PMC5573473_01
Extraoral examination of the patient revealed
a dysmorphic facial appearance, with (A) macrocephaly,
prominent forehead, hypertelorism, flattened and widened
nose and macrochelia, (B) short and broad fingers, (C)
short stature, vertebral anomalies and scoliosis.
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Physical examination revealed a short stature, vertebral anomalies, scoliosis, mesomelic limb shortening, short and broad fingers, macrocephaly and a dysmorphic face (Figure 1), characterized by a prominent forehead, hypertelorism, flattened and widened nose and macrocheilia.
Intraoral photograph of the patient before dental and
periodontal treatment.
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The patient had anterior and posterior crossbites, a lack of interocclusal dental contacts and poor oral hygiene. (Figure 2).
Panoramic radiograph revealing dental caries and nine misaligned impacted teeth.
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Panoramic radiography revealed nine misaligned impacted teeth, including four mandibular and five maxillary molars and dental caries (Figure 3).
Cone-beam computed tomography images of the maxilla,
showing (A) two impacted molar teeth in the posterior region of
the right quadrant and (B) three molar teeth in the left quadrant.
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Cone-beam computed tomography images of the
mandible (A) in the right and (B)left quadrant.
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The mandible also exhibited bilateral impacted molars with occlusal contact (Figure 5).All radiographic examinations were carried out by oral and maxillofacial radiologists (IP, KG and ZA). The craniofacial and oral findings of the patient and cases reported in the literature are shown in Table 1.
Intraoral photographs of the patient during periodontal surgery.
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During periodontal treatment practice (Figure 6), the increase of the insufficient keratinized mucosa is considered an effective strategy in the prevention of advance periodontal diseases.
Intraoral photographs of the patient (A) after and (B) 9 months after dental and periodontal treatment.
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All impacted molars were asymptomatic (Figure 7).