Dental Development in Children with Growth Hormone Insensitivity Syndrome: Demirjian Analysis of Serial Panoramic Radiographs

Growth Hormone insensitivity (Laron syndrome): Report of a new family and review of Brazilian patients

Laron's syndrome (LS) is a rare genetic disorder characterized by insensitivity to growth hormone (GH). Up to the present time, over 70 mutations of GH receptor (GHR) gene have been identified leading to GH/insulin-like growth factor type 1 (IGF1) signaling pathway defect. The number of LS patients worldwide is unknown, as many are probably undiagnosed. We report two sibs from a consanguineous family from Minas Gerais, southeastern Brazil. The parents have three children. The older, a 4-years-old girl was 80.2 cm tall (-5.7 SDS height/age), and the youngest sister, aged 3 years, was 73.2 cm tall (-5.82 SDS height/age). Their clinical and biochemical features are typical of LS patients, such as high serum level of GH and low IGF1 concentrations. A homozygous c.1A>T nucleotide substitution in GHR exon 2 in the probands' samples was identified. Their parents and healthy sister are heterozygous for the same variant that abolishes the translation initiation codon of GHR. This mutation has not been reported in Brazilian patients and was previously associated with an LS phenotype in a single 29-year-old Spanish man. In addition to this case report, we summarize the main characteristics and molecular data of the 21 LS Brazilian patients who have been published to date.

Assessment of Correlation of Growth Hormone Receptor Gene with Tooth Dimensions: A CBCT and Genotyping Study

Aim:

Assessment of root morphology, size, and amount of bone around tooth is essential before starting the orthodontic treatment. The present study aimed to assess the relationship between tooth dimensions with two gene variants of growth hormone (GH), namely rs6184 and rs6180.

Materials and Methods:

This study was conducted on 218 subjects (males: 104, females: 114) requiring orthodontic treatment. All underwent cone beam computed tomography (CBCT) scan for orthodontic treatment planning with Kodak CBCT machine. In all teeth, crown height (CH), root length (RL), and crown–root ratio were evaluated. Two growth hormone receptor (GHR) variants (rs6184 and rs6180) were genotyped using the TaqMan genotyping assay.

Results:

The mean CH and RL of all teeth, that is, maxillary and mandibular central incisors, lateral incisor, canine, first premolar, second premolar, first molar, and second molar, were measured. There was no significant difference in males and females (P > 0.05). Allele frequencies of GHR variants for rs6180 and rs6184 were 48.1% and 8.92%, respectively. Multiple regression analysis showed GHR rs6184 association with maxillary central incisor CH, maxillary canine RL, mandibular canine CH, and mandibular first premolar RL (P < 0.05).

Conclusion:

There was correlation of CH of maxillary and mandibular canine and RL of maxillary canine and mandibular first premolar with GHR rs6184.

Growth hormone receptor gene is related to root length and tooth length in human teeth

OBJECTIVES

To examine the relationship between tooth length and growth hormone receptor (GHR) gene variants in a healthy Japanese population.

MATERIALS AND METHODS

The subjects consisted of 193 Japanese adults (69 men, 124 women), aged 13 to 56 years. Genomic DNA was extracted from saliva and genotyped GHR rs6184 and rs6180 variants using the Taqman genotyping. Computed tomography (CT) images were acquired using a dental cone-beam CT scanner and reconstructed using open-source OsiriX medical image processing software. The maxillary (upper; U) and mandibular (lower, L) central incisors (1), lateral incisors (2), canines (3), first premolars (4), second premolars (5), first molars (6), and second premolars (7) were evaluated. Teeth were assessed for crown height (CH), root length (RL), overall tooth length (C+R), and crown to root ratio (C/R). The relationships between GHR variants and CH, RL, C+R, and C/R were statistically examined.

RESULTS

The GHR variant rs6184 was associated with the root lengths and tooth length for the upper and lower lateral incisors and upper canines (U2 RL; U3 RL, C+R; L2 RL [ P < .05]).

CONCLUSIONS

The results indicate that the GHR rs6184 variant is associated with tooth length and ratio dimensions in a Japanese cohort. Further studies utilizing a larger sample size are needed to confirm this finding.

Phenotypes of CCAAT/enhancer-binding protein beta deficiency: hyperdontia and elongated coronoid process

OBJECTIVES

This investigation aimed to conduct a case-control study of mandibular morphology and dental anomalies to propose a relationship between mandibular/dental phenotypes and deficiency of CCAAT/enhancer-binding protein beta (CEBPB).

MATERIALS AND METHODS

Skulls of CEBPB(-/-), CEBPB(+/-) and CEBPB(+/+) mice were inspected with micro-computed tomography. Mandibular morphology was assessed with a method of Euclidean distance matrix analysis.

RESULTS

Elongation of the coronoid process was identified in CEBPB(+/-) (P ≤ 0.046) and CEBPB(-/-) 12-month-olds (P ≤ 0.028) but not in 14-day-olds (P ≥ 0.217) and 0-day-olds (P ≥ 0.189) of either genotype. Formation of supernumerary teeth in CEBPB(-/-) adult mice was demonstrated (χ(2) = 6.00, df = 1, P = 0.014).

CONCLUSIONS

CEBPB deficiency was related to elongation of the coronoid process and formation of supernumerary teeth. The mandibular and dental phenotypes of CEBPB deficiency were unseen by the 14th day after birth. Future investigations into the influence of CEBPB on mandibular and dental development are needed.

Study of delayed development of the upper first molars

The present study was undertaken to analyze the status of formation of the upper first molar in individuals suspected as having delayed eruption of the upper first molar. The subjects of this study were 51 patients presenting to orthodontic specialists with delayed eruption of the upper first molars. The 95 teeth of these 51 patients were observed. The investigation of the tooth development status included evaluation of the tooth development stage on panoramic radiographs according to the method of Moorrees et al. The upper first molars that showed delayed development were at the stage of initial cleft formation, reflecting a delay by 2.09 years in boys and 2.84 years in girls. In most cases, the delayed eruption was bilateral, and the development stage of the subject teeth did not differ between right and left sides. The plot of the developmental stage of the subject teeth (Y-axis) against the calendar age of the subjects (X-axis) showing delayed upper first molar development was fitted to the logistic curve. The tooth development was at the stage of initial cleft formation was delayed 2.5 years or more, according to these curves.