Palabras clave
acromegalia, gemelos, cefalometría, cóndilo mandibular
Cómo citar
Comparación cefalométrica entre un paciente acromegálico y su hermano gemelo. (2019). Odontoestomatología, 21(33). https://odon.edu.uy/ojs/index.php/ode/article/view/271
Resumen
La acromegalia es una enfermedad caracterizada por una desfiguración somática de progresión lenta causada por la sobreproducción de hormona de crecimiento (GH) y factor de crecimiento insulinoide tipo 1 (IGF-1), predominantemente asociada con un adenoma hipofisario. La manifestación más evidente a nivel facial es un prognatismo mandibular por exceso de crecimiento de la mandíbula. El propósito del presente trabajo fue realizar una comparación morfológica craneofacial mediante análisis cefalométrico y superposición cefalométrica entre un paciente con diagnóstico de acromegalia y su hermano gemelo que no presenta la enfermedad. Nuestros resultados mostraron que en el hermano con acromegalia existe un significativo aumento del tamaño de la silla turca, un desplazamiento hacia anterior del maxilar y mandíbula, siendo más marcado el desplazamiento mandibular. El cambio morfológico que experimenta la mandíbula en la acromegalia es atribuido principalmente al crecimiento de la rama mandibular por aumento de la unidad condilar.
Referencias
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2. Chanson P, Salenave S. Acromegaly. Orphanet J Rare Dis. 2008; 3: 17.
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4. Salenave S, Boyce AM, Collins MT, Chanson P. Acromegaly and McCune-Albright síndrome. J Clin Endocrinol Metab. 2014; 99 (6): 1955-69.
5. Găloiu S, Poiană C. Current therapies and mortality in acromegaly. J Med Life. 2015; 8 (4): 411-5.
6. López-Macía A, Picó-Alfonso A. Clínica de la acromegalia: presentación, cuadro clínico y comorbilidades. Endocrinol Nutr. 2005; 52 Supl 3: 18-22.
7. Melmed S. Acromegaly. N Engl J Med. 1990; 322 (14): 966-77.
8. Chanson P, Salenave S, Kamenicky P, Cazabat L, Young J. Pituitary tumours: acromegaly. Best Pract Res Clin Endocrinol Metab. 2009; 23 (5): 555-74.
9. Vilar L, Vilar CF, Lyra R, Lyra R, Naves LA. Acromegaly: clinical features at diagnosis. Pituitary. 2017; 20 (1): 22-32.
10. Bruwier A, Albert A, Beckers A, Limme M, Poirrier R. Acromegaly and sleep apnea: cephalometric evaluations. Ann Endocrinol (Paris). 2011; 72 (3): 211-7.
11. Karakis D, Aktas-Yilmaz B, Dogan A, Yetkin I, Bek B. The bite force and craniofacial morphology in patients with acromegaly: a pilot study. Med Oral Patol Oral Cir Bucal. 2014; 19 (1): e1-7.
12. Künzler A, Farmand M. Typical changes in the viscerocranium in acromegaly. J Craniomaxillofac Surg. 1991; 19 (8): 332-40.
13. Dostálová S, Sonka K, Smahel Z, Weiss V, Marek J. Cephalometric assessment of cranial abnormalities in patients with acromegaly. J Craniomaxillofac Surg. 2003; 31 (2): 80-7.
14. Pelttari L, Polo O, Rauhala E, Vuoriluoto J, Aitasalo K, Hyyppä MT, Kronholm E, Irjala K, Viikari J. Nocturnal breathing abnormalities in acromegaly after adenomectomy. Clin Endocrinol (Oxf). 1995; 43 (2): 175-82.
15. Likubo M, Kojima I, Sakamoto M, Kobayashi A, Ikeda H, Sasano T. Morphological and histopathological changes in orofacial structures of experimentally developed acromegaly-like rats: an overview. Int J Endocrinol. 2012; 2012: 254367.
16. Agrawal M, Maitin N, Rastogi K, Bhushan R. Seeing the unseen: diagnosing acromegaly in a dental setup. BMJ Case Rep. 2013.
17. Smith CB, Waite PD. Surgical management of obstructive sleep apnea in acromegaly with mandibular prognathism and macroglossia: a treatment dilemma. J Oral Maxillofac Surg. 2012; 70 (1): 207-10.
