Trisomy 9

Resident’s Name: Joanne Lewis Date: June 11, 2010

Article title: Dental Management of a Child With Trisomy 9 Mosaicism: A Case Report

Author(s): Moti Moskovitz, DMD, PhD, et al

Journal: Pediatric Dentistry – 28:3 2006

Type of Article: case report

Summary: Affected patients present with congenital heart disease, skeletal and genito-urinary anomalies, abnormal palmar creases, failure to thrive, hypotonia, and mental retardation. Facial/oral manifestations include upward-slanted eyes, small palpebral fissures, microphthalmos, broad base and prominent tip of the nose, low-set malformed ears, microcephaly, micrognathia, protruding upper lip, pouched cheeks, cleft lip/palate, narrow high-arched palate, small mouth, and down-turned mouth. Mosaicism for trisomy 9 predicts longer survival than non mosaic trisomy 9. The patient in this case report was born at 37 weeks gestation after an uncomplicated pregnancy to Ashkenazi Jewish parents who have 4 other healthy children. Facial dysmorphic features include: narrow high arched palate, short philtrum, low set ears. Oral findings include a supernumerary tooth, and opalescent color change in maxillary central incisors. Also, severe psychomotor retardation and short stature. The patient was treated at age 11 under GA, and again at age 13 under oral conscience sedation. Skeletal abnormalities and tendency to vomit were reasons to treat in a more upright position and to use constant suction during treatment.