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Symptomatologie dentaire associée aux anomalies du tissu conjonctif
Peter J. De Coster,
Luc C. Martens
Service de Médecine Dentaire Pédiatrique
Centre de Médecine Dentaire Spécialisée – PeaCaMed Research
Cliniques Universitaires de Gand
Titre
original:
“Tandheelkundige symptomen van bindweefselstoornissen”.
Traduction: TvN.
Key words:
Collagen, fibrillin, connective tissue, oral health, temporomandibular
disorders, periodontal disease, pulp obliteration
Mots clés
:
collagène, fibrilline, tissu conjonctif, santé bucco-dentaire, troubles
temporo-mandibulaires, maladie parodontale, oblitération pulpaire
Summary
Subjects affected with
inherited disorders of the connective tissue make up an important population,
carrying high risks as to distinct aspects of oral health and dental treatment.
These generalized conditions may produce serious clinical symptoms in different
orofacial structures, which have to be dealt with, or anticipated, when
considering dental treatment. The most prevalent disorders result from
deficiency of Type I collagen, an important extracellular matrix protein
regulating both the structural and mechanical properties of most of the
orofacial tissues. Recurrent jaw fractures, an increased liability for
development of temporomandibular disorders, periodontal disease and mucosal
fragility, an abnormal tooth color and/or shape, and pulp obliteration may
feature as major clinical manifestations of the respective disorders. Deficiency
of fibrillin, a protein providing soft tissues with elastic capacities, may
produce a long face with a high and narrow palate, an increased liability for
the developnet of temporomandibular disorders and periodontal disease, and root
dsyplasia. Whenever present, these manifestations/risk factors have to be
integrated in dental treatment strategies. In cases with high risk for
cardiovascular complications, specific preventive measures, such as cardiac
output monitoring and the administration of appropriate local anesthetics, have
to be taken before starting any invase dental treatment. The present paper aims
to provide the practitioner with an appreciation of the most prevalent inherited
disorders of the connective tissue with their respective genetics, molecular
aspects of pathology, medical and oral manifestations, and guidelines for dental
treatment.
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