Kohlschütter-Tönz syndrome: Case report with novel feature and detailed review of features associated with ROGDI variants

Kohlschütter-Tönz syndrome (KTS) is a rare, autosomal recessive syndrome characterized by a triad of epilepsy, amelogenesis imperfecta and severe global developmental delay. It was first described in a Swiss family in 1974 by Alfried Kohlschütter and Otmar Tönz. It is caused by pathogenic variants in the ROGDI gene. To the best of our knowledge, there are currently 43 patients with a confirmed ROGDI gene pathogenic variant reported. Here, we review in detail the clinical manifestations of KTS, provide an overview of all reported genetically confirmed patients, and document an additional case of KTS-a 6-year-old Latvian girl-with a confirmed ROGDI gene pathogenic variant. In contrast to previous reports, we detected idiopathic bilateral nephrocalcinosis in this newly identified KTS patient. Perampanel proved an effective treatment for our patient with prolonged super-refractory status epilepticus. In order to better characterize this rare syndrome and its clinical course, it is important to report any additional symptoms and also the effectiveness of used therapies. Future research should focus on elucidating the mechanisms by which the absence/insufficiency of ROGDI-encoded protein causes the clinical manifestations of KTS. This knowledge could shape possible ways of influencing the disease's natural history with more effective therapies.

Prevention of occlusal caries using a ozone, sealant and fluoride varnish in children

OBJECTIVES

To compare ozone with fissure sealants and fluoride varnish in the prevention of occlusal caries in permanent premolars of children in 12 months period.

METHODS

A clinical trial was conducted on four groups of 10 years old schoolchildren: a group 1 - control group (n=50); a group 2 (n=21) in which fluoride varnish was applied and re-applied up to 12 months; a group 3 (n=17) in which sealant was applied and reapplied up to 12 months; and a group 4 (n=19) in which ozone was applied and re-applied up to 12 months. Percent caries reduction was studied in these initially healthy molars with complete occlusal eruption: 173 (control), 103 (varnish), 78 (sealants) and 103 (ozone) premolars met inclusion criteria. All patients were examined using DMFT index and Greene - Vermillion index at a baseline and in 6 months with a follow up period of 12 months. Each tooth was considered as the unit of the analysis. Data were analyzed using t-test and the chi-square tests.

RESULTS

The prevalence of caries was: in group 1 - 3.5% (n=6), in group 2 and group 3 - 0% (n=0), in group 4 - 2.9%, (n=3). The changes in occlusal caries incidence between all groups were not statistically significant.

CONCLUSIONS

The placement of fissure sealant, application of fluoride varnish, and application of ozone - are recommended to use in prevention of occlusal pit and fissure caries in permanent premolars in children. Furthermore, they are not significantly different from one another in their effectiveness.