1
|
Meng C, Le D, Wang X, Song Y, Song G. Orthodontic treatment of a patient with dentinogenesis imperfecta using a clear aligner system. J Am Dent Assoc 2024:S0002-8177(24)00074-6. [PMID: 38573273 DOI: 10.1016/j.adaj.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Orthodontic treatment for patients with dentinogenesis imperfecta (DGI) can be risky because of the fragility of their dental hard tissue. Although the Invisalign (Align Technology) clear aligner system should be a suitable orthodontic appliance for patients with DGI, to the authors' knowledge, there has been no related research. CASE DESCRIPTION A 28-year-old woman with DGI sought treatment with a 1 mm open bite, edge-to-edge occlusion of the central incisors, and a bilateral Class III cusp-to-cusp molar relationship. Invisalign was applied for her treatment, and after 3 and one-half years of orthodontic therapy, a normal overjet and overbite were achieved, accompanied by retraction of the lower lip as well as a bilateral Class I molar relationship. In addition, there was no iatrogenic injury to the patient's teeth. PRACTICAL IMPLICATIONS The Invisalign system may be a suitable orthodontic appliance for patients with DGI because clear aligners lessen the tensile stress to the teeth, decrease the number and area of bonds to the teeth, and offer protective effects through a full wrap of plastic that covers the crowns of the teeth.
Collapse
|
2
|
Prado HV, Teixeira SA, Rabello F, Vargas-Ferreira F, Borges-Oliveira AC, Abreu LG. Malocclusion in individuals with osteogenesis imperfecta: A systematic review and meta-analysis. Oral Dis 2020; 28:314-325. [PMID: 33222339 DOI: 10.1111/odi.13715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/28/2020] [Accepted: 10/30/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate whether individuals with osteogenesis imperfecta (OI) are more affected by malocclusion than individuals without OI. MATERIALS AND METHODS Searches in PubMed, Ovid, Web of Science, Scopus, Lilacs and gray literature were performed. Data extraction was conducted by two researchers. Risk of bias assessment employing the Newcastle-Ottawa Scale and meta-analysis were conducted. Results were provided with mean difference (MD), odds ratio (OR) and 95% confidence interval (CI). Strength of evidence was determined. RESULTS Six cross-sectional studies were included. In comparison with individuals without OI, the group with OI had 19.69-fold greater chance of exhibiting Angle Class III malocclusion (OR = 19.69, CI: 9.00-43.09) and presenting anterior crossbite greater (MD = 6.08, CI: 2.40-9.77). Individuals without OI had a significantly greater ANB angle (MD = 3.88, CI: 1.15-6.61) and SNA angle (MD = 2.11, CI: 0.24-3.98) in comparison with those with OI. No difference between groups was found for SNB (MD = -0.50, CI: -2.21 to 1.21) and open bite (MD = 0.98, CI: -0.29 to 2.25). Most studies included had moderate methodological quality. Strength of evidence was low or very low. CONCLUSIONS The occurrence of Angle Class III malocclusion and anterior crossbite was greater among individuals with OI compared to those without OI. These findings can assist stakeholders about the occlusal abnormalities affecting OI individuals.
Collapse
Affiliation(s)
- Heloisa Vieira Prado
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Suélen Alves Teixeira
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Flavia Rabello
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fabiana Vargas-Ferreira
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Borges-Oliveira
- Department of Dental Public Health, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
3
|
Kim DY, Baik U, Jeon JH. Osteogenesis imperfecta and combined orthodontics and orthognathic surgery: a case report on two siblings. J Korean Assoc Oral Maxillofac Surg 2020; 46:70-77. [PMID: 32158684 PMCID: PMC7049766 DOI: 10.5125/jkaoms.2020.46.1.70] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/23/2019] [Accepted: 09/11/2019] [Indexed: 11/25/2022] Open
Abstract
Osteogenesis imperfecta is a heterogeneous group of connective tissue diseases that is predominantly characterized by bone fragility and skeletal deformity. Two siblings with undiagnosed type I osteogenesis imperfecta underwent orthognathic surgery for the treatment of facial asymmetry and mandibular prognathism. The authors report two cases of combined orthodontics and orthognathic surgery in patients with type I osteogenesis imperfecta, mandibular prognathism, and facial asymmetry.
