Citation: Meriem Nait Melek, Manel Chalbi, Wiem Zouaoui, Med Ali Chamli (2023). Dental Management in Children
with Incontinencia Pigmenti (Bloch-Sulzberger Syndrome): Case Reports and Literature Review. Saudi J Oral Dent Res,
8(10): 313-318.
313
Saudi Journal of Oral and Dental Research
Abbreviated Key Title: Saudi J Oral Dent Res
ISSN 2518-1300 (Print) | ISSN 2518-1297 (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: https://saudijournals.com
Case Report Pediatric Dentistry
Dental Management in Children with Incontinencia Pigmenti (Bloch-
Sulzberger Syndrome): Case Reports and Literature Review
Meriem Nait Melek
1*
, Manel Chalbi
2
, Wiem Zouaoui
1
, Med Ali Chamli
3
1
Resident, Pediatric Dentistry Department, Hospital La Rabta, Tunisia, Laboratory of Research ABCDF, Faculty of Dental Medicine
of Monastir, Tunisia
2
Assitant Professor, Pediatric Dentistry Department, Hospital La Rabta, Tunisia, Laboratory of Research ABCDF, Faculty of Dental
Medicine of Monastir, Tunisia
3
Professor, Pediatric Dentistry Department, Hospital La Rabta, Tunisia, Laboratory of Research ABCDF, Faculty of Dental Medicine
of Monastir, Tunisia
DOI: 10.36348/sjodr.2023.v08i10.002 | Received: 17.04.2023 | Accepted: 31.05.2023 | Published: 06.10.2023
*Corresponding author: Meriem Nait Melek
Resident, Pediatric Dentistry Department, Hospital La Rabta, Tunisia, Laboratory of Research ABCDF, Faculty of Dental Medicine of
Monastir, Tunisia
Abstract
Introduction: Incontinentia Pigmenti (IP) is a multisystem genodermatosis characterized by cutaneous, neurologic,
ophthalmologic, and dental abnormalities. Skin alterations are the main characterestic of IP. They can change and even
disappear over time, in contrast, dental ones are permanent and considered as the most frequent extra cutaneous signs.
The aim of this work is to present two rare clinical reports of Incontinentia Pigmenti and to adress its frequent orofacial
manifestations in the dental litterature. Case Reports: In this paper, we report two clinical cases of incontinencia pigmenti
in two female patients, five and nine years old, who were first examined by a dermatologist due to skin changes and then
referred to our pediatric dentistry department in la Rabta hospital for oral examination. We managed these cases in
collaboration with the pediatric department. We also conducted a research in the following electronic databases: PubMed
and google scholar using the following keywords: ("Incontinentia Pigmenti" AND "Child" AND "Tooth Abnormalities”),
from 2011 to 2021, to compare dental findings in our patients with literature. Discussion: The most representative dental
features of IP are: delayed tooth eruption, agenesis, high arched palate, peg like and malformed teeth, affecting both
primary and permanent teeth. Therapeutic management of our patients consisted in the replacement of absent teeth with
an aesthetic and functional space maintainer. The assessment of orofacial manifestations in Children with Bloch
Sulzberger syndrome indicates that it appears almost exclusively in females and is usually lethal in males. The clinical
expression of this disease found in our patients reflects the Data reported in the literature. The latter showed that the
presence of symptoms other than skin changes is important if dermatological signs are subtle, which is in accordance
with both our patients’ clinical expression. The most relevant finding of this review is the observation that most IP
patients with odontological findings had the congenital absence of six or more teeth opposed to our second patient who
had only one absent tooth. Conclusions: Incontinencia pigmenti is of a good prognosis but it may affect patients' quality
of life hence the importance of knowing this syndrom and its oro-facial characteristics in order to obtain a correct
diagnosis and apply an appropriate approach treatment.
Keywords: Bloch-sulzberger, rare syndrom, dermatologic, oral manifestations, dental, management.
Copyright © 2023 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.
INTRODUCTION
Incontinentia Pigmenti (IP), also known as «
Bloch-sulzberger » disease, is an X-linked dominant
syndrom predominantly affecting females and lethal in
males because of x-chromosome dizygosity and
negative selection of cells carrying the mutant x
chromosome.
It’s a rare genodermatosis with an incidence of
0.7 per 100.000 births [1, 2].
This multisystem disease is characterized by
cutaneous, neurologic, ophthalmologic and dental
abnormalities. Skin alterations are the main
characterestic of IP. These manifestations can change