Camille Rojare1, Yasmin Opdenakker2, Amélie Laborde3, Romain Nicot3, Karine Mention4, Joel Ferri5. 1. University Lille 2, Roger-Salengro hospital, department of maxillofacial surgery, 59000 Lille, France. Electronic address: camillerojare@gmail.com. 2. University hospital Gand, department of maxillofacial surgery, Gand, Belgium. 3. University Lille 2, Roger-Salengro hospital, department of maxillofacial surgery, 59000 Lille, France. 4. University Lille 2, Jeanne-de-Flandres hospital, medical reference center for inherited metabolic diseases, Lille, France. 5. University Lille 2, Roger-Salengro hospital, department of maxillofacial surgery, 59000 Lille, France; Controlled Drug Delivery Systems and Biomaterials, Inserm U 1008, 59000 Lille, France.
Abstract
OBJECTIVE: Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder. It is due to a deficiency of 7-dehydrocholesterol reductase (DHCR7) that catalyses the reduction of 7-dehydrocholesterol (7-DHC) to cholesterol. The aim of this review is to gather all information, concerning diagnostic characteristics of this syndrome, with an emphasis on intraoral symptom presentation. MATERIALS AND METHODS: We conducted a review of the literature, including articles between 1964 and 2017. Data was collected regarding the clinical diagnosis, pathophysiology and treatment of SLOS patients. Moreover, two clinical cases are described, illustrating the oral and facial anomalies of SLOS patients, at the regional university hospital of Lille, France. DISCUSSION: Low cholesterol levels provoke a broad spectrum of clinical presentations, from mild to lethal forms. They can cause mental retardation, growth deficiency and congenital malformations. The SLOS features are often present at birth. Moreover, all the patients have facial anomalies. The dento-maxillofacial symptoms consist of crowded teeth, widely spaced incisors, oligodontia, polydontia, premature tooth eruption, enamel hypoplasia, a bifid uvula, broad alveolar ridges, bifid tongue, and Pierre-Robin syndrome symptoms (glossoptosis, retrognathia and cleft palate). These symptoms are warning signs and should increase the awareness of clinicians. CONCLUSIONS: All healthcare professionals can contribute to the SLOS patient diagnostics. The dento-maxillofacial anomalies, illustrated by two case reports, could help to detect undiagnosed patients. An early detection might improve the outcome of these patients, as cholesterol supplementation can improve symptoms. This study can benefit orthodontists by enabling them to recognize the clinical signs of SLOS in order to refer these young patients to a specialist if the diagnosis has not been established.
OBJECTIVE:Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive disorder. It is due to a deficiency of 7-dehydrocholesterol reductase (DHCR7) that catalyses the reduction of 7-dehydrocholesterol (7-DHC) to cholesterol. The aim of this review is to gather all information, concerning diagnostic characteristics of this syndrome, with an emphasis on intraoral symptom presentation. MATERIALS AND METHODS: We conducted a review of the literature, including articles between 1964 and 2017. Data was collected regarding the clinical diagnosis, pathophysiology and treatment of SLOSpatients. Moreover, two clinical cases are described, illustrating the oral and facial anomalies of SLOSpatients, at the regional university hospital of Lille, France. DISCUSSION: Low cholesterol levels provoke a broad spectrum of clinical presentations, from mild to lethal forms. They can cause mental retardation, growth deficiency and congenital malformations. The SLOS features are often present at birth. Moreover, all the patients have facial anomalies. The dento-maxillofacial symptoms consist of crowded teeth, widely spaced incisors, oligodontia, polydontia, premature tooth eruption, enamel hypoplasia, a bifid uvula, broad alveolar ridges, bifid tongue, and Pierre-Robin syndrome symptoms (glossoptosis, retrognathia and cleft palate). These symptoms are warning signs and should increase the awareness of clinicians. CONCLUSIONS: All healthcare professionals can contribute to the SLOSpatient diagnostics. The dento-maxillofacial anomalies, illustrated by two case reports, could help to detect undiagnosed patients. An early detection might improve the outcome of these patients, as cholesterol supplementation can improve symptoms. This study can benefit orthodontists by enabling them to recognize the clinical signs of SLOS in order to refer these young patients to a specialist if the diagnosis has not been established.
Authors: Edgar Soto; Shivani Ananthasekar; Srikanth Kurapati; Nathaniel H Robin; Cassi Smola; Mary Halsey Maddox; Carter J Boyd; René P Myers Journal: Ann Plast Surg Date: 2021-06-01 Impact factor: 1.763