A multicenter approach on dento-osseous anomalies in familial adenomatous polyposis

Abstract

<h3>Objectives</h3> Familial adenomatous polyposis (FAP) is a hereditary disorder characterized by early and unremitting development of intestinal polyps and extraintestinal manifestations requiring multidisciplinary screening and surveillance. Herein we describe a multicenter cross-sectional analysis of the dento-osseous radiographic findings of patients with FAP from South and North America. <h3>Study design</h3> Both cohorts included individuals diagnosed with FAP by standard clinical criteria. Subjects were paired with age- and gender-matched, healthy, non-FAP controls. Dental panoramic radiographs (DPR) of both cohorts, children and adults, were examined. <h3>Results</h3> Of 114 DPRs, 38 were from patients with FAP, composed of Group I (n=22), Group II (n=16), and 76 matched controls. Evaluators had excellent agreement on key findings (ICC=0.89). The prevalence of osseous anomalies was higher in FAP adults (75%), with mean age 35.3 years, than in children (65.4%). We found a high prevalence of multiple areas of idiopathic osteosclerosis (68.4%), a novel observation in the FAP population. Dental alterations such as odontomas and supernumerary teeth were more frequent in FAP children (mean age 13.5 years), with a prevalence of 15.4%. <h3>Conclusions</h3> We described important and significant differences in the prevalence of dento-osseous and dental anomalies in children compared with adult FAP patients. These findings should be considered with caution. The presence of these abnormalities in pediatric dental patients, even if not diagnosed with FAP, should be borne in mind as possibly indicating <i>de novo</i> or unrecognized disease. We recommend that dental examination and radiographic follow-up of FAP children in the mixed dentition (9 years old and older) and adults should be adopted as part of the surveillance protocol for FAP patients. <b>Statement of Ethical Review</b> Human/Animal subjects were used and this study was approved by an institutional ethics panel