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Jenabzadeh T, Bohner L, Köppe J, Kleinheinz J, Hanisch M, Oelerich O. Temporomandibular disorders in individuals with Marfan syndrome: an exploratory analysis. Head Face Med 2024; 20:26. [PMID: 38659050 PMCID: PMC11040890 DOI: 10.1186/s13005-024-00427-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/05/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND This study aims to analyze to what extent patients with Marfan syndrome (MFS) are affected by temporomandibular disorders (TMD) and its impact on oral health-related quality of life (OHRQoL). To collect data, an online questionnaire was created to recruit participants from Germany, Austria, and Switzerland through social media and support groups. The questionnaire consists of free-text questions, the German versions of the Oral Health Impact Profile (OHIP-G14), the Depression Anxiety Stress Scale (DASS), and the Graded Chronic Pain Status (GCPS). RESULTS A total of 76 participants with diagnosed MFS were included. Of these, 65.8% showed TMD symptoms, the most common being pain or stiffness of the masticatory muscles in the jaw angle (50.0%). Only 14.5% of the participants were already diagnosed with TMD. Of the participants with an increased likelihood of a depression disorder, 76.9% showed TMD symptoms. Of those with a critical score for an anxiety disorder, 90.9% showed TMD symptoms. 73.3% of participants with TMD symptoms reached the critical score for a stress disorder. TMD symptoms were associated with a higher risk for chronic pain. In the median, participants with TMD showed statistically notably higher OHIP-G14 scores than participants without TMD (11.5 [IQR 17] vs. 1 [IQR 3] points, p ≤ 0.001). CONCLUSION TMD symptoms had a noticeable impact on OHRQoL in patients with MFS, i.e., chronic pain and psychological impairment. TMD seems underdiagnosed, and more research is needed to prevent the associated chronification of pain and psychological burden to improve the OHRQoL.
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Affiliation(s)
- Termeh Jenabzadeh
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Lauren Bohner
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Jeanette Köppe
- Institute of Biostatistics and Clinical Research, University of Münster, Schmeddingstraße 56, D-48149, Münster, Germany
| | - Johannes Kleinheinz
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Marcel Hanisch
- Department of Oral and Maxillofacial Surgery, University Hospital Münster, 48149, Münster, Germany
| | - Ole Oelerich
- Department of Prosthodontics, University Hospital Münster, D-48149, Münster, Germany.
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Umezawa K, Kajiwara T, Ishii K, Hasegawa T, Suzuki S, Nakano M, Sawaguchi M, Venkataiah VS, Yahata Y, Ito K, Saiki Y, Saito M. A case series describing the risk of periodontal disease in Marfan syndrome patients harboring a possible aortic aneurysm or dissection. BMC Oral Health 2022; 22:336. [PMID: 35945519 PMCID: PMC9360735 DOI: 10.1186/s12903-022-02361-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/21/2022] [Indexed: 12/05/2022] Open
Abstract
Background Marfan syndrome (MFS) is a systemic disorder of connective tissues caused by insufficient elastic fiber formation that leads to structural weakness and results in various tissue disorders, including cardiovascular and periodontal disease. Notably however, the risk of periodontal disease in MFS patients affected by an aortic aneurysm or dissection has not yet been clarified.
Methods We investigated the periodontal condition in the following three groups: MFS patients diagnosed with an aortic aneurysm or dissection with a planned aortic surgery (MFS surgery), MFS patients who had already undergone aortic surgery (MFS post-surgery) and healthy control patients (Healthy). The periodontal condition of all of these patients was evaluated at their first visit, reassessed again at two-month after the first visit, and evaluated again at a six-month follow-up after the reassessment.
Results A total of 14 participants, 3 MFS surgery patients, 4 MFS post-surgery patients and 7 healthy control volunteers were examined. Saliva examinations revealed no significant differences between any of the groups at the first visit, reassessment, or follow-up. Interestingly, the MFS surgery cases showed a higher BOP and PISA at the first visit and follow-up compared with the other groups. In contrast, the MFS surgery patients showed an improvement in their LVDd and EF values, both markers of cardiac function, at the reassessment and follow-up compared with the first visit. Conclusions MFS associated with an aortic aneurysm or dissection leads to a higher risk of periodontal disease, indicating the need for more frequent oral hygiene maintenance in these patients. In addition, MFS patients who undergo frequent professional cleaning of their teeth show a lower onset of cardiovascular disease, suggesting that professional oral hygiene in these cases contributes to a healthier condition. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02361-5.