18. Kashyap RR, Babu GS, Shetty SR. Dental patient with acromegaly: a case report. J Oral Sci. 2011; 53 (1): 133-6.
19. Wittmann AL. Macroglossia in acromegaly and hypothyroidism. Virchows Arch A Pathol Anat Histol. 1977; 373 (4): 353-60.
20. Lima DL, Montenegro RM Jr, Vieira AP, Albano MF, Rego DM. Absence of periodontitis in acromegalic patients. Clin Oral Investig. 2009; 13 (2): 165-9.
21. Herrmann BL, Mortsch F, Berg C, Weischer T, Mohr C, Mann K. Acromegaly: a cross-sectional analysis of the oral and maxillofacial pathologies. Exp Clin Endocrinol Diabetes. 2011; 119 (1): 9-14.
22. Cortet-Rudelli C. The mouth of patients with acromegaly. Presse Med. 2017; 46 (9): 831-837.
23. Björk A. Variations in the growth pattern of the human mandible: longitudinal radiographic study by the implant method. J Dent Res. 1963; 42 (1) Pt 2: 400-11.
24. Skieller V, Björk A, Linde-Hansen T. Prediction of mandibular growth rotation evaluated from a longitudinal implant sample. Am J Orthod. 1984; 86 (5): 359-70.
25. Roldan SI, Carvajal CM, Rey D, Buschang PH. Método de superposición estructural de Björk para evaluar crecimiento y desarrollo craneofacial. Rev. CES Odont. 2013; 26 (2): 127-133.
26. Griffiths AJF, Miller JH, Suzuki DT, Lewontin RC, Gelbart WM. An Introduction to Genetic Analysis. In: W. H. Freeman. 7 ed. New York, 2000.
27. Fraga MF, Ballestar E, Paz MF, Ropero S, Setien F, Ballestar ML, Heine-Suñer D, Cigudosa JC, Urioste M, Benitez J, Boix-Chornet M, Sanchez-Aguilera A, Ling C, Carlsson E, Poulsen P, Vaag A, Stephan Z, Spector TD, Wu YZ, Plass C, Esteller M. Epigenetic differences arise during the lifetime of monozygotic twins. Proc Natl Acad Sci U S A. 2005; 102 (30): 10604-9.
28. Šidlauskas M, Šalomskienė L, Andriuškevičiūtė I, Šidlauskienė M, Labanauskas Ž, Šidlauskas A. Mandibular morphology in monozygotic twins: a cephalometric study. Stomatologija. 2014; 16 (4): 137-43.
29. Manjusha KK, Jyothindrakumar K, Nishad A, Manoj KM. Growth and Development of Dentofacial Complex influenced by Genetic and Environmental Factors using Monozygotic Twins. J Contemp Dent Pract. 2017; 18 (9): 754-758.
30. Chang HP, Tseng YC, Chou TM. An enlarged sella turcica on cephalometric radiograph. Dentomaxillofac Radiol. 2005; 34 (5): 308-12.
31. Fariña R, Bravo R, Villanueva R, Valladares S, Hinojosa A, Martinez B. Measuring the condylar unit in condylar hyperplasia: from the sigmoid notch or from the mandibular lingula?. Int J Oral Maxillofac Surg. 2017; 46 (7): 857-860.
32. Gershberg H, Heinemann HO, Stumpf HH. Renal function studies and autopsy report in a patient with gigantism and acromegaly. J Clin Endocrinol Metab. 1957; 17 (3): 377-85.
33. Ardran GM, Kemp FH. The tongue and mouth in acromegaly. Clin Radiol. 1972; 23 (4): 434-44.
34. Benda C. Akromegalie. Deutsche Klinik am Eingange Des Zwanzigsten Jahrhunderts. 1902; 3: 261.
35. Chalk WO. Partial dislocation of the lower jaw from an enlarged tongue. Transactions of the Pathological Society. 1856; 8: 305-308.
36. Kawafuji A, Suda N, Ichikawa N, Kakara S, Suzuki T, Baba Y, Ogawa T, Tsuji M, Moriyama K. Systemic and maxillofacial characteristics of patients with Beckwith-Wiedemann syndrome not treated with glossectomy. Am J Orthod Dentofacial Orthop. 2011; 139 (4): 517-25.
37. Argandoña J, Pantoja R, Cortés J. Rol de la lengua en la génesis de Dismorfosis Maxilares (I parte). Revista Dental de Chile. 1998; 89 (1): 37-42.
