Objective: To carry out a review about Prader-Willi Syndrome based on the most recent data about the subject and to give recommendation for the general pediatricians for early diagnoses and follow-up. Data sources: Scientific articles in the PubMed and SciELO databases. The research was not limited to a specific time period and included all articles in such databases.Data synthesis: The Prader-Willi Syndrome (PWS) is a rare genetic disorder resulting from the loss of imprinted gene expression within the paternal chromosome 15q11-q13. PWS is characterized by endocrine abnormalities, such as growth hormone (GH) deficiency, obesity, central adrenal insufficiency, hypothyroidism, hypogonadism and complex behavioral and intellectual difficulties. PWS individuals also may present other comorbidities, such as sleep disorders, scoliosis, constipation, dental issues and coagulation disorders. The follow-up protocol of the Children’s Institute at Universidade de São Paulo is based on four main pillars: diet, exercise, recombinant human growth hormone (rhGH) therapy and behavioral and cognitive issues. The diet must include a caloric restriction of 900 kcal/day, according to the Prader-Willi Eating Pyramid and exercise plan is focused on daily aerobic exercises and postural therapy. The rhGH therapy is highly recommended by the international scientific literature and must be started as soon as the diagnostic is made. The management of behavioral issues is based on strategies to establish routine and rules. Conclusions: If the general pediatrician becomes more familiar with PWS, the diagnosis and treatment will start earlier, which is essential to improve the quality of life and care for these individuals.
Objetivo: Avaliar a saúde bucal e o crescimento craniofacial de pacientes pediátricos com Síndrome de Prader-Willi (SPW), em comparação a crianças obesas não-sindrômicas. Métodos e resultados: Foram selecionadas 40 crianças com SPW e 40 controles não obesos com SPW, com idade de 10,9 anos (controle: 11,89 anos) e IMC 22,72 kg / m2 (controle 36,43 kg / m2). Foram avaliados o número de dentes, tipo de dentição, presença de cárie, sangramento gengival, má oclusão, acúmulo de placa bacteriana, erosão dentária, hiperplasia gengival e hipoplasia do esmalte. Os questionários avaliaram os hábitos de higiene bucal. Radiografias panorâmicas avaliaram o crescimento craniofacial. O grupo caso teve um número 6,8% menor de dentes em comparação ao grupo controle. Observou-se diferença estatisticamente significante no sangramento gengival, erosão dentária e hipoplasia do esmalte (p = 0,009; p = 0,02 ep = 0,006, respectivamente). Não houve diferença estatisticamente significante, observou-se um número aumentado de lesões de cárie e apinhamento dentário em crianças com SPW (p = 0,35 ep = 0,07). Ambos os grupos apresentaram má higiene dental. As crianças com SPW apresentaram crescimento aumentado do ramo mandibular com diferença estatisticamente significante (p = 0,03). Conclusão: As crianças com SPW apresentaram sangramento gengival estatisticamente aumentado e hipoplasia do esmalte do que os controles não obesos com SPW. Crianças com SPW podem apresentar crescimento vertical craniofacial aumentado. Mais investigações são necessárias para essa população.
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