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Affiliation(s)
- Kouta Umezawa
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Takako Kajiwara
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Kyoko Ishii
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Tatsuya Hasegawa
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Shigeto Suzuki
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Masato Nakano
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Mayu Sawaguchi
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Venkata Suresh Venkataiah
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Yoshio Yahata
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Koki Ito
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Masahiro Saito
- Division of Restorative Dentistry, Department of Ecological Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan.
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Galletti C, Toledano-serrabona J, Camps-font O, Teixido-tura G, Llobet-poal I, Subirà-pifarré C, Fiorillo L, Gay-escoda C, Vozza I. Prevalence of Periodontitis among Patients Diagnosed with Marfan Syndrome: A Cross-Sectional Study Comparing Samples of Healthy Patients. BioMed Research International 2022; 2022:1-8. [PMID: 35692596 PMCID: PMC9177325 DOI: 10.1155/2022/6238099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/28/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022]
Abstract
Periodontitis is an inflammatory condition caused by a bacterial plaque and characterized by progressive destruction of the tooth-supporting apparatus. Patients with Marfan syndrome (MFS) exhibit a connective tissue disorder, which can also affect oral soft and hard tissue. Thus, the aims of this cross-sectional study were to assess the association between periodontitis and MFS and secondly, to compare periodontal parameters and prevalence of disease with a control group (CG) without MFS. 152 patients (
) were recruited to evaluate the following periodontal parameters: probing depth, gingival margin, clinical attachment level, plaque index, and bleeding on probing. The 2017 World Workshop guideline was followed for the diagnosis of the periodontal status. A multivariate analysis was performed using a multinomial logistic regression adjusted for age, gender, and smoking. The level of significance required was
. Patients with MFS did not show a higher prevalence of periodontitis compared to the CG. However, patients with MFS did have higher values in probing depth, gingival recession, clinical attachment level, and plaque index compared to the CG patients (
). In conclusion, although similar prevalence of periodontitis was found among the studied groups, MFS patients showed worse periodontal parameters.
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Alam MK, Alfawzan AA, Shrivastava D, Srivastava KC, Alswairki HJ, Mussallam S, Abutayyem H, Ahmed N. Oral Health Status in Marfan Syndrome: A Systematic Review and Meta-Analysis of 353 Cases. Int J Environ Res Public Health 2022; 19:5048. [PMID: 35564443 PMCID: PMC9101956 DOI: 10.3390/ijerph19095048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/10/2022]
Abstract
This meta-analysis aimed to compare Marfan syndrome (MFS) patients with non-MFS populations based on orofacial health status to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, for articles published between 1 January 2000 and 17 February 2022. PRISMA guidelines were followed to carry out this systematic review. We used the PECO system to classify people with MFS based on whether or not they had distinctive oral health characteristics compared to the non-MFS population. The following are some examples of how PECO is used: P denotes someone who has MFS; E stands for a medical or genetic assessment of MFS; C stands for people who do not have MFS; and O stands for the orofacial characteristics of MFS. Using the Newcastle-Ottawa Quality Assessment Scale, independent reviewers assessed the articles' methodological quality and extracted data. Four case-control studies were analyzed for meta-analysis. Due to the wide range of variability, we were only able to include data from at least three previous studies. There was a statistically significant difference in bleeding on probing and pocket depth between MFS and non-MFS subjects. MFS patients are more prone to periodontal tissue inflammation due to the activity of FBN1 and MMPs. Early orthodontic treatment is beneficial for the correction of a narrow upper jaw and a high palate, as well as a skeletal class II with retrognathism of the lower jaw and crowding of teeth.