Collapse
Affiliation(s)
- Dong-Young Kim
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, Seoul, Korea
| | | | - Ju-Hong Jeon
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, Seoul, Korea
| |
Collapse
|
4
|
Abstract
Osteogenesis imperfecta (OI) is characterized by brittle bones, premature hearing loss, blue sclera, dental abnormalities, and short stature. Maxillofacial pathology is marked in many OI patients and includes a high incidence of class III malocclusion secondary to a retrusive maxilla relative to both the mandible and cranial base.Review of literature shows that most of the orthognathic surgeries performed in the setting of OI are double jaw surgeries, in the form of maxillary advancement and mandibular setback. However, severe maxillary hypoplasia is usually not correctable with single-stage maxillary advancement. Distraction osteogenesis (DO) is a technique that relies on the normal healing process that occurs between controlled, surgically osteotomized bone segments and it is a relatively widely used technique in modern management of craniofacial conditions.Distraction osteogenesis has been reported in only several patients with OI. There is only 1 previously documented case of maxillary distraction in the craniofacial literature. The authors present here the successful management of a patient with OI and severe class III malocclusion using LeFort I osteotomy and DO with an external rigid distractor.At 12 months follow-up, the patient had no complications and maintained stable maxillary position with normal occlusion, improvement of facial appearance, obstructive airway symptoms, speech, and chewing.This case serves to reinforce the safety and efficacy of DO in patients with OI. The authors did not significantly change our distraction protocol and did not have any complications, therefore the authors believe that DO should be the preferable treatment technique for severe malocclusion in OI patient population.
Collapse
|
5
|
Friedrich RE, Scheuer HA, Höltje W. The effect of bisphosphonate medication on orthodontics and orthognathic surgery in patients with osteogenesis imperfecta. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2019; 8:Doc06. [PMID: 31149556 PMCID: PMC6532328 DOI: 10.3205/iprs000132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Osteogenesis imperfecta (OI) is a genetic disease that primarily affects bone formation and metabolism. Craniofacial malformations belong to the broad spectrum of the OI phenotype. The introduction of bisphosphonate medications was intended to counteract the significant brittleness of the bones of OI patients. In connection with the application of bisphosphonates, drug-associated osteonecrosis of the jaw has become known as an undesirable effect of the therapeutically intended reduction of osteoclast activity. Originally, the pharmacological inhibition of bone loss was mainly used in oncological therapy. For some time now, osteoporosis has also been treated with substances that inhibit bone resorption. In OI, malposition of the jaws is relatively common, in particular retrognathia of the maxilla and progeny of the mandible. The literature discloses complications of orthognathic surgery in OI patients. Previous literature reviews suggest that bisphosphonate medication has no significant impact on the performance of and healing after oral surgery in OI patients. Materialandmethods: An essential prerequisite of a therapy adapted to the patient’s condition is the knowledge of the patient's medical history. This case report describes the orthodontic-surgical treatment of an OI patient and the treatment experience derived in dealing with the condition. The unusual circumstance of this case is that the patient had concealed both his underlying disease and his medication during the current treatment period. In addition, the relevant literature is evaluated for combining the keywords OI, orthodontic therapy, bisphosphonates, and orthognathic surgery. Results: Based on the literature and our own experience, it is concluded that orthodontic treatment with bisphosphonate medication can also be carried out in OI patients. However, considerably greater forces and longer time intervals should be scheduled for each treatment. Orthognathic surgery with bisphosphonate medication turned out to be uncomplicated in our own case, considering the underlying disease in the planning of surgical procedures. However, there have been very few reports of OI patients in whom orthodontic-surgical treatment of jaw malformation has been performed with bisphosphonate medication. Conclusion: Taking into account the reported experience of severe complications of orthognathic surgery, the multiple documented adjustments to the treatment strategy of OI patients should be taken seriously. The basic condition of therapy adapted to the disease is that the patient informs the practitioner in an appropriate manner about his or her state of health.
