Amniotic Band Syndrome: A Multidisciplinary Care Approach to the Treatment of a Rare Case

Abstract

Amniotic band syndrome (ABS) is a rare developmental disorder associated with defects such as syndactyly, facial and/or palatal clefts, and dental anomalies like malformed or impacted teeth. In this report, a patient with ABS was successfully treated with orthodontic, endodontic, and periodontal therapies. Cone beam computed tomography revealed a unique eruptive path of the impacted central incisor through the incisive canal and cleft area. The tooth was occlusally and functionally stable after 1 year of treatment. Multidisciplinary care was critical to the success of this case. Available literature on ABS is also briefly reviewed.

Amniotic Band Syndrome: Head-to-Toe Manifestations and Clinical Management Guidelines

“…10 Craniofacial defects that are seen in association with ABS include Tessier clefts; hydrocephalus; encephalocele; myelomeningocele; plagiocephaly; mandibular hypoplasia; hair whorls; skin tags; forehead prominence; and supernumerary, impacted, malformed, or absent teeth. 6,11,33,[35][36][37][38] In addition, ophthalmologic deformities including telecanthus, epiphora, microphthalmos, microcornea, and colobomas have been reported. 39 Although the exact mechanism of facial clefting in association with ABS is unclear, it has been observed that facial clefts in the setting of ABS are more complex than isolated facial clefts, and can also present with translocation of upper extremity appendages into the facial cleft itself.…”

“…10 These interventions often necessitate the involvement of a multidisciplinary team of specialists for orthognathic, orthodontic, and ophthalmologic management. 6,39 Possible interventions by the pediatric plastic surgeon include cleft lip repair, cleft palate reconstruction, facial cleft closure, macrostomia repair, and mandibular distraction osteogenesis. 10,11,37…”

“…5 There are no known genetic causes or predispositions for the condition, and no patterns of associations among genders or race/ethnicity have been observed. 6 The proposed pathophysiologic hypotheses of origin for ABS fall into two main categories: intrinsic and extrinsic mechanisms. The intrinsic theory, originally postulated by Streeter in 1930, asserts that the constrictive rings form as a result of an underlying common genetic insult causing disruption of the germinal 339e disk, with subsequent formation of "raw surfaces" along the fetal exterior that become primed for amniotic band adhesion early during embryologic development.…”

A Rare Presentation of Amniotic band syndrome: Antenatal diagnosis and perinatal management

“…Amniotic band syndrome is a rare syndrome occurring about 1,200 in 15,000 newborns [1,2] and is a major cause of congenital malformation of the fetus. In most cases, there are membranes binding the fetus's limbs, fi ngers, toes [3][4][5], and skull, including a deformation of face, mouth, nose, eyes, chest, ribs, spinal bone, front surface of sexual organs, and anal hole [6,7]. The prediction of the disease depends on the severity of the pathology caused by the organs tied with membranes causing an abortion up to 1 in 70 people [8,9].…”