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Affiliation(s)
- Mohammad Khursheed Alam
- Orthodontics, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Ahmed Ali Alfawzan
- Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass 52571, Saudi Arabia;
| | - Deepti Shrivastava
- Periodontics, Preventive Dentistry Department, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia;
| | | | - Samir Mussallam
- Orthodontist, Private Clinic in Dubai, Dubai P.O. Box 65882, United Arab Emirates;
| | - Huda Abutayyem
- Department of Clinical Sciences, Center of Medical and Bio-Allied Health Sciences Research, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates;
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi 75500, Pakistan;
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
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Demir F, Tüzüner T, Baygın Ö, Kalyoncu M. Evaluation of Dental Status and Temporomandibular Joint in Children With Generalized Joint Hypermobility. J Clin Rheumatol 2021; 27:e312-e316. [PMID: 32149927 DOI: 10.1097/rhu.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the dental status and temporomandibular diseases (TMDs)-related symptoms in children with generalized joint hypermobility (GJH) and compare them with healthy controls (HCs). METHODS This is a cross-sectional, observational study carried out between September 2016 and April 2017. A total of 124 children with GJH (n = 62) and HC (n = 62) were enrolled. The GJH was assessed with the Beighton hypermobility score. The subjects were screened for dental status and TMD-related symptoms. The assessment included the index for "decayed," "missing," and "filled teeth" (DMFT, dmft); plaque; gingival bleeding; tooth mobility; and temporomandibular joint (TMJ) evaluation. RESULTS The mean Beighton hypermobility score was 6.3 ± 1.2 in the GJH group. Visible plaque index and gingival bleeding index scores were found to be significantly higher in children with GJH then in the HC (p = 0.031, p = 0.023). No differences were found regarding the DMFT scores between the groups (p = 0.16). Temporomandibular disorder-related symptom frequencies were significantly higher in children with GJH (p < 0.001). The most common clinically determined sign of TMD was clicking with a maximum active mouth-opening. Combined TMJ symptoms and TMD were observed in approximately one third of the children with GJH. CONCLUSIONS The presence of GJH in a child may be indicative of future dental or TMJ problems, and it may cause dental problems due to increased gingival bleeding index and visible plaque index scores. Therefore, children with GJH require preventive dental and TMJ care.
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Affiliation(s)
- Ferhat Demir
- From the Department of Pediatric Rheumatology, Faculty of Medicine
| | - Tamer Tüzüner
- Department of Pediatric, Dentistry Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Özgül Baygın
- Department of Pediatric, Dentistry Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
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Yamada S, Tsushima K, Kinoshita M, Sakashita H, Kajikawa T, Fujihara C, Yuan H, Suzuki S, Morisaki T, Murakami S. Mouse Model of Loeys-Dietz Syndrome Shows Elevated Susceptibility to Periodontitis via Alterations in Transforming Growth Factor-Beta Signaling. Front Physiol 2021; 12:715687. [PMID: 34456753 PMCID: PMC8385443 DOI: 10.3389/fphys.2021.715687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/23/2021] [Indexed: 11/16/2022] Open
Abstract
Loeys–Dietz syndrome (LDS) is a syndromic connective tissue disorder caused by a heterozygous missense mutation in genes that encode transforming growth factor (TGF)-β receptor (TGFBR) 1 and 2. We encountered a patient with LDS, who had severe periodontal tissue destruction indicative of aggressive periodontitis. The patient had a missense mutation in the glycine and serine-rich domain of TGFBR1 exon 3. This G-to-T mutation at base 563 converted glycine to valine. We established an LDS model knock-in mouse that recapitulated the LDS phenotype. Homozygosity of the mutation caused embryonic lethality and heterozygous knock-in mice showed distorted and ruptured elastic fibers in the aorta at 24 weeks of age and died earlier than wildtype (WT) mice. We stimulated mouse embryonic fibroblasts (MEFs) from the knock-in mouse with TGF-β and examined their responses. The knock-in MEFs showed downregulated Serpine 1 mRNA expression and phosphorylation of Smad2 to TGF-β compared with WT MEFs. To clarify the influence of TGF-β signaling abnormalities on the pathogenesis or progression of periodontitis, we performed pathomolecular analysis of the knock-in mouse. There were no structural differences in periodontal tissues between WT and LDS model mice at 6 or 24 weeks of age. Micro-computed tomography revealed no significant difference in alveolar bone resorption between WT and knock-in mice at 6 or 24 weeks of age. However, TGF-β-related gene expression was increased significantly in periodontal tissues of the knock-in mouse compared with WT mice. Next, we assessed a mouse periodontitis model in which periodontal bone loss was induced by oral inoculation with the bacterial strain Porphyromonas gingivalis W83. After inoculation, we collected alveolar bone and carried out morphometric analysis. P. gingivalis-induced alveolar bone loss was significantly greater in LDS model mice than in WT mice. Peritoneal macrophages isolated from Tgfbr1G188V/+ mice showed upregulation of inflammatory cytokine mRNA expression induced by P. gingivalis lipopolysaccharide compared with WT macrophages. In this study, we established an LDS mouse model and demonstrated that LDS model mice had elevated susceptibility to P. gingivalis-induced periodontitis, probably through TGF-β signal dysfunction. This suggests that TGF-β signaling abnormalities accelerate the pathogenesis or progression of periodontitis.