Collapse
Affiliation(s)
- Reinhard E Friedrich
- Department of Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | | | - Wolf Höltje
- Oral and Craniomaxillofacial Surgery, Klinikum Nord, Hamburg, Germany
| |
Collapse
|
6
|
Affiliation(s)
- Stephen A Sachs
- The New York Center for Orthognathic and Maxillofacial Surgery, State University of New York at Stony Brook, Hofstra North Shore-Long Island Jewish School of Medicine, 2001 Marcus Avenue, Lake Success, New York 11042, USA.
| |
Collapse
|
7
|
Combined treatment with laser sintering and zirconium: a case report of dentinogenesis imperfecta. Case Rep Dent 2013; 2013:745959. [PMID: 23533828 PMCID: PMC3606756 DOI: 10.1155/2013/745959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 02/09/2013] [Indexed: 11/28/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a heterogeneous disorder of connective tissue that manifests mainly as skeletal deformity and bone fragility. Dentinogenesis imperfecta (DI) is sometimes an accompanying symptom of OI. The treatment protocol of these patients varies according to the clinical appearance. The case report here describes complete mouth rehabilitation of an 18-year-old male patient with OI and DI using direct metal laser sintering (DMLS) technique of metal-ceramic restorations and zirconium all-ceramic crowns. DMLS is an additive metal fabrication technology that is simpler, more precise, and healthier than conventional manufacturing and can be remarkably cost effective. Moreover, the technique affords highly accurate production of fixed partial dentures with ideal marginal fit and excellent mechanical properties. The patient was treated using a multidisciplinary strategy that focused on controlling caries, protecting teeth from further wear, obtaining an appropriate vertical dimension, and providing soft tissue support to return the facial profile to a normal appearance using new technology in the field of prosthetics.
Collapse
|
8
|
|
9
|
Rosén A, Modig M, Larson O. Orthognathic bimaxillary surgery in two patients with osteogenesis imperfecta and a review of the literature. Int J Oral Maxillofac Surg 2011; 40:866-73. [PMID: 21459557 DOI: 10.1016/j.ijom.2011.02.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 01/07/2011] [Accepted: 02/22/2011] [Indexed: 10/18/2022]
Abstract
Orthognathic surgery in patients with osteogenesis imperfecta is rare. Most cases result in a successful outcome with stable and good occlusion. Two patients with, probably severe types III and IV, and malocclusion class III with retrognathic maxilla and prognathic mandible, were treated with orthodontic treatment and bimaxillary surgical correction. The surgical outcome and follow up are presented together with a review of published cases of orthognathic surgery in patients with different types of osteogenesis imperfecta. The authors conclude that it is possible to perform combined orthodontic and orthognathic surgery in patients with osteogenesis imperfecta despite the greater risk of complications. The treatments were successful with follow up times of 5-6 years.
Collapse
Affiliation(s)
- A Rosén
- Department of Dental Medicine, Division of Oral and Maxillofacial Surgery, Karolinska Institute, Huddinge, Sweden.
