Compound heterozygous WNT10A missense variations exacerbated the tooth agenesis caused by hypohidrotic ectodermal dysplasia

BACKGROUND

The aim of this study was to analyse the differences in the phenotypes of missing teeth between a pair of brothers with hypohidrotic ectodermal dysplasia (HED) and to investigate the underlying mechanism by comparing the mutated gene loci between the brothers with whole-exome sequencing.

METHODS

The clinical data of the patients and their mother were collected, and genomic DNA was extracted from peripheral blood samples. By Whole-exome sequencing filtered for a minor allele frequency (MAF) ≤0.05 non-synonymous single-nucleotide variations and insertions/deletions variations in genes previously associated with tooth agenesis, and variations considered as potentially pathogenic were assessed by SIFT, Polyphen-2, CADD and ACMG. Sanger sequencing was performed to detect gene variations. The secondary and tertiary structures of the mutated proteins were predicted by PsiPred 4.0 and AlphaFold 2.

RESULTS

Both brothers were clinically diagnosed with HED, but the younger brother had more teeth than the elder brother. An EDA variation (c.878 T > G) was identified in both brothers. Additionally, compound heterozygous variations of WNT10A (c.511C > T and c.637G > A) were identified in the elder brother. Digenic variations in EDA (c.878 T > G) and WNT10A (c.511C > T and c.637G > A) in the same patient have not been reported previously. The secondary structure of the variant WNT10A protein showed changes in the number and position of α-helices and β-folds compared to the wild-type protein. The tertiary structure of the WNT10A variant and molecular simulation docking showed that the site and direction where WNT10A binds to FZD5 was changed.

CONCLUSIONS

Compound heterozygous WNT10A missense variations may exacerbate the number of missing teeth in HED caused by EDA variation.

Hypohidrotic ectodermal dysplasia: a case report

Hypohidrotic ectodermal dysplasia is a common variation of ectodermal dysplasia, characterized by hypohidrosis (or anhidrosis), hypotrichosis, hypodontia, and other distinct facial features. Furthermore, ocular tissues of ectodermal origin may also be affected in this disease. The most common ocular manifestations of hypohidrotic ectodermal dysplasia are dry eye, madarosis, alterations in the meibomian glands, abnormalities in the nasolacrimal duct, and infantile glaucoma. Herein, author reports a case of hypohidrotic ectodermal dysplasia in a 12-year-old Indian boy with dry eye and lacrimal sac mucocele.

Prosthetic rehabilitation of a child with X-linked hypohidrotic ectodermal dysplasia: a case report and 12-month follow-up

The hereditary condition known as ectodermal dysplasia (ED) is characterized by the absence of or a defect in 2 or more ectodermally derived structures such as skin, nails, hair, sweat glands, or teeth. Patients with this disorder usually present with reduced salivary gland function and absence of some or all teeth, which compromises orofacial function and development. In addition, children with ED usually experience difficulty in social interactions because of their appearance. This article reviews previously published case reports pertaining to ED and describes oral rehabilitation with removable partial dentures (RPDs) in a 5-year-old girl diagnosed with X-linked hypohidrotic ED, which presented as hypodontia. An orthodontic expander screw was inserted in the maxillary prosthesis to correct the patient's crossbite, and periodic recall examinations were scheduled to monitor the effects of the patient's growth on occlusion and fit of the prosthesis. The child was monitored for 12 months, during which she exhibited significant improvement in physiologic function, appearance, and social behavior. Because negative esthetic, functional, and psychological consequences are associated with this condition, dentists must be knowledgeable about its common oral manifestations.