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Affiliation(s)
- Satoru Yamada
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan.,Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Kenichiro Tsushima
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masaki Kinoshita
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Hiromi Sakashita
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Tetsuhiro Kajikawa
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Chiharu Fujihara
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Hang Yuan
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Shigeki Suzuki
- Department of Periodontology and Endodontology, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Takayuki Morisaki
- Division of Molecular Pathology, Laboratory of Genome Technology IMSUT Hospital, Department of Internal Medicine, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Bunkyo, Japan
| | - Shinya Murakami
- Department of Periodontology, Osaka University Graduate School of Dentistry, Suita, Japan
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Cervino G, Cicciù M, De Stefano R, Falcomatà D, Bianchi A, Crimi S, Laino L, Herford AS, Gaeta M, Fiorillo L. Oral health in patients with Marfan syndrome. Arch Oral Biol 2020; 116:104745. [PMID: 32446937 DOI: 10.1016/j.archoralbio.2020.104745] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/03/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The role of this study is to highlight a correlation between patients with Marfan syndrome and oral health status by evaluating and reviewing the relevant scientific literature. The syndrome is characterized by an abnormal production of the fibrillin1 protein. The manifestations of Marfan syndrome affect organs that contain connective tissue such as the skeletal system, the eyes, the heart and the blood vessels, the lungs and the fibrous membranes that cover the brain and the spine. The facial bony and soft structures can therefore be affected, influencing the stage of tooth formation and the structure of the teeth, we also want to analyze in this study, the periodontal complications and the management of the latter, with the use of surgical techniques that include the use of biomaterials. MATERIALS AND METHODS A comprehensive review of the literature was conducted according to PRISMA guidelines. After a careful analysis of the work obtained by two independent academics, there have been 18. All data from the studies were compared and many of these highlighted the presence of abnormalities in the oral district. RESULTS The studies taken into consideration a whole series of oral manifestations related to the Marfan syndrome. Oral mucosa, periodontal, dental abnormalities, bone abnormalities or joint dysfunction are frequently involved in patients affected by this disease. CONCLUSIONS All the research have given positive results in terms of dental or oral anomalies. This information may be essential to limit and intervene early improving the oral health of syndromic patients.
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Affiliation(s)
- Gabriele Cervino
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy
| | - Marco Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy
| | - Rosa De Stefano
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, ME, Italy
| | - Domenico Falcomatà
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy
| | - Salvatore Crimi
- Department of General Surgery and Medical-Surgery Specialities, University of Catania, 95100 Catania CT, Italy
| | - Luigi Laino
- Department of Biomedical and Surgical, Biomedical Sciences Naples University, Naples, NA, Italy
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA
| | - Michele Gaeta
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, ME, Italy
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, ME, Italy.
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Kutkut A, Abu-Eid R, Sharab L, Al-Sabbagh M. Full-Mouth Rehabilitation With Implant-Prosthesis in Marfan Syndrome Patient: Clinical Report and Literature Review. J ORAL IMPLANTOL 2020; 46:115-121. [DOI: 10.1563/aaid-joi-d-19-00151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this case report is to present implant-retained maxillary and mandibular complete overdentures in a patient with Marfan syndrome. The patient initially presented with generalized periodontitis (stage IV, grade C). Due to the progressive nature of periodontal disease, the patient elected to have implant-retained maxillary and mandibular complete dentures. Bilateral maxillary sinus augmentation was performed 6 months before full-mouth extraction, alveoloplasty, and immediate implant placement. Maxillary and mandibular immediate overdentures were delivered. After 4 months of healing, the final overdenture was fabricated. The patient was seen regularly throughout the healing process for peri-implant maintenance. Soft-tissue grafts were completed to increase the thickness of the mucosa around the implants. The patient has been followed for 2 years and is functioning well without major complications. For patients with Marfan syndrome, implant-retained prostheses are a viable treatment option in the presence of a failing dentition.