38. Balos Tuncer B, Canigur Bavbek N, Ozkan C, Tuncer C, Eroglu Altinova A, Gungor K, Akturk M, Balos Toruner F. Craniofacial and pharyngeal airway morphology in patients with acromegaly. Acta Odontol Scand. 2015; 73 (6): 433-40.
39. Vetter U, Zapf J, Henrichs I, Gammert C, Heinze E, Pirsig W. Human nasal septal cartilage: analysis of intracellular enzyme activities, glycogen content, cell density and clonal proliferation of septal chondrocytes of healthy adults and acromegalic patients. Connect Tissue Res. 1989; 18 (4): 243-54.
2. Chanson P, Salenave S. Acromegaly. Orphanet J Rare Dis. 2008; 3: 17.
3. Rozario KS, Lloyd C, Ryan F. GH and IGF-1 Physiology In Childhood. En: De Groot LJ, Chrousos G, Dungan K. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. 2000. [Actualizado: 2015 Nov 20; Acceso: 2018 Ago 14] Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK343487/.
4. Salenave S, Boyce AM, Collins MT, Chanson P. Acromegaly and McCune-Albright síndrome. J Clin Endocrinol Metab. 2014; 99 (6): 1955-69.
5. Găloiu S, Poiană C. Current therapies and mortality in acromegaly. J Med Life. 2015; 8 (4): 411-5.
6. López-Macía A, Picó-Alfonso A. Clínica de la acromegalia: presentación, cuadro clínico y comorbilidades. Endocrinol Nutr. 2005; 52 Supl 3: 18-22.
7. Melmed S. Acromegaly. N Engl J Med. 1990; 322 (14): 966-77.
8. Chanson P, Salenave S, Kamenicky P, Cazabat L, Young J. Pituitary tumours: acromegaly. Best Pract Res Clin Endocrinol Metab. 2009; 23 (5): 555-74.
9. Vilar L, Vilar CF, Lyra R, Lyra R, Naves LA. Acromegaly: clinical features at diagnosis. Pituitary. 2017; 20 (1): 22-32.
10. Bruwier A, Albert A, Beckers A, Limme M, Poirrier R. Acromegaly and sleep apnea: cephalometric evaluations. Ann Endocrinol (Paris). 2011; 72 (3): 211-7.
11. Karakis D, Aktas-Yilmaz B, Dogan A, Yetkin I, Bek B. The bite force and craniofacial morphology in patients with acromegaly: a pilot study. Med Oral Patol Oral Cir Bucal. 2014; 19 (1): e1-7.
12. Künzler A, Farmand M. Typical changes in the viscerocranium in acromegaly. J Craniomaxillofac Surg. 1991; 19 (8): 332-40.
13. Dostálová S, Sonka K, Smahel Z, Weiss V, Marek J. Cephalometric assessment of cranial abnormalities in patients with acromegaly. J Craniomaxillofac Surg. 2003; 31 (2): 80-7.
14. Pelttari L, Polo O, Rauhala E, Vuoriluoto J, Aitasalo K, Hyyppä MT, Kronholm E, Irjala K, Viikari J. Nocturnal breathing abnormalities in acromegaly after adenomectomy. Clin Endocrinol (Oxf). 1995; 43 (2): 175-82.
15. Likubo M, Kojima I, Sakamoto M, Kobayashi A, Ikeda H, Sasano T. Morphological and histopathological changes in orofacial structures of experimentally developed acromegaly-like rats: an overview. Int J Endocrinol. 2012; 2012: 254367.
16. Agrawal M, Maitin N, Rastogi K, Bhushan R. Seeing the unseen: diagnosing acromegaly in a dental setup. BMJ Case Rep. 2013.
17. Smith CB, Waite PD. Surgical management of obstructive sleep apnea in acromegaly with mandibular prognathism and macroglossia: a treatment dilemma. J Oral Maxillofac Surg. 2012; 70 (1): 207-10.
18. Kashyap RR, Babu GS, Shetty SR. Dental patient with acromegaly: a case report. J Oral Sci. 2011; 53 (1): 133-6.
19. Wittmann AL. Macroglossia in acromegaly and hypothyroidism. Virchows Arch A Pathol Anat Histol. 1977; 373 (4): 353-60.
20. Lima DL, Montenegro RM Jr, Vieira AP, Albano MF, Rego DM. Absence of periodontitis in acromegalic patients. Clin Oral Investig. 2009; 13 (2): 165-9.
