Dental management of a child with trisomy 9 mosaicism: a case report

This case report presents the dental management of a 13-year-old girl with mosaic trisomy 9. She had: (1) severe psychomotor retardation; (2) short stature; (3) progressive microcephaly; (4) flat feet; (5) genu valgum; and (6) severe kyphoscoliosis. Dysmorphic facial features included: (1) maxillary prognathism; (2) narrow high-arched palate; (3) short philtrum; (4) small low posterior dysplastic ears; and (5) down slanting palpebral fissures with right eye ptosis. The case report describes initial treatment under general anesthesia and further treatments using conscious sedation. Emphasis was placed on the need to adjust the treatment to patient's skeletal malformations and respiratory problems by adjusting her ability to sit in the dental chair in an upright position. Supernumerary premolars and opalescent changes of the maxillary incisors might be part of the clinical features related to trisomy 9 mosaic syndrome.