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Affiliation(s)
- Ahmad Kutkut
- Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, Ken
| | - Rasha Abu-Eid
- Institute of Dentistry, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Lina Sharab
- Division of Orthodontics, College of Dentistry, University of Kentucky, Lexington, Ken
| | - Mohanad Al-Sabbagh
- Division of Periodontology, College of Dentistry, University of Kentucky, Lexington, Ken
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von Kodolitsch Y, Demolder A, Girdauskas E, Kaemmerer H, Kornhuber K, Muino Mosquera L, Morris S, Neptune E, Pyeritz R, Rand-Hendriksen S, Rahman A, Riise N, Robert L, Staufenbiel I, Szöcs K, Vanem TT, Linke SJ, Vogler M, Yetman A, De Backer J. Features of Marfan syndrome not listed in the Ghent nosology – the dark side of the disease. Expert Rev Cardiovasc Ther 2020; 17:883-915. [DOI: 10.1080/14779072.2019.1704625] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Yskert von Kodolitsch
- German Aorta Center Hamburg at University Hospital Hamburg Eppendorf University Heart Centre, Clinics for Cardiology and Heart Surgery, VASCERN HTAD European Reference Centre
| | - Anthony Demolder
- Center for Medical Genetics and Department of Cardiology, Ghent University Hospital, VASCERN HTAD European Reference Centre, Ghent, Belgium
| | - Evaldas Girdauskas
- German Aorta Center Hamburg at University Hospital Hamburg Eppendorf University Heart Centre, Clinics for Cardiology and Heart Surgery, VASCERN HTAD European Reference Centre
| | - Harald Kaemmerer
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich of the Free State of Bavaria, Munich
| | - Katharina Kornhuber
- Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich of the Free State of Bavaria, Munich
| | - Laura Muino Mosquera
- Department of Pediatric Cardiology and Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Shaine Morris
- Department of Pediatrics-Cardiology, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA
| | - Enid Neptune
- Division of Pulmonary and Critical Care Medicine and Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Reed Pyeritz
- Departments of Medicine and Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Svend Rand-Hendriksen
- TRS, National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Alexander Rahman
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover
| | - Nina Riise
- TRS, National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Leema Robert
- Department of Clinical Genetics, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Ingmar Staufenbiel
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Hannover
| | - Katalin Szöcs
- German Aorta Center Hamburg at University Hospital Hamburg Eppendorf University Heart Centre, Clinics for Cardiology and Heart Surgery, VASCERN HTAD European Reference Centre
| | - Thy Thy Vanem
- TRS, National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Stephan J. Linke
- Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Ophthalmological practice at the University Clinic Hamburg-Eppendorf, zentrumsehstärke, Hamburg, Germany
| | - Marina Vogler
- German Marfan Association, Marfan Hilfe Deutschland e.V, Eutin, Germany
| | - Anji Yetman
- Vascular Medicine, Children’s Hospital and Medical Center, Omaha, USA
| | - Julie De Backer
- Center for Medical Genetics and Department of Cardiology, Ghent University Hospital, VASCERN HTAD European Reference Centre, Ghent, Belgium
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Galletti C, Camps-Font O, Teixidó-Turà G, Llobet-Poal I, Gay-Escoda C. Association between Marfan syndrome and oral health status: A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2019; 24:e473-e482. [PMID: 31232392 PMCID: PMC6667010 DOI: 10.4317/medoral.23037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/08/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The purpose was to identify and assess the existing scientific evidence from epidemiologic, non-experimental, observational studies of associations between Marfan's syndrome and oral diseases. MATERIAL AND METHODS Electronic literature searches in MEDLINE (OVID), The Cochrane Library, Scopus and the Web of Science were conducted to identify all relevant articles. Eligibility was based on inclusion criteria, and quality assessments were conducted. The outcome variables were probing depth, gingival margin, clinical attachment level, bleeding on probing, gingival status, periodontal status, tooth mobility, furcation involvement and decayed, missing and filled teeth index. After extracting data, meta-analyses were carried out. RESULTS Out of 527 potentially eligible papers, 3 cross-sectional studies were included. No statistically significant differences were found in the number of sites with bleeding on probing (OR: 1.26; 95% CI: 0.47 to 3.42; P = 0.65; I2: 0%), probing depth (MD: -0.14 mm; 95% CI: -0.24 to 0.53; P = 0.46; I2: 93%), periodontal status (WMD: 0.68 points; 95% CI: -0.48 to 1.83; P = 0.25; I2: 98%) nor number of decayed, missing and filled teeth index score (MD: 1.08 points.; 95% CI: -1.27 to 3.42; P = 0.37; I2: 0%). CONCLUSIONS Patients diagnosed with Marfan's syndrome do not seem to have worsened oral health status. Due to the high number of patients with Marfan's syndrome that have prosthetic heart valves, an adequate dental monitoring as well as a strict maintenance therapy program should be implemented.
