Suspected cerebral gigantism diagnosed by dental examination

Cerebral gigantism is an overgrowth disorder that occurs from the prenatal stage through childhood and features such clinical symptoms as advanced bone age, macrocephaly, characteristic facial appearance, and learning difficulties. A 4-year 3-month-old girl was referred to our clinic for consultation regarding anterior crossbite and occlusal pain in the molar region. An intraoral examination showed that the mandible was considerably larger than the maxilla. The dental age of the entire dentition estimated from orthopantomogram images was approximately 1 year ahead of chronological age. Cephalometrics analysis demonstrated maxillary protrusion, prominent mandibular protrusion, and vertically severe short face. The size of maxilla was slightly small, whereas that of mandible was above the average. Since height and body weight were above the 97 percentile, the patient was referred to a pediatrician for a general examination prior to dental treatment and diagnosed with suspected cerebral gigantism. As for occlusal pain in the molar region, we considered that it was caused by excessive occlusal pressure. Following application of splinting and several adjustments, the pain gradually disappeared.