Prosthetic rehabilitation in a pediatric patient with hypohidrotic ectodermal dysplasia: a case report

Hypohidrotic ectodermal dysplasia (HED) is a rare ectodermal disease with a systemic expression. Oral abnormalities are common and may include hypodontia and shape irregularities in the primary and permanent dentitions. Rehabilitation of the dental arches in pediatric patients with HED is a challenge because HED is a multifactorial disease that demands a complicated treatment approach and most dentists have limited experience or training in the necessary treatment. In addition, pediatric patients often lack the patience or ability to cooperate with complex prosthetic treatment. This case report describes a simplified technique used to fabricate complete dentures for a 4-year-old HED patient in 4 sessions.

Dental Findings and Functional Prosthesis use in Child with Hypohidrotic Ectodermal Dysplasia: A Case Report

Fabrication of maxillary and mandibular esthetic functional prostheses in a 5-year-old female patient with ectodermal dysplasia is reported. This report presents, clinically and radiographically, the orofacial manifestations of a child diagnosed with hypohidrotic ectodermal dysplasia, along with the construction of removable prosthetic devices.

Classification of Systemic and Localized Sweating Disorders

Hyperhidrosis can be subdivided into generalized hyperhidrosis, with increased sweating over the entire body, and focal hyperhidrosis, in which the excessive sweating is restricted to specific parts of the body. Generalized hyperhidrosis may be either primary (idiopathic) or secondary. Secondary generalized hyperhidrosis may be caused by infections such as tuberculosis, hyperthyroidism, endocrine and metabolic disturbances such as pheochromocytoma, neurological disorders, or drugs. Focal hyperhidrosis may also be primary (idiopathic) or secondary. Frey's syndrome is one form of secondary focal hyperhidrosis that occurs during eating together with reddening of the area in front of the ear following parotid gland surgery or injury. Primary focal hyperhidrosis is particularly common on the palms and soles of the feet, in the axilla, and on the head. Anhidrosis may be either congenital/genetic or acquired. Some of the most typical forms of congenital/genetic anhidrosis include hypohidrotic ectodermal dysplasia, congenital insensitivity to pain and anhidrosis, and Fabry disease. Acquired anhidrosis is classified as secondary anhidrosis, which may be due to an underlying disorder such as a neurological disorder, an endocrine or metabolic disturbance, or the effect of drugs, or idiopathic anhidrosis for which the pathology, cause, and mechanism are unknown. Idiopathic anhidrosis is classified into acquired idiopathic generalized anhidrosis (AIGA), idiopathic segmental anhidrosis, and Ross syndrome. AIGA is divided into three categories according to differences in the site of disturbance: (1) sudomotor neuropathy, (2) idiopathic pure sudomotor failure, and (3) sweat gland failure.

Implants in children with hypohidrotic ectodermal dysplasia: an alternative approach to esthetic management: case report and review of the literature

Ectodermal dysplasia (ED) is a rare congenital disease that affects several ectodermal structures. Children with ED may have various manifestations of the disease that differ in severity. In addition to its other symptoms, ED causes anadontia and hypodontia of the primary or permanent teeth, impacted teeth, malformed and widely spaced peg-shaped teeth, and underdeveloped alveolar ridges. Since the oral rehabilitation of these cases is often difficult, particularly in pediatric patients, treatment should be provided by a multidisciplinary team. Dental implants are the treatment of choice when growth has stabilized, and implants can be used to support, retain, and stabilize the prosthesis. The purpose of this paper was to present a case report of implant placement in a 7-year-old girl with hypohidrotic ectodermal dysplasia and review the current literature to discuss the use of dental implants in such patients.

Speech prosthesis in child patient with ectodermal dysplasia. Case report

Fabrication of several esthetic speech prostheses in a 4-year-old child patient with ectodermal dysplasia is reported. This report details, clinically and radiographically, effects in a child diagnosed with hypohidrotic ectodermal dysplasia, as well as speech device construction.