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Affiliation(s)
- C Galletti
- Faculty of Medicine and Health Sciences, University of Barcelona, Campus de Bellvitge, Surgery and Oral Implantology, C/ Feixa Llarga, s/n; Pavelló Govern, 2da planta, 08907 L'Hospitalet de Llobregat; Barcelona, (Spain),
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11
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Johnson CM, Spruiell B, Wiesen C, Pimenta LA, Vann W, Frazier‐Bowers SA. Craniofacial characterization of Marfan Syndrome. Orthod Craniofac Res 2019; 22 Suppl 1:56-61. [DOI: 10.1111/ocr.12295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Christian M. Johnson
- Department of OrthodonticsThe University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Brittany Spruiell
- Department of OrthodonticsTexas A and M University College of Dentistry Dallas Texas
| | - Chris Wiesen
- The Odum InstituteUniversity of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Luiz A. Pimenta
- Department of Dental EcologyUNC Craniofacial CenterThe University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - William Vann
- Department of Pediatric DentistryThe University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Sylvia A. Frazier‐Bowers
- Department of OrthodonticsThe University of North Carolina at Chapel Hill Chapel Hill North Carolina
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Venza N, Danesi C, Contò D, Fabi F, Mampieri G, Sangiuolo F, Laganà G. Periodontal condition in growing subjects with Marfan Syndrome: a case-control study. PeerJ 2019; 7:e6606. [PMID: 31065451 PMCID: PMC6485202 DOI: 10.7717/peerj.6606] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/12/2019] [Indexed: 12/18/2022] Open
Abstract
Background Marfan's syndrome (MFS) is a systemic disorder of connective tissue caused by mutations in the extracellular matrix protein fibrillin-1. Orofacial characteristics may be useful in identification of the syndrome. Severe periodontitis is sometimes observed in MFS patients, but no in-depth information has been reported in Italian groups of growing subjects with MFS. The aim of this study was to analyze the periodontal condition on a group of growing subjects affected by MFS, in comparison with a typically developed control group. Methods A group of 16 subjects with diagnosed MFS were recruited from the Centre for Rare Diseases for Marfan Syndrome and Related Disorders of Tor Vergata University Hospital. The Marfan Group (MG) was compared with a Control Group (CG) composed by 20 nonsyndromic subjects. The periodontal clinical parameters like Marginal Gingival Thickness (GT), Plaque Index (PI), Bleeding On Probing (BOP) and Modified Periodontal Screening and Recording (PSR) were assessed. Results The mean value of PI in MG was 59%, instead in CG it reached 21%. Analysis showed a significant difference between MG and CG also for the BOP. In MG the mean value of BOP attained 36% and in CG it reached 16%. A statistical significant difference of distribution of PSR index between the two groups was found for all sextant examined. Discussion Patients with Marfan syndrome reveal a higher presence of plaque and consequently a generalized inflammation in the oral cavity when compared with a control group.
