Rare case of skeletal third class in a subject suffering from Solitary Median Maxillary Central Incisor syndrome (SMMCI) associated to panhypopituitarism

Abstract

Background The median solitary maxillary central incisor syndrome (SMMCI) is a rare malformative syndrome consisting of multiple defects, mainly found on the body midline. It can be correlated to the etiopathological and phenotypic pattern of panhypopituitarism. This case-report describes the rare case of a patient suffering from SMMCI and panhypopituitarism, showing an unusual craniofacial morphology. Case presentation From the cephalometric analysis, a skeletal class III was identified (despite the other cases described in literature described as skeletal class II), derived from hypomaxillia and mandibular protrusion. A convex lip profile, with tendency to mandibular hyper-divergency, airway patency, anterior and posterior cross-bite were observed. At the clinical examination, a maxillary cant was evident on the frontal plane that appeared asymmetric, with the prevalence of the third lower part of the face. There were some dysmorphic signs such as: small nose, rectilinear eyelid line and reduced interocular distance. Conclusions The present clinical case shows how, despite the literature, SMMCI can be associated with a III skeletal class, with maxillary hypoplasia and mandibular protrusion. The interdisciplinary collaboration between dentist and pediatrician is therefore important for the early interception of the malocclusions associated with these syndromes.

Dental manifestation and management in a patient with combined pituitary hormone deficiency: a two-year case report

“…In the 11-year-old female patient diagnosed with CPHC reported by Nota et al [13] in 2021, severe skeletal class III due to maxillary hypoplasia and mandibular protrusion with anterior and posterior crossbite were among the oral manifestations. But in our case, the cephalometric analysis revealed a class I skeletal relationship.…”

“…Recently, Nota et al [13] 2021 reported on the oral manifestations of an 11-year-old female patient diagnosed with CPHC. That patient was diagnosed with severe skeletal class III due to maxillary hypoplasia, mandibular protrusion, and as well as Solitary Median Maxillary Central Incisor syndrome.…”

A Case Report of Solitary Median Maxillary Central Incisor Reported in Tehsil Headquarter Hospital, Gujjar Khan, Pakistan

“…Treatment options for patient may include widening the palate to the provision of enough room for SMMCI tooth to move a side of the midline (7). After widening the palate an artificial central incisor can be implanted at the age of 17-18 years (8). Literature supports that SMMCI is a rarely occurring developmental disorder of abnormal positioning of the upper central incisor (9,10).…”

Anterior crossbite in children – Literature review

“…Se caracteriza por la relación molar y canina Clase III tanto en oclusión como en relación céntrica con perfil cóncavo acompañado de retroquelia superior, mentón prominente y tercio inferior disminuido. Puede ser causada por problemas de desarrollo en la mandíbula, lo cual tiene relación con el hueso, es decir, el crecimiento excesivo de la mandíbula o deficiencia en cuanto al desarrollo maxilar 16,17 .…”

“…Los incisivos de leche están pág. 16 World Health Journal desviados permanente; exfoliación lenta Los incisivos de leche están desalineados erupción de incisivos permanentes; dientes frontales súper números; odontomas; patrones congénitos Erupción anormal y circunferencia de arco débil. 28 Rodríguez Bedoya Montoya 28 afirma que el uso del dispositivo Bemler C para tratar pacientes con la mordida cruzada anterior, es más recomendable debido a que su flexibilidad permite una transmisión eficiente de los movimientos musculares a los dientes, que es lo más fructífero.…”