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PubMed This is a summary of 17 peer-reviewed journal articles Updated
Pediatric Dentistry

Dental Development and Facial Structure in Hallermann-Streiff Syndrome

At a Glance

Dental care for Hallermann-Streiff Syndrome is a long-term process requiring a team of specialists. Because the condition causes a small jaw and missing teeth, treatment involves ongoing orthodontics, jaw surgery, and often dental implants to build a functional and healthy smile into adulthood.

Managing the dental and facial structure in Hallermann-Streiff Syndrome (HSS) is often described as a “marathon.” Because HSS affects the growth of the skull and jaw bones, dental care is not just about teeth—it is about rebuilding the functional foundation of the mouth [1][2].

Understanding the Facial Framework

The distinctive facial structure of HSS is largely due to the way the jaw bones develop.

  • Micrognathia (Small Lower Jaw): The lower jaw is significantly smaller than average, which can lead to early feeding and breathing challenges [3][4].
  • Maxillary Atrophy (Small Upper Jaw): The upper jaw bone (maxilla) may also be underdeveloped. Over time, the bone that supports the teeth can become thin or “atrophied,” making traditional dental treatments more complex [1][5].
  • Malocclusion: Because the jaws do not line up correctly, the teeth often do not meet properly when the mouth is closed (malocclusion), which can affect chewing and speech [1][6].

Dental Anomalies in HSS

Children with HSS often have a unique dental landscape that requires early and ongoing attention from a pediatric dentist:

  • Natal Teeth: Some babies are born with teeth already present (natal teeth). These may need to be monitored or removed if they are loose or interfere with feeding [7].
  • Hypodontia (Missing Teeth): It is very common for children with HSS to be missing several permanent teeth [1].
  • Atypical Morphology: The teeth that do emerge may have unusual shapes, colors, or structures [6][3].

A Multidisciplinary Care Path

Because dental and jaw issues evolve as a child grows, care is provided by a coordinated team of specialists including orthodontists, oral surgeons, and prosthodontists (specialists in tooth replacement).

Early Childhood (Ages 0-5)

  • Feeding and Airway: The focus is on ensuring the child can eat effectively and breathe safely. Specialized bottles or feeding tubes may be used. Doctors will closely monitor jaw growth [8].
  • Monitoring Teeth: Natal teeth or uniquely shaped baby teeth are monitored and managed by a pediatric dentist to ensure proper chewing and speech development.

Childhood and Early Adolescence (Ages 6-15)

  • Orthodontics: Braces and other appliances are used to widen the palate, guide the teeth into the best possible positions, and prepare the jaws for future surgeries [9][10].
  • Genioplasty: This surgery may be performed to reshape or advance the chin, which can improve both the facial profile and the airway [11][12].

Late Adolescence and Adulthood (Ages 16+)

As your child reaches physical maturity and the jaw finishes growing, the focus shifts to long-term function and aesthetics:

  • Bone Augmentation: Because the jaw bones may be thin, surgeons may use bone grafting or “ridge preservation” techniques to build a stronger foundation for dental implants [13][14].
  • Implant-Supported Prostheses: For many adults with HSS, the best solution for missing teeth is a total implant-supported prosthesis. This involves placing titanium posts (implants) into the jaw bone to support a full set of permanent, artificial teeth [1][15].
  • Virtual Surgical Planning: Modern care often uses 3D computer modeling to plan these complex surgeries with high precision, improving the final result [16][17].

While this journey involves many steps and specialists, the goal is to provide your child with a smile that is both beautiful and fully functional for a lifetime.

Common questions in this guide

Will my baby with Hallermann-Streiff syndrome be born with teeth?
Some babies with HSS are born with teeth already present, known as natal teeth. A pediatric dentist will monitor these closely and may recommend removing them if they are loose or interfere with safe feeding.
What does maxillary atrophy mean for my child's dental care?
Maxillary atrophy refers to the underdevelopment and thinning of the upper jaw bone. This can affect how the upper and lower teeth align and often makes standard dental treatments more complex as a child grows.
Why do children with HSS need orthodontic treatment so early?
Because HSS affects jaw growth and tooth positioning, early orthodontic care helps widen the palate and guide emerging teeth. This early intervention is essential for preparing the jaw for future reconstructive surgeries.
Can adults with Hallermann-Streiff syndrome get dental implants?
Yes, many adults with HSS receive implant-supported prostheses to replace missing permanent teeth. However, because their jaw bones are often thin, they typically need bone grafting or augmentation procedures first to build a strong foundation for the implants.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.When should my child have their first visit with a pediatric dentist experienced in craniofacial syndromes?
  2. 2.Does my child have natal teeth that need to be monitored or removed to prevent choking?
  3. 3.How will the small size of the upper jaw (maxillary atrophy) impact my child's ability to eat and speak?
  4. 4.At what stage would you involve an orthodontist and an oral surgeon to plan for long-term jaw reconstruction?
  5. 5.Are dental implants an option for my child in the future, and what bone-building procedures might they need first?
  6. 6.Can we discuss a timeline for surgeries like genioplasty or orthognathic surgery as my child grows?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (17)
  1. 1

    Implant-Supported Maxillary and Mandibular Rehabilitation in a Patient With Hallermann-Streiff Syndrome.

    von Marttens A, Perilla A, Wen S, et al.

    The Journal of craniofacial surgery 2021; (32(1)):e20-e23 doi:10.1097/SCS.0000000000006832.