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Affiliation(s)
- Nicolò Venza
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Carlotta Danesi
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Diego Contò
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Francesco Fabi
- Laboratory of Medical Genetics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Gianluca Mampieri
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
| | - Federica Sangiuolo
- Laboratory of Medical Genetics, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppina Laganà
- Department of Clinical Sciences and Translational Medicine, University of Roma "Tor Vergata", Roma, Italia
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Hanisch M, Wiemann S, Jung S, Kleinheinz J, Bohner L. Oral Health-Related Quality of Life in People with Rare Hereditary Connective Tissue Disorders: Marfan Syndrome. Int J Environ Res Public Health 2018; 15:E2382. [PMID: 30373236 DOI: 10.3390/ijerph15112382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/13/2018] [Accepted: 10/23/2018] [Indexed: 12/19/2022]
Abstract
Background: The aim of this study was to analyze data on oral health-related quality of life (OHRQoL) in people with Marfan syndrome and to obtain information on the diagnosis period, orthodontic treatment, and oral symptoms. Methods: A questionnaire was developed consisting of open questions and the standardized German version of the OHIP-14 (Oral Health Impact Profile) questionnaire for the evaluation of OHRQoL. The age of diagnosis, time period from the first signs of the disease to diagnosis, and OHIP-values were compared between male and female participants. Additionally, the OHIP-values between participants who were orthodontically treated and those who were not treated were assessed. The statistical analysis was performed using the Mann–Whitney test with a significance level at p = 0.05. Results: A total of 51 questionnaires were evaluated, which included 34 female and 17 male participants. Overall, 84% of respondents reported oral symptoms. Male respondents tended to diagnose the disease earlier (p = 0.00), with a smaller period between the first symptom and the diagnosis (p = 0.04). The OHIP-14 score was gender-neutral at 13.65 ± 13.53 points. Conclusion: In Marfan syndrome, many years (12.01 ± 11.61) elapse between the onset of first symptoms and correct diagnosis of the disease. People with Marfan syndrome have a worse OHRQoL than do the general population.
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Abstract
Marfan's Syndrome is a multisistemic pathology of connective tissues, a dominant autosomal transmission, first discovered by a French pediatrician, Antoine Bernard-Jean Marfan, who first found in some of his patients a disproportionate alteration of inferior infertility. This alteration was caused by the mutation of the FBN1 gene, located on the long arm of the chromosome 15, which encodes for an extracellular matrix protein, fibrin-1. Later it was discovered that the disease could occasionally be due also to the mutation of the TGFBR2 gene, which encodes for a TGF-beta receptor 1. The estimated incidence of the disease is 2-3 subjects affected every 10,000, in the absence of predilection ratial, ethnic, geographic and gender. It is believed that some 15,000 people in Italy suffer from Marfan Syndrome. The disease is characterized by a wide range of clinical manifestations that affect different organs. The study evaluates through a literature review the manifestations in the oral cavity of the marfan syndrome and the correct management of the patient during dental maneuvers.
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Affiliation(s)
- P Bollero
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - L Arcuri
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - M Miranda
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - L Ottria
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - R Franco
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - A Barlattani
- Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
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Abstract
Marfan syndrome is an autosomal dominant disorder of connective tissue primarily characterized with anomalies affecting the musculoskeletal system, the
cardiovascular system and the eyes. It has been suggested that early diagnosis of the syndrome is important, because of the risk of infective endocarditis. A
7-year-old female was referred to our clinic, with a chief complaint of dental crowding in the anterior region of mandible. It was observed that the patient needed
multiple treatments based on detailed clinical and radiographic examinations. The treatment was carried out with antibiotic prophylaxis an hour prior to her
appointment considering her profound caries. The patient was advised to visit regularly for follow up and she was referred for orthodontic evaluation.
