马凡氏综合征:一般信息和牙科学表现

Antônio Ernando Carlos Ferreira Junior, Lorena Walesca Macedo Rodrigues, M. Verde, P. Rebouças
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摘要

马凡氏综合征(MS)是一种多系统的遗传性结缔组织疾病。它是由FBN1基因突变引起的,该基因编码微原纤维的主要成分原纤维蛋白。因此,这种干扰在许多结缔组织系统中引起影响,如骨骼和心血管系统。马凡氏综合征患者骨骼表型的特点是身材高大、关节活动过度、韧带松弛、髋臼臂突出、腿长、手指不成比例(蛛关节)头多畸形、上颚高、脊柱侧凸、胸骨突出(胸骨隆起)或凹陷(胸骨漏斗);降低了上、下三分之一的骨骼与骨膜分裂之间的关系。主要的心血管表现为二尖瓣脱垂和主动脉扩张,这增加了主动脉剥离、破裂和主动脉反流的风险。口腔面部特征经常被描述并用于该综合征的诊断。颌面缺损多见于上颌骨缩窄、上颚高,并伴有牙块拥挤、后交叉咬合和开咬合。头盖骨和面部呈底栖,通常为头侧畸形和II型错颌畸形。上颌收缩会影响鼻腔阻力的增加,从而导致严重的阻塞性睡眠呼吸暂停,这在经常使用呼吸机的患者中发病率很高。关节囊韧带和肌肉的松弛可导致颞下颌关节功能障碍和习惯性运动或半脱位。这些患者的牙科治疗主要集中在骨科疾病的解决上,包括多头畸形、上深腭和阻塞性呼吸暂停的发生。重要的是要了解伴随综合征的全身特征,以便进行安全和适当的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Marfan's Syndrome: General Informations and Odontologic Manifestations
Marfan syndrome (MS) is a multisystemic, inherited disorder of the connective tissue. It is caused by mutations in the gene FBN1, encoding fibrillin, a major component of microfibrils. Thus, this disturbance causes effects in many systems composed of connective tissue such as skeletal and cardiovacular mainly. The skeletal phenotype of patients with Marfan syndrome is characterized by tall stature, joint hypermobility, ligamentous laxity, protrusion acetabular arms and long legs, disproportionate fingers (arachnodactyly) dolichocephaly, high palate, scoliosis, protrusion (pectus carinatum) or depression ( pectus excavatum) of the sternum; decreasing the relationship between the upper and lower third of the skeleton and espondilolistesis. The main cardiovascular manifestations are mitral valve prolapse and aortic dilation, and these increases the risk of dissection and rupture of the aorta and aortic regurgitation. Orofacial characteristics are frequently described and used in the diagnosis of the syndrome. The orofacial defects more prevalent are constriction of the maxilla and high palate, with concomitant dental crowding, posterior cross bite and open bite. The cranium and the face is present Benthic, usually the dolicocephalic and type II malocclusion is often found. The maxillary constriction can influence the increase in nasal resistance, which can cause severe obstructive sleep apnea, which has a high prevalence in These Patients who are respirators mouth often. The looseness of the capsular ligaments and muscles can hyperextensibility contribute to dysfunction and habitual movements or subluxation of the temporomandibular joint. Dental treatment of these patients is mainly focused on the resolution of orthopedic disorders, which include features like dolichocephaly, upper deep palate and occurrence of obstructive apnea. It is important to know the systemic features that accompany the syndrome to enable safe and proper treatment.
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