissions and errors in the way jaw deformity is determined and how health impairment is determined.
Collapse
Affiliation(s)
- Sydney A Schneider
- Resident and Graduate Student, Department of Orthodontics, University of Texas Houston Health Science Center School of Dentistry, Houston, TX
| | - Jaime Gateno
- Chairman, Oral and Maxillofacial Surgery Department, Houston Methodist Hospital, Professor of Oral and Maxillofacial Surgery, Houston Methodist Academic Institute, Houston, TX; and Professor of Clinical Surgery (Oral and Maxillofacial Surgery), Weill-Cornell Medical College, New York, NY
| | - Kevin B Coppelson
- Former Advanced Oral and Maxillofacial Surgery Fellow, Houston Methodist Hospital, Houston, TX
| | - Jeryl D English
- Professor and Chairman, Department of Orthodontics, University of Texas Houston Health Science Center School of Dentistry, Houston, TX
| | - James J Xia
- Director of Surgical Planning Laboratory, Oral and Maxillofacial Surgery Department, Houston Methodist Hospital, Houston, TX; Professor of Oral and Maxillofacial Surgery, Houston Methodist Academic Institute, Houston, TX; and Professor of Surgery (Oral and Maxillofacial Surgery), Weill-Cornell Medical College, New York, NY.
| |
Collapse
|
3
|
Staged autogenous calvarial bone grafting and dental implants placement in the management of oligodontia: a retrospective study of 20 patients over a 12-year period. Int J Oral Maxillofac Surg 2021; 50:1511-1520. [PMID: 33648816 DOI: 10.1016/j.ijom.2021.01.014] [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: 04/17/2020] [Revised: 11/30/2020] [Accepted: 01/21/2021] [Indexed: 11/22/2022]
Abstract
Oligodontia demands multidisciplinary management due to its repercussions on dentofacial growth. To place implants to realize implant-borne fixed denture, preimplant surgery may be necessary if bone volumes are insufficient. Our aim was to assess bone increase following autogenic bone grafting and to discuss prosthetic options. Twenty patients followed for oligodontia, who underwent bone grafting, were treated from 2008 to 2019. Transversal and vertical bone levels were measured pre- and postoperatively to assess alveolar ridge augmentation. Mean horizontal grafting increase was 4.60 mm [standard deviation (SD) 0.79 mm], mean sinus lift increase was 9.95 mm (SD 2.35 mm). Mean implants placed per patient was 9, mean implants placed on grafted site was 5 per patient. Overall implant survival rate was 100%. All patients benefited from prosthetic procedures when it was planned to perform implant-borne fixed dentures. Within the framework of a complete treatment plan (involving paediatric dentistry, dentofacial orthopaedics, oral and maxillofacial surgery, and prosthodontics), autologous bone grafting combined or not with orthognathic surgery is fully adapted to patients with oligodontia. It allows reconstruction of favourable bone volumes for placement of implants to realize implant-borne fixed dentures, with high implant survival rates and great improvements to quality of life.
Collapse
|
4
|
Sonnesen L, Jasemi A, Gjørup H, Daugaard-Jensen J. Upper cervical spine and craniofacial morphology in hypohidrotic ectodermal dysplasia. Eur Arch Paediatr Dent 2018; 19:331-336. [DOI: 10.1007/s40368-018-0362-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/17/2018] [Indexed: 11/28/2022]
|
5
|
Clinical outcomes of implant therapy in ectodermal dysplasia patients: a systematic review. Int J Oral Maxillofac Surg 2016; 45:1035-43. [DOI: 10.1016/j.ijom.2016.03.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 03/09/2016] [Accepted: 03/16/2016] [Indexed: 11/22/2022]
|
6
|
Ectrodactyly-ectodermal dysplasia clefting syndrome (EEC syndrome). J Oral Biol Craniofac Res 2015; 4:135-9. [PMID: 25737931 DOI: 10.1016/j.jobcr.2014.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/05/2014] [Indexed: 11/20/2022] Open
Abstract
Ectrodactyly-ectodermal dysplasia- clefting syndrome (also k/a. split hand- split foot malformation <SHFM>/split hand-split foot ectodermal dysplasia- cleft syndrome/ectodermal dysplasia cleft lip/cleft palate syndrome) a rare form of ectodermal dysplasia, is an autosomal dominant disorder inherited as a genetic trait and characterized by a triad of (i) ectrodactyly, (ii) ectodermal dysplasia and, (iii) & facial clefts.