A new mutation in EDA gene in X-linked hypohidrotic ectodermal dysplasia associated with keratoconus

Hypohidrotic ectodermal dysplasia (HED) was first described in 1848 by Thurnam. HED belongs to ectodermal dysplasias (EDs), which are developmental impairments of ectodermal-derived tissues. X-linked hypohidrotic ectodermal dysplasia (XLHED) is the most common form of the EDs and consists in abnormal development of teeth, hair, and eccrine sweat glands. XLHED is determined by mutations in the ED1 gene, which is responsible for the coding of ectodysplasin-A(EDA-A), a protein that regulates ectodermal appendage formation. In the present study we found both in our proband and in the mother the same missense mutation in exon 9 (c.957 C>A), which resulted in an aminoacid change at position 319 (Ser319Arg). This latter anomaly might alter the charges in the TNF domain of EDA-A, affecting the stability of the protein and therefore the interaction with its receptor. The male propositus presented classical manifestations of HED except for keratoconus (KC) and, to the best of our knowledge, this association has not been previously described. The identification of this new mutation may contribute to evaluating the genotype/phenotype correlations. Finally, this report can give useful information about the genetic basis of KC and HED. Future studies will allow us to understand if a genetic bond exists between them.

Total anodontia in patient with hypohidrotic ectodermal dysplasia. Report of rare case of Christ-Siemens Touraine syndrome

Ectodermal dysplasias are a complex group of genetically determined disorders clinically characterized by congenital alterations of the structures derived from the ectoderm. Even though ectodermal dysplasia with partial anodontia is common, this condition with total anodontia is not. We describe features of hypohidrotic ectodermal dysplasia with complete anodontia in a 6-year-old boy. In order to improve esthetics, speech and mastication, the child was provided with upper and lower complete dentures.

Consequences of X-linked hypohidrotic ectodermal dysplasia for the human jaw bone

Mutations of the Eda gene, which encodes for ectodysplasin-A1, result in X-linked hypohydrotic ectodermal dysplasia (XLHED). This pathology may lead to severe oligodontia, subsequently requiring implant therapy. Since Eda is suspected to participate in bone development, the jaw bone status was investigated in XLHED patients in order to adjust the surgical protocol. Using computed tomography, densitometric profiles and 3D reconstructions, the bone structure was analyzed and compared to that of control individuals; our results showed that the morphological changes comprised mandibular bone flattening. Craniofacial CT scans showed medullary bone hyperdensity, including in the mandibular symphysis area, where implants must be placed. These alterations in bone structure were also observed in locations where the presence/absence of teeth cannot interfere. If the changes in jaw bone morphology can be a consequence of oligodontia, the changes in bone structure seem to be tooth-independent and suggest a direct effect of the mutation on bone formation and/or remodeling.

A simple prosthetic restorative solution of a single peg-shaped upper central primary incisor in a case of ectodermal dysplasia

INTRODUCTION

This clinical report describes the oral rehabilitation of a 7-year-old male diagnosed with hypohidrotic ectodermal dysplasia and anodontia.

BACKGROUND

Ectodermal dysplasia (ED) comprises a large, heterogeneous group of inherited disorders, which are defined by primary defects in the development of two or more tissues derived from the embryonic ectoderm (skin, hair follicles, nails, teeth, sebaceous and sweat glands). Our patient exhibited the typical general and cranio-facial features of ED as well as emotional and behavioral problems. The patient presents only one conical primary central incisor.

CLINICAL MANAGEMENT

The treatment was focused to improve his esthetic needs and oral functions and included the fabrication of removable prostheses and of an acrylic crown on the single tooth existing in his mouth, manufactured by an original simple method. Six months follow-up points out that restorative treatment provided psychosocial and functional comfort to the young boy.

CONCLUSIONS

This clinical report demonstrates the importance of the prosthodontic treatment for oral rehabilitation in children with ED. The partial and complete removable dentures associated with the acrylic crown can be a reversible and inexpensive method of treatment for ED patients.