    PMID: 33186282
  2. 2

    Diagnosis, Early Care, and Treatment of Hallermann-Streiff Syndrome: A Review of the Literature.

    Godzieba A, Smektała T, Dowgierd K, et al.

    Pediatric annals 2021; (50(5)):e227-e231 doi:10.3928/19382359-20210415-01.

    PMID: 34044702
  3. 3

    Hallermann Streiff syndrome: Cranio-facial manifestations systematic review and report of two cases.

    Preudhomme R, Veyssiere A, Ambroise B, Benateau H

    Journal of stomatology, oral and maxillofacial surgery 2022; (123(4)):e219-e223 doi:10.1016/j.jormas.2021.11.002.

    PMID: 34800747
  4. 4

    Hallermann-Streiff Syndrome and Psychosis: A Case Report.

    Peacock T, Khokhar U, Murphy J, Murphy Z

    HCA healthcare journal of medicine 2022; (3(1)):29-33 doi:10.36518/2689-0216.1311.

    PMID: 37426871
  5. 5

    Zygomatic implants in the rehabilitation of severe maxillary atrophy: A retrospective study of 274 zygomatic implants with a mean follow-up period of 7.5 years.

    Felice P, Bonifazi L, Pistilli R, et al.

    International journal of oral implantology (Berlin, Germany) 2024; (17(4)):401-408.

    PMID: 39559940
  6. 6

    Comprehensive dental management in a Hallermann-Streiff syndrome patient with unusual radiographic appearance of teeth.

    Gungor OE, Nur BG, Yalcin H, et al.

    Nigerian journal of clinical practice 2015; (18(4)):559-62 doi:10.4103/1119-3077.156910.

    PMID: 25966733
  7. 7

    Hallermann-Streiff Syndrome in Concordant Monozygotic Twins With Congenital Cataracts, Exudative Retinal Detachments, and One Case of Corneal Perforation Requiring Keratoplasty.

    Sims DT, Mattson NR, Huang LC, et al.

    Cornea 2023; (42(7)):899-902 doi:10.1097/ICO.0000000000003286.

    PMID: 37088900
  8. 8

    Feeding and reflux in children after mandibular distraction osteogenesis for micrognathia: A systematic review.

    Breik O, Umapathysivam K, Tivey D, Anderson P

    International journal of pediatric otorhinolaryngology 2016; (85()):128-35.

    PMID: 27240511
  9. 9

    Combined orthodontic and surgical treatment for a patient with Hallermann-Streiff-Francois syndrome, severe obstructive sleep apnea, and history of antiresorptive medication.

    Sondeijker CFW, Apperloo RC, Kalaykova SI, et al.

    American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics 2021; (159(1)):97-107 doi:10.1016/j.ajodo.2019.06.026.

    PMID: 33189488
  10. 10

    Clinical efficacy of combined orthodontic and implant-supported prosthodontic treatment for dentition defects with dentofacial deformities.

    Yang J, Sheng H, Wei R

    Medicine 2026; (105(5)):e47506 doi:10.1097/MD.0000000000047506.

    PMID: 41630342
  11. 11

    Implant-Based Chin Augmentation Vs Osseous Genioplasty: A Systematic Review of Indications and Outcomes.

    Kauke-Navarro M, Knoedler L, Allam O, et al.

    Aesthetic surgery journal. Open forum 2025; (7()):ojaf048 doi:10.1093/asjof/ojaf048.

    PMID: 40666078
  12. 12

    Osseous genioplasty in conjunction with bimaxillary orthognathic surgery: a review of 262 consecutive cases.

    Posnick JC, Choi E, Chang RP

    International journal of oral and maxillofacial surgery 2016; (45(7)):904-13.

    PMID: 26972157
  13. 13

    Volumetric Evaluation of Alveolar Ridge Preservation Using Dense PTFE (d-PTFE) Membranes Intentionally Exposed to the Oral Cavity After Immediate Implant Placement-A Retrospective Study.

    Dayube URC, Asbi T, Formiga M, et al.

    Dentistry journal 2025; (13(2)) doi:10.3390/dj13020058.

    PMID: 39996932
  14. 14

    Advancements in dental implantology: The alveolar ridge split technique for enhanced osseointegration.

    Luo F, Mo Y, Jiang J, et al.

    Clinical implant dentistry and related research 2024; (26(5)):1012-1031 doi:10.1111/cid.13363.

    PMID: 39075020
  15. 15

    Prosthetic Oral Rehabilitation with CAD/CAM Suprastructures in Patients with Severe Tissue Deficits: A Case Series.

    Laurila M, Mäntynen P, Mauno J, Suojanen J

    Dentistry journal 2023; (11(12)) doi:10.3390/dj11120289.

    PMID: 38132427
  16. 16

    Modern Oncologic Maxillary Reconstruction.

    Morrison EJ, Matros E

    Plastic and reconstructive surgery 2024; (154(3)):601e-618e doi:10.1097/PRS.0000000000011476.

    PMID: 39196869
  17. 17

    Novel approach for treating challenging implant-borne maxillary dental rehabilitation cases of cleft lip and palate: a retrospective study.

    Rahlf B, Korn P, Zeller AN, et al.

    International journal of implant dentistry 2022; (8(1)):6 doi:10.1186/s40729-022-00401-x.

    PMID: 35106688

This page provides educational information about dental and facial development in Hallermann-Streiff Syndrome. Always consult your pediatric dentist and craniofacial care team for personalized treatment plans.

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