Collapse
|
7
|
Frank J, Poblete-Gutiérrez P, Giehl K. [Genetic hair diseases. An update]. Hautarzt 2013; 64:830-42. [PMID: 24177665 DOI: 10.1007/s00105-013-2578-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Patients suffering from hair loss or undesirable excessive hair growth are a challenge for dermatologists because the pathogenesis of most hair diseases is not well understood and therapeutic options are limited. This particularly holds true for genetic hair disorders, in which all current treatment attempts are unsuccessful. Furthermore, these diseases also pose a diagnostic challenge due to a broad range of clinical and genetic heterogeneity. However, the enormous progress in molecular biology over the past 20 years, in particular the availability of different new techniques such as whole exome and genome sequencing, has enabled us to elucidate the genetic basis of most monogenic hair disorders, given the availability of suitable index patients and families as well as adequate technical equipment and sufficient financial resources. In this review we provide an update on clinical and genetic aspects of selected monogenic and polygenic hair diseases manifesting with hypertrichosis and hypotrichosis.
Collapse
Affiliation(s)
- J Frank
- Hautklinik und Sektion für Genodermatosen, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland,
| | | | | |
Collapse
|
8
|
Maspero C, Giannini L, Sesso G, Terzi L. Aspetti terapeutici della displasia ectodermica. DENTAL CADMOS 2013. [DOI: 10.1016/s0011-8524(13)70028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
WITHDRAWN: Aspetti terapeutici della displasia ectodermica. DENTAL CADMOS 2012. [DOI: 10.1016/j.cadmos.2012.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
10
|
de Aquino SN, Paranaíba LMR, Swerts MSO, Martelli DRB, de Barros LM, Júnior HM. Orofacial features of hypohidrotic ectodermal dysplasia. Head Neck Pathol 2012; 6:460-6. [PMID: 22421994 PMCID: PMC3500897 DOI: 10.1007/s12105-012-0349-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 02/28/2012] [Indexed: 10/28/2022]
Abstract
Hypohidrotic ectodermal dysplasia (HED) is a type of genodermatosis characterized by the abnormal development of sweat glands, teeth, and hair. The most prevalent form of HED is X-linked hypohidrotic ectodermal dysplasia (XLHED), which is associated with mutations in the EDA gene. The aim of this case report was to describe a family with XLHED with emphasis on differences in orofacial features between members. Family members were systematically evaluated to characterize the pattern of inheritance and clinical features. Dental examination included evaluation of agenesis and abnormal teeth structure. The pedigree of the last seven generations of the family was constructed. Clinical examination and medical history revealed five males affected by HED and nine female as heterozygous carriers. The males exhibited the classic phenotype of XLHED, with dental abnormalities, hypohydrosis, and craniofacial dysmorphologies. The heterozygous carriers of the X-linked gene defect principally exhibited dental agenesis of the lateral maxillary incisors. Careful clinical examination, including dental evaluation, is an important way to detect heterozygous carriers of X-linked HED. Heterozygous parents of patients with HED may also show some features of the disorder. The identification of female carriers results in genetic counseling being offered to affected families, as well as providing adequate treatment as necessary and long-term follow-up of these patients.