X-linked hypohidrotic ectodermal dysplasia: a ten-year case report and clinical considerations

BACKGROUND

Ectodermal Dysplasias (EDs) are a large group of syndromes that are heterogeneous under clinical and genetic aspects, and are characterised by anomalies in the structures of ectodermal origin. In EDs dental anomalies in shape and number (oligo-hypodontia) occur frequently and severely and can affect both the primary and permanent dentition.

CASE REPORT

The oral habilitation of a child affected by X-linked Hypohidrotic-Ectodermal Dyspasia with oligodontia over a period of ten years is described. This report includes discussion of the aetiology of EDs as well as discussion of the long-term prognosis for the patient.

CONCLUSION

The success of treatment in the case reported is based on an early diagnosis and a correct timing of interventions addressing the preservation of the existing dental elements, early functional rehabilitation and aesthetic correction.

Treatment considerations for a patient with hypohidrotic ectodermal dysplasia: a case report

AIM

This clinical report describes the oral rehabilitation of a 6-year-old male ectodermal dysplasia (ED) patient diagnosed with hypodontia.

BACKGROUND

ED is a hereditary disease characterized by a congenital dysplasia of one or more ectodermal structures and their accessory appendages. Common manifestations include defective hair follicles and eyebrows, frontal bossing with prominent supraorbital ridges, nasal bridge depression, and protuberant lips. Intraorally, most common findings are anadontia or hypodontia, conical teeth, and generalize spaces. The patient may suffer from dry skin, hyperthermia, and unexplained high fever as a result of deficiency of sweat glands.

REPORT

A six-year-old boy who exhibited many of the manifestations of ED as well as behavioral problems and a severe gag reflex. The treatment was designed to improve his appearance and oral functions and included the fabrication of several removable prostheses and acid-etched composite resin restorations during his growth and development.

SUMMARY

Young patients with ED need to be evaluated early by a dental professional to determine the oral ramifications of the condition. When indicated, appropriate care needs to be rendered throughout the child's growth cycle to maintain oral functions as well as to address the esthetic needs of the patient. This clinical report demonstrates that removable partial dentures associated with direct composite restorations can be a reversible and inexpensive method of treatment for young ED patients.

Hypohidrotic ectodermal dysplasia with true anodontia of the primary dentition

Ectodermal dysplasia is a rare congenital hereditary entity. The most commonly observed forms of ectodermal dysplasia are the hidrotic and hypohidrotic types; discrimination is based on the absence or presence of sweat glands. In this report, a child with hypohidrotic ectodermal dysplasia having true anodontia of the primary dentition is presented. Physical, mental, and intraoral examinations were performed. Photographs and occlusal and panoramic radiographs were taken. A medical consultation and biopsies were requested. Mentally, the patient was normal. His hair and eyebrows were light colored and sparse. He had frontal bossing, a saddle nose, reduced vertical facial dimension, and prominent supraorbital ridges and chin. Radiographs revealed absence of all primary and permanent teeth except the bilaterally unerupted maxillary permanent canines. An armpit biopsy specimen revealed the absence of eccrine and apocrine glands. A removable prosthesis was made to satisfy the patient's esthetic and functional needs. The absence of primary teeth (true anodontia) is a rare phenomenon. It is claimed that primary teeth must be present for the development of their permanent successors. In the present case, however, the permanent canines existed despite the absence of their predecessors. Dental clinicians can be the first to diagnose ectodermal dysplasia. The dental team should be aware of its signs and symptoms in order to provide the correct therapies for the functional and psychologic needs of these patients.

Full mouth rehabilitation of a hypohidrotic ectodermal dysplasia patient with dental implants: a clinical report

Prosthodontic treatment in patients with ectodermal dysplasia (ED) is difficult to manage because of the oral deficiencies typical in this disorder and because afflicted individuals are quite young when they are evaluated for treatment. This clinical report describes an 18-year-old patient with hypohidrotic ED treated with dental implants. Treatment included a maxillary implant overdenture and a mandibular hybrid prosthesis supported by osseointegrated implants. At the one-year follow-up, the patient presented significant improvements in oral function and psychosocial activities.