21. Herrmann BL, Mortsch F, Berg C, Weischer T, Mohr C, Mann K. Acromegaly: a cross-sectional analysis of the oral and maxillofacial pathologies. Exp Clin Endocrinol Diabetes. 2011; 119 (1): 9-14.
22. Cortet-Rudelli C. The mouth of patients with acromegaly. Presse Med. 2017; 46 (9): 831-837.
23. Björk A. Variations in the growth pattern of the human mandible: longitudinal radiographic study by the implant method. J Dent Res. 1963; 42 (1) Pt 2: 400-11.
24. Skieller V, Björk A, Linde-Hansen T. Prediction of mandibular growth rotation evaluated from a longitudinal implant sample. Am J Orthod. 1984; 86 (5): 359-70.
25. Roldan SI, Carvajal CM, Rey D, Buschang PH. Método de superposición estructural de Björk para evaluar crecimiento y desarrollo craneofacial. Rev. CES Odont. 2013; 26 (2): 127-133.
26. Griffiths AJF, Miller JH, Suzuki DT, Lewontin RC, Gelbart WM. An Introduction to Genetic Analysis. In: W. H. Freeman. 7 ed. New York, 2000.
27. Fraga MF, Ballestar E, Paz MF, Ropero S, Setien F, Ballestar ML, Heine-Suñer D, Cigudosa JC, Urioste M, Benitez J, Boix-Chornet M, Sanchez-Aguilera A, Ling C, Carlsson E, Poulsen P, Vaag A, Stephan Z, Spector TD, Wu YZ, Plass C, Esteller M. Epigenetic differences arise during the lifetime of monozygotic twins. Proc Natl Acad Sci U S A. 2005; 102 (30): 10604-9.
28. Šidlauskas M, Šalomskienė L, Andriuškevičiūtė I, Šidlauskienė M, Labanauskas Ž, Šidlauskas A. Mandibular morphology in monozygotic twins: a cephalometric study. Stomatologija. 2014; 16 (4): 137-43.
29. Manjusha KK, Jyothindrakumar K, Nishad A, Manoj KM. Growth and Development of Dentofacial Complex influenced by Genetic and Environmental Factors using Monozygotic Twins. J Contemp Dent Pract. 2017; 18 (9): 754-758.
30. Chang HP, Tseng YC, Chou TM. An enlarged sella turcica on cephalometric radiograph. Dentomaxillofac Radiol. 2005; 34 (5): 308-12.
31. Fariña R, Bravo R, Villanueva R, Valladares S, Hinojosa A, Martinez B. Measuring the condylar unit in condylar hyperplasia: from the sigmoid notch or from the mandibular lingula?. Int J Oral Maxillofac Surg. 2017; 46 (7): 857-860.
32. Gershberg H, Heinemann HO, Stumpf HH. Renal function studies and autopsy report in a patient with gigantism and acromegaly. J Clin Endocrinol Metab. 1957; 17 (3): 377-85.
33. Ardran GM, Kemp FH. The tongue and mouth in acromegaly. Clin Radiol. 1972; 23 (4): 434-44.
34. Benda C. Akromegalie. Deutsche Klinik am Eingange Des Zwanzigsten Jahrhunderts. 1902; 3: 261.
35. Chalk WO. Partial dislocation of the lower jaw from an enlarged tongue. Transactions of the Pathological Society. 1856; 8: 305-308.
36. Kawafuji A, Suda N, Ichikawa N, Kakara S, Suzuki T, Baba Y, Ogawa T, Tsuji M, Moriyama K. Systemic and maxillofacial characteristics of patients with Beckwith-Wiedemann syndrome not treated with glossectomy. Am J Orthod Dentofacial Orthop. 2011; 139 (4): 517-25.
37. Argandoña J, Pantoja R, Cortés J. Rol de la lengua en la génesis de Dismorfosis Maxilares (I parte). Revista Dental de Chile. 1998; 89 (1): 37-42.
38. Balos Tuncer B, Canigur Bavbek N, Ozkan C, Tuncer C, Eroglu Altinova A, Gungor K, Akturk M, Balos Toruner F. Craniofacial and pharyngeal airway morphology in patients with acromegaly. Acta Odontol Scand. 2015; 73 (6): 433-40.
39. Vetter U, Zapf J, Henrichs I, Gammert C, Heinze E, Pirsig W. Human nasal septal cartilage: analysis of intracellular enzyme activities, glycogen content, cell density and clonal proliferation of septal chondrocytes of healthy adults and acromegalic patients. Connect Tissue Res. 1989; 18 (4): 243-54.