Antoine Cassia

Leukodystrophy associated with oligodontia in a large inbred family: Fortuitous association or new entity?

We describe a large inbred Syrian pedigree with an autosomal recessive neurodegenerative disorder. The clinical picture of the affected patients is oligodontia, and a degenerative neurological condition with onset around age 12, characterized by progressive ataxia and pyramidal syndrome. Abnormalities in the white matter and cortical atrophy were assessed by magnetic resonance imaging. Differential diagnosis and the possibility of a fortuitous association or the report of a hitherto unreported dento‐leukoencephalopathy are discussed.

Sexual dimorphism of mandibular angle in a Lebanese sample

Sexual dimorphism represents a group of morphologic characteristics that differentiate males from females. Craniofacial morphology and more specifically the mandibular angle have been evaluated for their interest in orthodontic, anthropologic and forensic applications. Currently, limited data are available relative to the significance of the mandibular angle in sex determination in various populations. The objective of this preliminary study is to evaluate the significance of the mandibular angle in sex determination in a sample of Lebanese young individuals. Lateral cephalometric radiographs were obtained from 83 young individuals (40 males and 43 females) aged between 17 and 26 years. No statistically significant differences were detected between both genders relative to the mean values of A1, A2 and A3 measured for each individual using the ramus plane intersected with the mandibular planes of Downs, Sassouni and Steiner, respectively. This study demonstrated no significant difference of the mandibular angle in sex determination in the young Lebanese population. Further investigations with a larger sample size and a strongly established Lebanese background should be conducted to test the applicability of the mandibular angle sexual dimorphism.

Mandibular Canine Dimorphism in Establishing Sex Identity in the Lebanese Population

Background and Objective. In forensic investigations, mandibular canines provide excellent materials to identify gender since they are more likely to survive disasters. The objective of this study was to investigate gender dimorphism by comparing the mesiodistal width of mandibular permanent canines and intercanine distance in a group of Lebanese population. Methods. Participants consisted of undergraduate students from the School of Dentistry, Lebanese University, for two academic years who fulfilled the inclusion criteria. Canine widths and intercanine distance were measured by one operator directly on dental casts using a digital caliper. Results. One hundred thirty-three Lebanese dental students (54 males and 69 females) aged 18–25 were included in the study. The intercanine distance was significantly greater in males (P value < 0.0001). The right and the left canine widths were significantly greater in males than in females (P value < 0.0001). However, no significant difference was found between left and right canines for males (P value > 0.05) and females (P value > 0.05). The mean width of canine was greater than 7.188 mm for males. Conclusion. The parameters measured in the present study are of great help in sex identification in forensic investigations in the Lebanese adult population.

Five mandibular incisors: an autosomal recessive trait?

A fifth mandibular incisor is a eumorphic supernumerary tooth and has rarely been described in the medical literature. We report here a large Lebanese consanguineous family where four individuals displayed five incisors in the anterior mandible. Such familial observation has not been previously described. The possibility of an autosomal recessive inheritance for this nonsyndromic trait is discussed.

Prevalence of dentinogenesis imperfecta in a French population

Background: Dentinogenesis imperfecta is a genetic disorder of the dentin occurring during the tooth development. It leads to many structural changes that can be identified clinically (brownish colored teeth, cracked enamel) and radiologically (globular crown, cervical constriction, short roots, and obliterated pulp chamber and/or root canals). The aim of this study was to determine by panoramic radiographs assessment the incidence of dentinogenesis imperfecta in a group of patients attending a specialized maxillofacial imaging center in Paris, France. Material and Methods: A retrospective observational study was conducted using panoramic radiographs of 8830 patients (3723 males and 5107 females), which were used to search the radiological criteria of dentinogenesis imperfecta. Results: In our sample, the prevalence of dentinogenesis imperfecta was 0.057%. Out of the 8830 subjects, 0.080% of the males presented the radiological signs of the dentinogenesis imperfecta against 0.039% of the females. Conclusion: In our study, we found that dentinogenesis imperfecta is a relatively rare dental anomaly in France, with a rate different from the rates reported in other studies and with no disparity in prevalence among genders.

EVALUATION OF DENTURE-RELATED FACTORS PREDISPOSING TO DENTURE STOMATITIS IN A LEBANESE POPULATION.

