[Oradlist] Orthodontic Tx in Gardner's syndrome patient?

Tue Feb 1 05:01:10 PST 2005

Hello Apirum,

  Sorry about the delay in replying to your inquiry. As my thesis defense deadline looms, I'm finding it harder and harder to do independent research on interesting topics. With beads of sweat rolling down my forehead, I medline-searched and googled "orthodontic treatment AND Gardner's syndrome" and various other combinations of words that I thought may appeal to the search engines. I found tons of articles related to how the dental finding helped diagnose the more serious intestinal polyposis, but nothing on the actual implications on the movement of teeth (as if they ceased to exist once the medical people take over!). The only thing I found that came even remotely close was this link:

http://www.emedicine.com/derm/topic163.htm

which, in one very terse line, talks about how the osteomas can be excised if they are disfiguring (?in the way of your impacted maxillary canine?). I also found this page interesting:

http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=114

 It says nothing at all about dental treatment, but talks about the genetics of Familial Adenomatous Polyposis (FAP) in a non-complicated way, and touches upon the genetic varient "Gardner's Syndrome" very briefly, as well as other varients that give other manifestations as well as the polypsis, but I like the way the page touches upon the newest developments in treatment for these syndromes. I thought this may be of interest for all our colleagues in Oradlist.

 I sent out an email to our orthodontic department with your original message, and will forward their reply as soon as I get it.

 Many warm wishes (from Arctic Boston!) for you and Kevin for a wonderful new year.

 Dania

	-----Original Message----- 
	From: oradlist-bounces at lists.ucla.edu on behalf of Apirum Janhom 
	Sent: Tue 1/25/2005 3:37 AM 
	To: Oral Radiology Discussion Group 
	Cc: 
	Subject: [Oradlist] Orthodontic Tx in Gardner's syndrome patient?

	Dear all,

	I have seen a 22 year-old female patient with multiple radiopaque masses
	in both jaws and in skull and impacted upper right canine. Her elder
	brother and her elder sister also have similar radiopaque pattern. Her
	brother told me he had his 10 impacted teeth removed 7 years ago. I was
	concerned about their conditions of Gardner's syndrome and asked them to
	check with the GI doctor for polyps in intestine and colon. The GI doctor
	called me the day before telling me that the youngest sister doesn't have
	any polyp but her elder brother does. The girl would like to have
	orthodontic treatment to correct her impacted canine and also malocclusion
	on lower anterior area. Does any of you have experienced the consequence
	of orthodontic movement in Gardner's patient? I have not talked to the
	orthodontist yet I am sure she will ask me is it all right for orthodontic
	treatment in this case. The radiopaque masses are pretty big and for the
	maxilla area it even causes a recession of the floor of the left maxillary
	sinus. Any comment would be appreciated.

	Best regards,

	Apirum

	Apirum  Janhom,DDS,MS,Ph.D.
	Department of Oral Radiology
	Faculty of Dentistry
	Chiang Mai University
	THAILAND 50200
	FAX:+66-53-222844
	e-mail: dnipjnhm at chiangmai.ac.th

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