Collapse
Affiliation(s)
- Sibele Nascimento de Aquino
- Department of Oral Diagnosis, School of Dentistry, State University of Campinas, Av. Limeira 901, Piracicaba, São Paulo 13414-018 Brazil
| | | | - Mário Sérgio Oliveira Swerts
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of Alfenas, Alfenas, Minas Gerais Brazil
| | | | - Letízia Monteiro de Barros
- Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of Alfenas, Alfenas, Minas Gerais Brazil
| | - Hercílio Martelli Júnior
- Stomatology Clinic, Dental School, State University of Montes Claros, Montes Claros, Minas Gerais Brazil ,Center for Rehabilitation of Craniofacial Anomalies, Dental School, University of Alfenas, Alfenas, Minas Gerais Brazil
| |
Collapse
|
11
|
The Contribution of Orthodontics to the Prosthodontic Treatment of Ectodermal Dysplasia. J Am Dent Assoc 2010; 141:1340-5. [DOI: 10.14219/jada.archive.2010.0078] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
12
|
Grecchi F, Mancini G, Parafioriti A, Mineo G, Zollino I, Pricolo A, Carinci F. Ectodermal dysplasia treated with one-step surgical rehabilitation: a case report. ACTA ACUST UNITED AC 2010; 31:9-14. [PMID: 23739251 DOI: 10.1016/s0377-5291(12)70003-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Ectodermal dysplasia (ED) comprises a large heterogeneous group of inherited disorders that are characterized by primary defects in the skin, hair, nails, eccrine glands and teeth. The most characteristic findings are the reduced number of teeth. All rehabilitative programmes involve proper evaluation of skeletal relationships. Prosthetic-implantological treatment at the end of bony growth can be used. In this article a case of ED treated with Le Fort I for maxillary advancement, femur homografts, implants' insertion and immediate loading is described. In December 2007, a 38-year-old female was referred to the Maxillofacial Department of Galeazzi Hospital (Milan, Italy) who had a diagnosis of ED. Twelve implants were inserted in one-step surgical procedure. No implant was lost and all are stable. The occlusion is stable after 15 months of follow-up. The results indicate that the one-step oral rehabilitation can be performed in adults who are affected by ED. Also, this significantly reduces the time of oral and facial rehabilitation.
Collapse
|
13
|
Lauwers L, Wojcik T, Delbarre A, Movaghar R, Ferri J. L’oligodontie : stratégie thérapeutique à partir de 30 cas. ACTA ACUST UNITED AC 2009; 110:263-8. [DOI: 10.1016/j.stomax.2008.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Accepted: 10/24/2008] [Indexed: 10/20/2022]
|
14
|
[Anhidrotic ectodermal dysplasia. Rehabilitation]. ACTA ACUST UNITED AC 2009; 110:50-4. [PMID: 19155030 DOI: 10.1016/j.stomax.2008.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 09/28/2008] [Accepted: 10/11/2008] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Anhidrotic ectodermal dysplasia (EAD) is an inherited syndrome with an incidence of one per 100,000 live births and is characterized by hypotrichosis, anhidrosis or hypohidrosis, and oligodontia. Various treatment options for the dental rehabilitation of children presenting with this disease have been published. There is however no consensus on what age implants should be placed. Our purpose was to describe the disease and rehabilitation with early implants through two case reports. OBSERVATION Our two patients, a brother and sister, aged 14 and 15 years respectively, presented with EAD, maxillary hypodontia, and mandibular anodontia. They benefited from an orthodontic surgical treatment followed by prosthetic treatment. We designed a removable prosthesis on mandibular implants for the boy when he was 14, which was later replaced by a fixed prosthesis on implants. We shifted the lateral maxillary incisors orthodontically to a canine position, then performed autologous bone grafting for the placement of six implants. The same bone graft technique was used for the sister to insert four maxillary implants. The follow-up after implant placement was 7 and 4years, respectively. On the latest follow-up, the results were stable, functional, and esthetic. DISCUSSION Dental implants are a reliable oral rehabilitation treatment for children presenting with ectodermal dysplasia.
