Tuberous sclerosis: a case report

Oral parafunction and bruxism in Rett syndrome and associated factors: An observational study

OBJECTIVES

To explore patterns of parafunction, and bruxism, and its relationships with genotype and snoring in individuals with Rett syndrome (RTT).

METHODS

Retrospective observational data of those with confirmed MECP2 mutations in the InterRett database (n = 216) were used to investigate experience of parafunctional habits, and bruxism and their relationships with genotype and snoring using multivariable linear regression.

RESULTS

The prevalence of parafunction was 98.2%. Bruxism was reported (66.2%) with the patterns mostly both diurnal and nocturnal (44.1%) and exclusively diurnal (42.7%). Compared to individuals with C-terminal deletion, individuals with p.Arg106Trp mutations were less likely to have bruxism reported (aOR = 0.15; 95% CI 0.02-0.98, p = 0.05) and those with p.Arg168* mutation were more likely to have frequent bruxism than none or occasional bruxism reported (aROR 3.4; 95% CI 1.1-10.7 p = 0.04). The relative odds of having nocturnal bruxism constantly, compared to none/occasionally, were higher among those 'always' snoring (aROR 6.24; 95% CI 2.1-18.2, p = 0.001) than those with no snoring.

CONCLUSIONS

There appeared to be genotypic association with bruxism in p.Arg168* and p.Arg106Trp mutations and association between nocturnal bruxism and frequent snoring in an international sample of individuals with RTT. Clinical significance of the high prevalence of bruxism should be highlighted in relation to difficulty communicating pain and increased dental treatment need in RTT.

Tuberous sclerosis: a case report

Tuberous sclerosis is an inherited neurocutaneous disorder that occurs in approximately 1 in 7,500 live births. It is characterized by benign neoplasms of the skin, heart, kidneys, lungs, central nervous system, and mucosa. Oral lesions are usually fibrous in nature and most commonly occur on the anterior gingivae. Patients may suffer with epilepsy and learning difficulties, which may complicate dental management. When a 10-year-old girl with a history of tuberous sclerosis was brought in for a routine dental check-up, a leafy growth on the anterior gingiva was detected. An excisional biopsy was carried out. Histologically, the appearance was described as nonspecific, but was consistent with a diagnosis of tuberous sclerosis. Tuberous sclerosis is a rare condition that may exhibit oral manifestations. The patients may also exhibit epilepsy and learning difficulties. Dental management of affected patients may therefore be more complicated and complex.