François Côme Ferré , 1 , 2 , 3 , 4 , Michael Frank 5 , Bruno Gogly 1 , 2 , 3 , 4 , Lisa Golmard 5 , Adrien Naveau 1 , 2 , 3 , 4 , Hafida Chérifi 1 , 2 , 3 , 4 , Joseph Emmerich 5 , 6 , Frédérick Gaultier 1 , Ariane Berdal 2 , 3 , 4 , Xavier Jeunemaitre 5 , 7 , Benjamin P J Fournier 1 , 2 , 3 , 4
5 April 2012
Vascular Ehlers–Danlos syndrome (vEDS) is a rare genetic condition related to mutations in the COL3A1 gene, responsible of vascular, digestive and uterine accidents. Difficulty of clinical diagnosis has led to the design of diagnostic criteria, summarised in the Villefranche classification. The goal was to assess oral features of vEDS. Gingival recession is the only oral sign recognised as a minor diagnostic criterion. The authors aimed to check this assumption since bibliographical search related to gingival recession in vEDS proved scarce.
17 consecutive patients with genetically proven vEDS, aged 19–55 years, were compared with 46 age- and sex-matched controls.
Complete oral examination (clinical and radiological) with standardised assessment of periodontal structure, temporomandibular joint function and dental characteristics were performed. COL3A1 mutations were identified by direct sequencing of genomic or complementary DNA.
Prevalence of gingival recession was low among patients with vEDS, as for periodontitis. Conversely, patients showed marked gingival fragility, temporomandibular disorders, dentin formation defects, molar root fusion and increased root length. After logistic regression, three variables remained significantly associated to vEDS. These variables were integrated in a diagnostic oral score with 87.5% and 97% sensitivity and specificity, respectively.
Prevalence of gingival recession and periodontitis was low among patients with vEDS.
Conversely, patients showed marked gingival fragility, temporomandibular joint disorders, dentin formation defects, molar root fusion and increased root length.
Several new specific oral signs of this disease were identified, whose combination may be of greater diagnostic value.