Collapse
|
15
|
Clauss F, Manière MC, Obry F, Waltmann E, Hadj-Rabia S, Bodemer C, Alembik Y, Lesot H, Schmittbuhl M. Dento-craniofacial phenotypes and underlying molecular mechanisms in hypohidrotic ectodermal dysplasia (HED): a review. J Dent Res 2009; 87:1089-99. [PMID: 19029074 DOI: 10.1177/154405910808701205] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The hypohidrotic ectodermal dysplasias (HED) belong to a large and heterogeneous nosological group of polymalfomative syndromes characterized by dystrophy or agenesis of ectodermal derivatives. Molecular etiologies of HED consist of mutations of the genes involved in the Ectodysplasin (EDA)-NF-kappaB pathway. Besides the classic ectodermal signs, craniofacial and bone manifestations are associated with the phenotypic spectrum of HED. The dental phenotype of HED consists of various degrees of oligodontia with other dental abnormalities, and these are important in the early diagnosis and identification of persons with HED. Phenotypic dental markers of heterozygous females for EDA gene mutation-moderate oligodontia, conical incisors, and delayed dental eruption-are important for individuals giving reliable genetic counseling. Some dental ageneses observed in HED are also encountered in non-syndromic oligodontia. These clinical similarities may reflect possible interactions between homeobox genes implicated in early steps of odontogenesis and the Ectodysplasin (EDA)-NF-kappaB pathway. Craniofacial dysmorphologies and bone structural anomalies are also associated with the phenotypic spectrum of persons with HED patients. The corresponding molecular mechanisms involve altered interactions between the EDA-NF-kappaB pathway and signaling molecules essential in skeletogenic neural crest cell differentiation, migration, and osteoclastic differentiation. Regarding oral treatment of persons with HED, implant-supported prostheses are used with a relatively high implant survival rate. Recently, groundbreaking experimental approaches with recombinant EDA or transgenesis of EDA-A1 were developed from the perspective of systemic treatment and appear very promising. All these clinical observations and molecular data allow for the specification of the craniofacial phenotypic spectrum in HED and provide a better understanding of the mechanisms involved in the pathogenesis of this syndrome.
Collapse
Affiliation(s)
- F Clauss
- Department of Pediatric Dentistry, Louis Pasteur University, National French Reference Center for Dental Manifestations of Rare Diseases, University Hospital, place de l'Hôpital, F-67000 Strasbourg, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Dellavia C, Sforza C, Malerba A, Strohmenger L, Ferrario VF. Palatal Size and Shape in 6-Year Olds Affected by Hypohidrotic Ectodermal Dysplasia. Angle Orthod 2006; 76:978-83. [PMID: 17090173 DOI: 10.2319/111105-395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Accepted: 12/01/2005] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To analyze the size and shape of the hard tissue palate of Italian subjects with hypohidrotic ectodermal dysplasia (HED).
Materials and Methods: The morphology and the dimensions of the hard tissue palate were analyzed in eight 6-year-old boys affected by HED. Four of the boys were completely edentulous and four partially dentate. Palatal landmarks were identified on stone casts and digitized with three-dimensional computerized electromagnetic instrumentation. Palatal length, slope, width, and maximum palatal height in both the sagittal and frontal planes were measured. From the coordinates of palatal landmarks, a mathematical equation of palatal shape was constructed, independent of size. HED palatal data were compared with reference data obtained from 12 healthy boys with a complete deciduous dentition.
Results: Palatal length and height in both the sagittal and frontal planes were significantly reduced in HED as compared with control individuals. A less steep (not significant) palatal slope was found in HED than in reference subjects, whereas similar palatal width values were observed. All palatal measurements were larger in partially dentate than in edentulous patients. Both HED and edentulousness influenced palatal shape. The HED boys had a relatively lower palate than the reference boys. In the edentulous HED boys, the hard tissue palate was relatively lower than in partially dentate HED subjects.
Conclusions: Palatal size and shape were significantly modified by the presence of hypohidrotic ectodermal dysplasia, and the major alterations were found in edentulous HED subjects.