Background: Denture stomatitis is a common fungal oral infection of multifactorial etiology. Denture-related factors such as denture’s age, hygiene, night wearing and colonization by Candida albicans are known to predispose to denture stomatitis. The aim of this study was to evaluate these factors and their relationship with the occurrence of denture stomatitis in a Lebanese population. Material and methods: Sixty patients (40 women, 20 men; age range 40-80 years) showing clinical evidence of denture-related stomatitis were selected for this study. Swab samples from the palate and the palatal surfaces of the upper dentures of these patients were collected and examined mycologically. Denture’s age, hygiene, night wearing and colonization by Candida albicans were evaluated and analyzed statistically. Results: The statistical analysis showed a significant role for denture’s hygiene, night wearing, and colonization by Candida albicans in the installation of the denture stomatitis. Patient’s gender and age, as well as the denture’s age, were not significant predictors of the disease. Conclusion: In a sample of Lebanese population, poor denture hygiene, continuous denture use, and Candida denture colonization are important etiological factors that contribute to denture stomatitis.

Prevalence and Distribution of Oral Mucosal Lesions by Sex and Age Categories: A Retrospective Study of Patients Attending Lebanese School of Dentistry

Background Prevalence and distribution of oral mucosal lesions in a sample of Lebanese population attending the School of Dentistry of Lebanese University is necessary to evaluate their oral health situation. Objectives The aim of the present study was to determine the prevalence and distribution of oral mucosal lesions of patients attending the School of Dentistry. Methods A descriptive study was carried out by retrospectively examining a total of 231 medical and clinical examination record files of patients, attending the School of Dentistry Lebanese University for multidisciplinary dental treatments. 178 medical records were retained. Each medical and clinical examination record was done by an undergraduate student and then evaluated by a doctor. The record file included a civil status, chief complaint, medical history, and extraoral and intraoral clinical examination during the period between October 2014 and May 2015. Exclusion criteria were lack of written information in their medical and clinical examination record and being nonevaluated by a doctor. Data regarding age, gender, socioeconomic status, chief complaint, systemic diseases, and drugs intake were collected by using a questionnaire while the type of extraoral and oral mucosal lesions by clinical examination. Results The sample consisted of 102 (57.3%) females and 76 (42.7%) males. The age ranged from 10 to 92 years with a mean age of 40.1 years. Among these subjects, 110 (61.8%) presented with one or more lesions. All patients were Lebanese. The most common lesion diagnosed was coated/hairy tongue affecting 17.4% of the subjects, followed by melanotic macule (11.2%), gingivitis (9.6), linea alba (6.2%), tongue depapillation (5.1), leukoplakia (5.1), traumatic fibroma (4.5), frictional keratosis (3.9%), fissured tongue (3.9%), hemangiomas (3.9%), Fordyce granules (3.9%), dry mucosa (3.4), angular cheilitis (2.2), gingival hyperplasia (2.2), and crenulated tongue (1.7%). Overall, the prevalence of oral mucosal lesions did not significantly differ between sex and age groups. Conclusions The high prevalence of oral mucosal lesions necessitates adequate awareness and management of these lesions in the general population. Dental clinicians should be knowledgeable and familiar with the etiopathogenesis, clinical presentation, diagnosis, and management of these lesions.

Diode laser versus scalpel in the treatment of hereditary gingival fibromatosis in a 6-year old boy

Hereditary gingival fibromatosis (HGF) is a rare disease characterized by a benign enlargement of the gingiva involving both the mandible and the maxilla. This case is about a 6-year-old child with non syndromic HGF showing a severe gingival enlargement covering almost all surfaces of the teeth, in both arches, hence causing major aesthetic, phonetic and masticatory problems. The aim of the present article is to compare the outcomes of two therapeutical approaches: i) classical surgical removal with scalpel; and ii) diode laser resection. Compared to the surgical approach, the clinical results show that the main advantages of the diode laser technique are a better visibility during the intervention, minimal postoperative discomfort combined to a better gingival recontouring. However, the time consumption and the high cost of the laser equipment remain the main disadvantages of the systematic use of this technique.

Is the homozygous region on chromosome 16q12.2 responsible for a fifth mandibular incisor

The presence of a fifth mandibular incisor, a eumorphic supernumerary tooth, has rarely been described in the literature. Recently we reported on a large Lebanese consanguineous family where 4 individuals displayed 5 mandibular incisors with the same shape and size. This type of familial clustering of the trait has not been previously described. We previously postulated several theories to explain the etiology of this anomaly. The possibility of an autosomal recessive inheritance for this nonsyndromic trait was discussed. We now report the use of homozygosity mapping to identify a homozygous region with different alleles at chromosome 16q12.2, located at the marker D16S415, which likely harbors the gene underlying this anomaly.