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Affiliation(s)
- Busra Bostanci
- Department of Pediatric Dentistry Faculty of Dentistry Abant Izzet Baysal University Turkey
| | - Emre Korkut
- Department of Pediatric Dentistry Faculty of Dentistry Konya Necmettin Erbakan University Turkey
| | - Nımet Unlu
- Department of Restorative Dentistry Faculty of Dentistry Konya Necmettin Erbakan University Turkey
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von Kodolitsch Y, Rybczynski M, Vogler M, Mir TS, Schüler H, Kutsche K, Rosenberger G, Detter C, Bernhardt AM, Larena-Avellaneda A, Kölbel T, Debus ES, Schroeder M, Linke SJ, Fuisting B, Napp B, Kammal AL, Püschel K, Bannas P, Hoffmann BA, Gessler N, Vahle-Hinz E, Kahl-Nieke B, Thomalla G, Weiler-Normann C, Ohm G, Neumann S, Benninghoven D, Blankenberg S, Pyeritz RE. The role of the multidisciplinary health care team in the management of patients with Marfan syndrome. J Multidiscip Healthc 2016; 9:587-614. [PMID: 27843325 PMCID: PMC5098778 DOI: 10.2147/jmdh.s93680] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS. First, we show how the initiative and collaboration of patient representatives, scientists, and physicians resulted in the foundation of Marfan centers, initially in the US and later in Germany, and how and why such centers evolved over time. Then, we elucidate the three main structural elements; a team of coordinators, core disciplines, and auxiliary disciplines of health care. Moreover, we explain how a multidisciplinary health care team integrates into many other health care structures of a university medical center, including external quality assurance; quality management system; clinical risk management; center for rare diseases; aorta center; health care teams for pregnancy, for neonates, and for rehabilitation; and in structures for patient centeredness. We provide accounts of medical goals and standards for each core discipline, including pediatricians, pediatric cardiologists, cardiologists, human geneticists, heart surgeons, vascular surgeons, vascular interventionists, orthopedic surgeons, ophthalmologists, and nurses; and of auxiliary disciplines including forensic pathologists, radiologists, rhythmologists, pulmonologists, sleep specialists, orthodontists, dentists, neurologists, obstetric surgeons, psychiatrist/psychologist, and rehabilitation specialists. We conclude that a multidisciplinary health care team is a means to maximize therapeutic success.
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Affiliation(s)
| | | | | | - Thomas S Mir
- Clinic for Pediatric Cardiology, University Heart Centre
| | | | | | | | | | | | | | - Tilo Kölbel
- Clinic of Vascular Medicine, University Heart Centre
| | | | - Malte Schroeder
- Department of Trauma, Hand, and Reconstructive Surgery
- Department of Orthopedics
| | - Stephan J Linke
- Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Smilow Center for Translational Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bettina Fuisting
- Clinic of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Peter Bannas
- Diagnostic and Interventional Radiology Department and Clinic
| | | | - Nele Gessler
- Clinic of Electrophysiology, University Heart Centre
| | - Eva Vahle-Hinz
- Department of Orthodontics, Center for Dental and Oral Medicine
| | | | | | | | | | - Stefan Neumann
- Business Unit Quality Management, University Medical Center Hamburg-Eppendorf
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Molina-García A, Castellanos-Cosano L, Machuca-Portillo G, Posada-de la Paz M. Impact of rare diseases in oral health. Med Oral Patol Oral Cir Bucal 2016; 21:e587-94. [PMID: 27475682 PMCID: PMC5005096 DOI: 10.4317/medoral.20972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 05/29/2016] [Indexed: 02/06/2023] Open
Abstract
Background Rare diseases (RD) are those that present a lower prevalence than 5 cases per 10.000 population. The main objective of this review was to study the effect on oral health in rare diseases, while the secondary objective of the study is theme upgrade. Material and Methods Comparative observational case-control studies were analysed and a systematic review was conducted in PubMed. Each rare disease listed on the statistical data record of the Health Portal of the Ministry of Equality, Health and Social Policies Board of Andalusia was associated with “oral health”. The variables studied included dental, oral mucosa and occlusion alterations, oral pathologies (caries, periodontal disease) and other alterations (mouth breathing, parafunctional habits, etc). A bias analysis of the variable caries was conducted. Results Six RD were selected through our inclusion and exclusion criteria (hypogammaglobulinemia, Rett syndrome, Marfan syndrome, Prader-Willi syndrome, cystic fibrosis and Cri du chat syndrome) in a total of 8 publications, of which four trials were classified as high risk of bias and one of them as medium risk. There were not trials with low risk of bias. Conclusions The main statistically significant differences found by Syndrome compared to a control group were in Hypogammaglobulinemia with a greater tendency to enamel hypoplasia and dry mouth. The Rett syndrome had, as well, a greater tendency to an anterior open bite, ogival palate, bruxism, mouth breathing and tongue thrusting. Prader-Willi syndrome had a tendency of dental erosion, and Cri du chat syndrome showed a higher association to Tannerella forsythia. Key words:Rare diseases, oral health.
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Affiliation(s)
- A Molina-García
- Department of Stomatology, School of Dentistry, University of Seville, C/ Avicena s/n 41009 Seville, Spain,
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