Collapse
Affiliation(s)
- Claudia Dellavia
- Dipartmento de Morfologia Umana, Universitá degli Studi di Milano, Milano, Italy.
| | | | | | | | | |
Collapse
|
17
|
Yavuz I, Baskan Z, Ulku R, Dulgergil TC, Dari O, Ece A, Yavuz Y, Dari KO. Ectodermal Dysplasia: Retrospective Study of Fifteen Cases. Arch Med Res 2006; 37:403-9. [PMID: 16513494 DOI: 10.1016/j.arcmed.2005.06.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2005] [Accepted: 06/29/2005] [Indexed: 11/30/2022]
Abstract
The aim of this article is to review possible cranio-maxillofacial deformative consequences associated with hypohidrotic ectodermal dysplasia and embryonic malformations, which include dental ageneses, and describe the oral habilitation. Hypohidrotic ectodermal dysplasia patients had a clinical examination and underwent radiographic and Steiner's analyses and a respiratory capability test before assessment and treatment. Fifteen patients (eight males and seven females, aged 5-45 years) had tooth ageneses (from hypodontia to anodontia) associated with cutaneous dyshydrosis and hair and nail dystrophy. Most patients had sparse or absent hair, a short face with an unusual facial concavity, a maxillary retrusion and a relative mandibular protrusion. Dentists must conduct a comprehensive and multidisciplinary approach to these patients in order to improve their dental, masticatory, growth and orthognathic conditions.
Collapse
Affiliation(s)
- Izzet Yavuz
- Department of Pediatrics, Fuculty of Dentistry, Dicle University, Diyarbakir, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Baskan Z, Yavuz I, Ulku R, Kaya S, Yavuz Y, Basaran G, Adiguzel O, Ozer T. Evaluation of Ectodermal Dysplasia. Kaohsiung J Med Sci 2006; 22:171-6. [PMID: 16679298 DOI: 10.1016/s1607-551x(09)70303-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This case series report outlines possible cranio-maxillofacial deformation consequences associated with ectodermal dysplasia (ED) and embryonic malformations, including dental agenesis. Also described are the oral aspects and rehabilitation. A total of 14 ED patients (7 males and 7 females, aged 5-45 years) underwent clinical examination before assessment and treatment. Lateral cephalometric radiography, Steiner's analysis, and respiratory capacity tests were performed. Most of the patients had sparse or absent hair, a short face with an unusual facial concavity, a maxillary retrusion, and a relative mandible protrusion. Depending on age and orthopedic abnormalities, patients were treated with prosthodontic and orthodontic approaches or implant treatment. Therapists should take a comprehensive and multidisciplinary approach with these patients to improve their dental, masticatory, growth, and orthognathic conditions, as well as esthetic appearance.
Collapse
Affiliation(s)
- Zelal Baskan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Dicle University, Diyarbakir, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Salinas TJ, Sheridan PJ, Castellon P, Block MS. Treatment planning for multiunit restorations--the use of diagnostic planning to predict implant and esthetic results in patients with congenitally missing teeth. J Oral Maxillofac Surg 2005; 63:45-58. [PMID: 16125015 DOI: 10.1016/j.joms.2005.05.155] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Indexed: 11/22/2022]
Abstract
Patients afflicted with congenitally missing teeth are a unique patient population for consideration of treatment with osseointegrated implants. Frequently, these patients have limited development of the alveolar process and differences in spatial position relative to the opposing arch, which places emphasis on ancillary treatment with orthodontics and oral surgery. A thorough diagnostic workup should include an interdisciplinary approach to ensure optimal treatment and timing of treatment in those who are developing. This article outlines considerations for treating these types of patients and scenarios of treatment paths frequently taken to restore the partially dentate and edentulous to esthetics and function.
