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

Head Face Med. 2021 Nov 23;17(1):49. doi: 10.1186/s13005-021-00300-3.

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.

Keywords: Children disease; Congenital syndromes; Dental anomalies; Dentistry; Hormonal deficiency; Interceptive orthodontics; Panhypopituitarism; Pituitary gland; SMMCI.

Publication types

  • Case Reports

MeSH terms

  • Anodontia*
  • Holoprosencephaly*
  • Humans
  • Hypopituitarism
  • Incisor / abnormalities
  • Incisor / diagnostic imaging
  • Maxilla / diagnostic imaging

Supplementary concepts

  • Combined Pituitary Hormone Deficiency
  • Single upper central incisor