Abstract
PurposeOro-facial manifestations of acromegaly are among the earliest signs of the disease and are reported by a significant number of patients at diagnosis. Despite this high prevalence of acromegaly oral manifestation, dentists do not play a pivotal role in acromegaly identification and diagnosis. The aim of our study was to evaluate the ability of dentists and orthodontists in the early recognition of the oro-facial manifestations of acromegaly.MethodsA telematic questionnaire was administered to dentists and orthodontists. The questionnaire included photos with facial and oral-dental details and lateral teleradiography of acromegaly patients (ACRO).ResultsThe study included 426 participants: 220 dentists and 206 orthodontists. Upon reviewing the photos, dentists most often observed mandibular prognathism and lips projection, while orthodontists also reported the impairment of relative soft tissue. Orthodontists, who usually use photos to document patients’ oral-facial characteristics, paid more attention to oral-facial impairment than dentists. During dental assessment, 90% of the participants usually evaluated tongue size and appearance, diastemas presence, and signs of sleep impairment (mainly orthodontists). Orthodontists were also more able to identify sella turcica enlargement at teleradiography. A total of 10.8% of the participants had ACRO as patients and 11.3% referred at least one patient for acromegaly suspicion.ConclusionThe study highlighted dentists’ strategic role in identifying ACRO. Increasing dentists’ awareness about acromegaly clinical issues may improve early diagnosis, potentially resulting in an increased quality of life and decreased mortality among ACRO.
Highlights
Is a multisystemic disease characterized by somatic changes, such as acral overgrowth, brow prominence, prognatism, macroglossia, enlargement of lips and nose, and a wide range of comorbidities, such as cardiovascular and metabolic manifestations [1,2,3,4]
The anatomical details of the face of an acromegaly patients (ACRO) that were most often perceived by the interviewees as a sign of an altered systemic condition were mandibular prognathism and the appearance of the lips
None of the dentists identified any of the acromegaly patients as affected by a systemic condition
Summary
Is a multisystemic disease characterized by somatic changes, such as acral overgrowth, brow prominence, prognatism, macroglossia, enlargement of lips and nose, and a wide range of comorbidities, such as cardiovascular and metabolic manifestations [1,2,3,4]. Facial dysmorphism and oro-dental alterations are among the most common and earliest manifestations of acromegaly [8,9,10]. The appearance of facial dysmorphisms can precede acromegaly diagnosis by up to 10 years [11]. Facial features of acromegaly patients (ACRO) include mandibular prognathism, development of supraorbital ridges and cheekbones, alteration in the size of the nose and ears, thickening of soft tissues and lips, and asymmetry of the face [2, 5, 12, 13]. Up to 80% of these patients present with oral characteristics, including mandibular growth (22–24%), bite impairment, such as a dental class III [2, 5, 8, 12, 14], dental malocclusion, dental diastema (40–43%) [2, 5, 8], and macroglossia (54–58%) [2, 8, 14], all of which may contribute to the development of obstructive sleep disorders [2, 8, 14]
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