Collapse
Affiliation(s)
- Thomas J Salinas
- Department of Otolaryngology, Section of Maxillofacial Prosthodontics and Dental Oncology, The University of Nebraska Medical Center, 981225 Nebraska Medical Center, Omaha, NE 68198, USA.
| | | | | | | |
Collapse
|
20
|
Ferrario VF, Dellavia C, Serrao G, Sforza C. Soft-tissue facial areas and volumes in individuals with ectodermal dysplasia: a three-dimensional non invasive assessment. Am J Med Genet A 2004; 126A:253-60. [PMID: 15054838 DOI: 10.1002/ajmg.a.20590] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The objective of this study was to supply quantitative information about the facial soft-tissues of a group of patients with hypohidrotic ectodermal dysplasia. The three-dimensional coordinates of 28 soft-tissue facial landmarks were obtained by an electromagnetic digitizer in 11 male and 9 female patients with hypohidrotic ectodermal dysplasia aged 7-41 years, and in 318 healthy individuals of the same age, ethnicity, and sex. From the landmarks, facial areas (eyes, ears, nose, and lips) and volumes (nose and lips) were calculated according to a geometrical model of face. Data were compared to those collected in the normal subjects by computing z-scores. Male and female z-scores were not significantly different. In the pooled sample, the deviations from the norm were particularly evident in the lips, with a significant (Student's t-test, P < 0.05) increment of the total lip area (mean z-score: 0.96) and of the vermilion area of the upper lip (mean z-score: 1.07), a finding negatively related (r = -0.632) to the number of teeth present in the mouth. The eye area was reduced in most patients, a finding significant on the left side (mean z-score: -0.76). Most of the facial areas and volumes of the ectodermal dysplasia patients had z-scores deviating only +/-2 standard deviations from the reference groups. Only 4% of measurements had z-scores larger than +/-3. Additionally, a large inter-individual variability was found, together with a certain age-related trend of improvement of the number of measurements within the +/-2 interval. The method allowed a simple, low cost, fast, and non invasive examination of the patients, and provided a quantitative assessment of the deviation from the norm.
Collapse
Affiliation(s)
- Virgilio F Ferrario
- Functional Anatomy Research Center, Laboratorio di Anatomia Funzionale dell'Apparato Stomatognatico, Dipartimento di Anatomia Umana, Facoltà di Medicina e Chirurgia and Facoltà di Scienze Motorie, Università degli Studi di Milano, Italy.
| | | | | | | |
Collapse
|
21
|
Stamm T, Meier N, Hohoff A, Meyer U, Heinecke A, Joos U. Are collimated low-dose digital radiographs valid for performing Delaire's architectural analysis? Int J Oral Maxillofac Surg 2003; 32:600-5. [PMID: 14636609 DOI: 10.1054/ijom.2002.0437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Computed radiography (CR) provides the dynamic exposure range to reveal objects in film areas exposed by very low X-ray exposure. Conventional cephalometric radiographs are normally beam limited to the facial skeleton. The cranial vault and cervical vertebra are collimated and only exposed by extra-focal radiation and scatter. We hypothesize that, on conventional cephalometric radiographs obtained with CR, image data of collimated film areas can be enhanced for reliable performance of Delaire's cephalometric analysis of the entire skull. Therefore the aim of the present study was to compare the reproducibility of landmark placement on normal and underexposed film areas of CR images. Intra- and inter-observer reproducibility of landmark identification was evaluated on 200 randomly selected radiographs by calculating the error radius of repeated landmark placements. A paired-samples t-test revealed differences (P< 0.001) between intra- and inter-observer reproducibility. Intra-observer accuracy was influenced (P< 0.001) by variability of suture obliteration (bregma). Identification of landmarks in areas of extra-focal radiation showed no difference (P> 0.05) from that of landmarks inside the normally exposed area. CR offers the opportunity to perform of a full cranial analysis on a cephalometric radiograph collimated to the facial region.
Collapse
Affiliation(s)
- T Stamm
- Department of Orthodontics, Center for Dental, Oral and Maxillofacial Diseases, University of Münster, Germany.
| | | | | | | | | | | |
Collapse
|