title: A clinical multicenter study of orofacial features in 26 brazilian patients with different types of mucopolysaccharidosis.
abstract: This study aimed to describe the orofacial features of 26 unrelated Brazilian patients with mucopolysaccharidosis and to verify any possible associations between these findings and specific types of mucopolysaccharidosis.
  
  
  
  Patients were diagnosed with mucopolysaccharidosis and clinically evaluated. Following consent, a clinical assessment form was completed. Facial and intraoral examination was performed by evaluating facial pattern, malocclusions, dental caries, and tooth identification.
  
  
  
  Midface deficiency, increased lower facial third, anterior open bite, convex profile, macroglossia, gingival enlargement, and spaced arches were the most frequently observed features. These findings did not allow a differential diagnosis among the different types of mucopolysaccharidosis, except for pitting enamel, which significantly associated with mucopolysaccharidosis IVA (P < .001). Open bite was associated with mucopolysaccharidosis types I, II, III, and VI; however, only one patient with mucopolysaccharidosis IVA expressed this feature (P = .043).
  
  
  
  Our results suggest that pitted enamel in patients with mucopolysaccharidosis is most likely a feature of mucopolysaccharidosis type IVA; whereas, open bite is rarely observed in these patients. Orofacial features in mucopolysaccharidosis may help pediatric dentists recognize this disorder and minimize the delay between the initial signs/symptoms and diagnosis of the disease. Future studies should focus on the longitudinal manifestations, expression, and severity of mucopolysaccharidosis-associated orofacial anomalies.
authors.forename: Erlane Marques
authors.initials: EM
authors.lastname: Ribeiro
authors.forename: Cristiane S R
authors.initials: CS
authors.lastname: Fonteles
authors.forename: Adriana Bezerra
authors.initials: AB
authors.lastname: Freitas
authors.forename: Karla Shangela
authors.initials: KS
authors.lastname: da Silva Alves
authors.forename: André Jalles
authors.initials: AJ
authors.lastname: Monteiro
authors.forename: Carlos Antônio Bruno
authors.initials: CA
authors.lastname: da Silva
mesh_terms: D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009083:Mucopolysaccharidoses / Q000473:pathology*; D009057:Stomatognathic Diseases / Q000473:pathology*
keywords: glycosaminoglycans; malocclusions; metabolic disorders; mucopolysaccharidosis; orofacial abnormalities