Anomalies of tooth formation in hypohidrotic ectodermal dysplasia

OBJECTIVE

The X-linked hypohidrotic ectodermal dysplasia (HED) is the most common type of ectodermal dysplasia. The clinical identification of possible heterozygous females can be difficult because of the varying degrees of clinical signs caused by X-chromosome inactivation. This study is the first to elaborate on anomalies of tooth formation found in a group of hemizygous males and heterozygous females with known ED1 mutations. These tooth anomalies may be used as dental biomarkers for heterozygous females, enabling an earlier diagnosis, and therefore, better treatment and genetic counselling.

METHODS

Anomalies of tooth formation were examined using panoramic radiographs, dental casts and oral photographs in hemizygous males and heterozygous females who were identified by molecular genetic analysis. The results were compared to existing controls and normative data.

RESULTS

All affected males had multiple missing permanent teeth and tooth malformations. The heterozygous females had a significantly higher frequency of agenesis of permanent teeth compared to normative data. The heterozygous females had an increased prevalence of tooth malformations and reduced tooth size, especially in the mesiodistal dimension.

CONCLUSIONS

We conclude that observed anomalies of tooth formation may be used as dental biomarkers in the clinical identification of potentially heterozygous females.

Prosthodontic treatment of hypohidrotic ectodermal dysplasia with complete anodontia: case report

The hereditary condition known as ectodermal dysplasia is characterized by the absence or defect of 2 or more ectodermally derived structures. A case of a 6-year-old child with hypohidrotic ectodermal dysplasia with complete anodontia is presented. Common dental, oral, and physical conditions were taken into consideration. Clinical management consisted of removable complete dentures to improve psychologic development and to promote better functioning of the stomatognathic system.

Multiple agenesis and anhidrotic ectodermal dysplasia: a comparative longitudinal study of dental similarities and genetic differences in two groups of children

AIM

Dental anomalies in shape and number may be present isolated or associated with other manifestations. In anhidrotic ectodermal dysplasia they occur more frequently and severely. The authors examined a group of children with similar dental anomalies but no other ectodermal or extra-ectodermal signs.

METHODS

This study makes a comparative evaluation of similarities and differences of dental anomalies between two groups: A anhidrotic ectodermal dysplasia and B similar dental finding but without extra- dental anomalies.

RESULTS

In group A, the average number of agenesis in primary teeth was 3.5 (upper) and 5.33 (lower); in permanent teeth it was 5.4 and 5.8, respectively. In group B, the average was 1.62 (upper) and 0.25 (lower) in primary teeth, and 4.0 and 4.25 in permanent teeth respectively, with no constant pattern of occurrence. The study of tooth morphology of both groups revealed numerous anomalies in both dentitions. No differences were found in the average number of agenesis and morphological anomalies in the permanent teeth between both groups, but in the primary dentition group B presented a lower degree of incidence.

CONCLUSION

The presence of almost normal primary dentition (regarding to number), but with morphological anomalies, should lead to suspect their exacerbation in the permanent dentition.

Hypohidrotic ectodermal dysplasia: a unique approach to esthetic and prosthetic management: a case report

Hypohidrotic ectodermal dysplasia is a rare congenital disease that affects several ectodermal structures. The condition is usually transmitted as an x-linked recessive trait, in which gene is carried by the females and manifested in males. Manifestations of the disease differ in severity and involve teeth, skin, hair, nails and sweat and sebaceous gland. Ectodermal dysplasia is usually a difficult condition to manage. Prosthodontically, because of the typical oral deficiencies, and afflicted individuals are quite young to receive extensive prosthodontic treatment, which restores their appearance and helps them, for the development of positive self-image. This case report describes the management of upper jaw with over denture with copings on existing teeth i.e. two permanent peg shaped centrals as well as lateral incisors. However with adequate of retainer lower denture was provided with a new treatment modality.