Concurrent Scoliosis and Dentofacial Anomaly: A Case Report

Abstract

The relationship between scoliosis, dentofacial anomaly, and malocclusion is poorly understood. We report a novel and complex pediatric case of concurrent juvenile scoliosis, dentofacial anomaly, and malocclusion, successfully treated and managed by an interdisciplinary hospital team over a 15-year period. The degree of severity of the scoliosis and dentofacial anomaly necessitates surgical intervention. Successful orthopedic surgical procedures have improved the patient’s quality of life. Future surgical correction of the dentofacial anomaly and malocclusion is necessary to improve the patient’s condition from psychosocial, aesthetic, and functional standpoints. The patient’s condition is characterized by multiple congenital abnormalities, developmental delay, seizure disorder, juvenile scoliosis, and dentofacial anomaly with malocclusion. Intriguingly, a unifying diagnosis for the patient’s condition could not be confirmed despite the indication of a syndromic cause. The collection of characteristics is suggestive of the chromosome 22q11.2 deletion syndromes (including velocardiofacial syndrome [VCFS] or DiGeorge syndrome) as possible genetic causes. Clinical genetics testing was unable to establish a diagnosis of chromosome 22q11.2 deletion, VCFS or DiGeorge syndrome. Further investigation of the genotype-phenotype relationships of scoliosis, dentofacial anomaly, and malocclusion is required to improve medical knowledge, diagnostic capability, and patient care, specifically relating to cases of undiagnosed diseases. Future research utilizing next-generation sequencing techniques is necessary to aim for precise genetic diagnosis, including knowledge of the underlying cellular and molecular mechanisms, for the development of the potential of therapeutic approaches targeting gene repair.