Occlusal disharmonies in trisomy G (Downs' syndrome, mongolism)

Craniofacial and Airway Morphology in Down Syndrome: A Cone Beam Computed Tomography Case Series Evaluation

Background: Down syndrome (DS) is a genetic condition characterized by an extra copy of chromosome 21, resulting in various physical and cognitive features. This study aimed to comprehensively analyze the dental and craniofacial morphology of individuals with DS using Cone Beam Computed Tomography (CBCT). Methods: Six individuals with DS, comprising five males and one female aged 17 to 35 years, underwent CBCT scanning. Radiographic assessments included dentition, occlusion, paranasal sinuses, airway, skull bones, and suture calcification. Linear and angular cephalometric measurements were performed, and airway analysis was conducted using Dolphin 3D imaging software v.11. Results: The study revealed prognathic maxilla in five patients, prognathic mandible in four, and bimaxillary protrusion in two. Dental findings included microdontia, enamel hypoplasia, and congenitally missing teeth, with maxillary and mandibular third molars most commonly absent. Sinus abnormalities, delayed suture closure, and cervical spine anomalies were also observed. Conclusion: These findings contribute to a deeper understanding of DS-related craniofacial characteristics and emphasize the importance of considering these morphometric features in clinical management strategies for individuals with DS. This study's limited sample size underscores the significance of radiographic assessment in planning interventions such as cosmetic reconstructions, prosthetic rehabilitation, or orthodontic treatment for individuals with DS.

Longitudinal maxillary growth in Down syndrome patients

OBJECTIVE

To assess maxillary growth in a sample of patients diagnosed with Down syndrome (DS).

MATERIALS AND METHODS

The sample comprised 47 subjects (25 boys, 22 girls) with DS. All patients had at least two radiographs that showed the cranial base. To obtain comparisons among age groups, the sample was divided into three groups: prepubescent (8-11 years old), pubescent (12-14 years old), and postpubescent (15-18 years old). A control group included 38 subjects without DS (22 boys, 16 girls) who were part of a longitudinal growth sample. Computerized cephalometric analysis was performed on all subjects, and cephalometric superimpositions were made. Two-way analysis of variance (ANOVA) was used to study the overall changes between groups. In addition, one-way ANOVA and the Duncan multiple-range test were used to analyze possible differences in the age groups.

RESULTS

Sagittal maxillary growth in DS patients was constant from the age of 8 to 18 years; there was an average increase of 0.12 mm/year, measured at the level of point A. In the vertical plane it grows at an average rate of 0.62 mm/year and 0.70 mm/year, measured at the level of the ANS and PNS, respectively.

CONCLUSIONS

The maxilla in the DS group shows hypoplasia in the vertical plane and the sagittal plane, and there was a mean deficit of almost 10 mm in the latter.

Orthognathic treatment for a patient with Class III malocclusion and surgically restricted mandible

This case report describes the orthodontic-surgical treatment of an adult with Down syndrome and a Class III skeletal malocclusion with posterior open bite, horizontal facial pattern, missing mandibular posterior teeth, and surgical restriction of the mandible.

Dental anomalies in patients with Down syndrome

The purpose of the present study was to evaluate the incidence of dental anomalies in Brazilian patients with Down syndrome. A sample with 49 panoramic x-rays of syndromic patients aged 3 to 33 years (22 male and 27 female) was used. The characteristics of dental anomalies were observed in the panoramic radiographs in both the primary and permanent dentition, according to the ICD (International Classification of Diseases). The corresponding tables and percentile analysis were elaborated. There was a high incidence of syndromic patients with different types of anomalies, such as taurodontism (50%), proven anodontia (20.2%), suspected anodontia (10.7%), conic teeth (8.3%) and impacted teeth (5.9%). In conclusion, patients with Down syndrome presented a high incidence of dental anomalies and, in most cases, the same individual presented more than one dental anomaly.

Tooth malalignments in Chilean children with Down syndrome

The present study analyzes the frequencies and types of anomalies in tooth alignment in a sample of 136 children with Down syndrome, 147 mentally-impaired individuals without Down syndrome, and 149 normal individuals. Patients with Down syndrome showed a higher frequency of malalignments in both the deciduous and permanent dentitions compared with the children in control groups. In the three groups studied, the frequency of malalignments was higher in the permanent than in the deciduous dentition. In the deciduous dentition, the frequency of malalignments in the three groups was similar in the maxilla and mandible, and in both boys and girls. In the permanent dentition, the frequency of malalignments was higher in Down and mentally-impaired girls without Down syndrome, while the frequency of malalignments in the mandible was only increased in mentally-impaired individuals who did not have Down syndrome. In the deciduous dentition, the Down group presented a higher frequency of malalignment in the upper central incisor, lateral incisor, and canine regions compared with the normal children. When comparing teeth of Down children with those of mentally-impaired individuals who did not have Down syndrome, differences in malalignment were observed only in upper central incisor and canine regions. In the permanent dentition, the Down group showed a higher number of tooth malalignments than the normals (13 out of 28 teeth). A comparison of Down with non-Down mentally-impaired individuals, revealed only 8 teeth out of 28 were different. The most frequent malalignments in the deciduous dentition in Down patients were mesiopalatal, mesiolingual, and mesiovestibular. In the permanent dentition, the most frequent malalignments were distopalatal or distolingual.

Treatment of anterior skeletal open-bite deformity

Two patients with severe skeletal anterior open-bite have been presented. Treatment of these patients was accomplished mainly by mandibular repositioning (Case 1 by orthodontic means and Case 2 by a combination of surgery and orthodontics) and by an orthodontic change in the mandibular occlusal plane. A review and a discussion of the cause of this deformity were presented.