Síndrome de Marcus-Gunn / Marcus Gunn syndrome

Introducción: El síndrome de Marcus-Gunn se manifiesta con retracción o elevación del párpado ptótico ante la estimulación del músculo pterigoideo del mismo lado y el término "guiño mandibular" es inapropiado ya que el párpado no siempre desciende. Puede producirse en la apertura bucal, masticación, avance mandibular, al sonreír, silbar, bruxar, sacar la lengua, deglutir, chupar, cantar, en la contracción esternocleidomastoidea, maniobra de Valsalva, respirar o inhalar. Es congénito y de modalidad rara y autosómica dominante. Objetivo: Contribuir al conocimiento de esta rara enfermedad y a su relación con el ámbito odontológico. Presentación del caso: Se trata de un niño de 3 años diagnosticado de síndrome de Marcus-Gunn en el periodo neonatal, por la observación de la madre de una apertura palpebral izquierda durante la succión nutritiva. No presenta otras enfermedades ni antecedentes de interés. En la exploración extraoral se advierte una ptosis palpebral derecha y apertura palpebral izquierda en los movimientos mandibulares y deglución. La intensidad del reflejo se incrementa en estados de ansiedad derivados del tratamiento dental. Conclusiones: el síndrome de Marcus-Gunn es una entidad rara en pediatría, en la cual sus hallazgos clínicos determinan el diagnóstico. Teniendo en cuenta que en ocasiones presentan alteraciones oculares, nada nos hace sospechar la presencia de una enfermedad oral específica(AU)

Introduction: Marcus Gunn syndrome manifests with retraction or elevation of the eyelid ptotico while stimulation of the pterygoid muscle on the same side and the term jaw-winking is inappropriate because the eyelid does not always goes down. It can occur during mouth opening, mastication, mandibular advancement, while smiling, whistling, bruxing, sticking out the tongue, swallowing, sucking, singing, during the sternocleidomastoid contraction, the Valsalva maneuver, breathing or inhaling. This syndrome is congenital and rare, and of autosomal dominant modality. Objective: To contribute to the knowledge of this rare disease and its relationship with the odontologic field. Presentation of the case: 3 years old boy diagnosed with Marcus Gunn syndrome in the neonatal period by the observation of the mother of a left palpebral opening during the nutritive sucking. He does not present other diseases or a background of interest. In the extraoral exploration, it is noticed a right palpebral ptosis and a left palpebral opening in the jaw movements and in swallowing. The intensity of the reflex increases in anxiety states arising from the dental treatment. Conclusions: Marcus Gunn syndrome is a rare entity in pediatrics, in which its clinical findings determine the diagnosis. Taking into account that sometimes it presents ocular alterations, nothing makes us suspect the presence of a specific oral disease(AU)

Study of the influence of crossbite on the size of the apical area in a child population by analyzing panoramic X-ray.

BACKGROUND: The apical area is the space in the maxillary bones that contains teeth during formation and is subsequently occupied by the apices of the permanent teeth. Its dimensions are easy to perceive and determine by observing a panoramic X-ray. Our objective was to analyze the influence of crossbite on the size of the anterior and mesial apical area in Caucasian children. MATERIAL AND METHODS: Based on the ortopantomograph of 353 patients in mixed dentition and crossbite, the sizes of the apical areas of the four hemiarches were studied using the Tps Dig Version 2® computer program. These data were subjected to statistical analysis using the SPSS 22.0 for Windows program and applying the methods of descriptive statistics of quantitative variables, the Kolmogorov-Smirnov test, the non-parametric test Mann-Whitney-Wilcoxon test, and the paired Student t-test. RESULTS: In the group of boys, average values in the superior-mesial, superior-anterior, inferior-mesial and inferior-anterior apical areas of the crossbite were 173.43, 99.85, 180.32 and 87.56 respectively, with the lower values being in the hemiarch without malocclusion. In the group of girls, for the same apical areas, average values were 165.64, 94.24, 168.62 and 83.34 respectively, with all the highest values being in the hemiarch with crossbite, except for the inferior-mesial apical area. Statistically significant differences were found in the hemiarch with crossbite between both genders in the superior-anterior, inferior-anterior and inferior-mesial apical areas, with the significance being 0.001, 0.029 and 0.001 respectively, while in the hemiarch without malocclusion significance was observed in the superior-mesial, superior-anterior and inferior-mesial apical areas, with values of 0.004, 0.001 and 0.004, respectively. CONCLUSIONS: Crossbite affects the size of the anterior apical area in both arches and in both genders. The mesial apical area is influenced by this malocclusion in the jaw in boys and in the maxilla girls. Key words:Apical area, ortopantomography, crossbite.