| | | | | |
Collapse
|
10
|
Tashima H, Wattanawong K, Ho CT, Wen-Ching-Ko E, Nguyen A, Lo LJ. Orthognathic surgery considerations for patients with undiagnosed type I osteogenesis imperfecta. J Oral Maxillofac Surg 2011; 69:2233-41. [PMID: 21398007 DOI: 10.1016/j.joms.2010.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 09/09/2010] [Accepted: 11/02/2010] [Indexed: 11/30/2022]
Abstract
PURPOSE This study reports the senior author's experience of orthognathic surgery in patients with prognathism and undiagnosed type I osteogenesis imperfecta and includes a review of the literature. PATIENTS AND METHODS Two patients with undiagnosed type I osteogenesis imperfecta underwent orthognathic surgery for correction of prognathism at Chang Gung Craniofacial Center, Taipei, Taiwan. The initial surgical plan was to perform 2-jaw orthognathic surgery in both patients. RESULTS The bone quality was found to be fragile during the operation, and the original plan was changed intraoperatively to 1-jaw mandibular surgery. Both operations were performed without complications, and wound healing progressed normally. Both the final facial profile and occlusal outcome were satisfactory in 1 patient, with mild relapse occurring in the second patient. CONCLUSIONS For patients with type I osteogenesis imperfecta, the orthognathic surgery plan should be simplified as much as possible. Prolonged intermaxillary fixation is recommended to facilitate bone union. Complications could possibly be avoided.
Collapse
Affiliation(s)
- Hiroki Tashima
- Department of Plastic and Reconstructive Surgery, Chang Gung University, Taipei, Taiwan
| | | | | | | | | | | |
Collapse
|
11
|
Muhney K, Campbell PR. Pediatric dental management of a patient with osteogenesis imperfecta and dentinogenesis imperfecta. SPECIAL CARE IN DENTISTRY 2011; 27:240-5. [DOI: 10.1111/j.1754-4505.2007.tb01757.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Millet C, Viennot S, Duprez JP. Case report: Rehabilitation of a child with dentinogenesis imperfecta and congenitally missing lateral incisors. Eur Arch Paediatr Dent 2010; 11:256-60. [PMID: 20932402 DOI: 10.1007/bf03262758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dentinogenesis imperfecta is one of the most common hereditary disorders of dentine formation. Opalescent teeth composed of irregularly formed and undemineralised dentine that obliterates pulp chambers and root canals characterize it. Complete-coverage crowns are usually the preferred restoration for patients with this condition. CASE REPORT A 9 year-old girl presented with dentinogenesis imperfecta, congenitally missing maxillary lateral incisors and maxillary right permanent second molar retention. TREATMENT The treatment comprised an initial approach to allow the correct eruption of the retained second molar. The use of low-fusion metal ceramic restorations comprised a second stage to improve the aesthetic appearance and decrease the risk of overload on teeth with limited value. FOLLOW-UP The patient has been recalled regularly and at the last visit, 10 years after initial prosthetic treatment, no problems or signs of complications have occurred. The patient is now aged 25 years and is still satisfied with the prosthetic rehabilitation. CONCLUSION This case illustrates the need for appropriate and timely restorative treatment to prevent deterioration of the dentition. This case will also demonstrate that low-fusion metal ceramic restoration is a viable esthetic treatment option for today's patients.
Collapse
Affiliation(s)
- C Millet
- Department of Prosthodontics School of Dentistry, University Lyon I, Faculté d'Odontologie, Rue Guillaume Paradin, 69372 Lyon Cedex 08, France.
| | | | | |
Collapse
|
13
|
Roh WJ, Kang SG, Kim SJ. Multidisciplinary approach for a patient with dentinogenesis imperfecta and anterior trauma. Am J Orthod Dentofacial Orthop 2010; 138:352-60. [DOI: 10.1016/j.ajodo.2008.12.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2008] [Revised: 12/01/2008] [Accepted: 12/01/2008] [Indexed: 10/19/2022]
|
14
|
Aizenbud D, Peled M, Figueroa AA. A combined orthodontic and surgical approach in osteogenesis imperfecta and severe Class III malocclusion: case report. J Oral Maxillofac Surg 2008; 66:1045-53. [PMID: 18423300 DOI: 10.1016/j.joms.2008.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Revised: 12/10/2007] [Accepted: 01/01/2008] [Indexed: 11/30/2022]
Affiliation(s)
- Dror Aizenbud
- Orthodontics and Craniofacial Center, Department of Oral and Dental Medicine, Rambam Medical Campus and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | | | | |
Collapse
|
15
|
Kamoun-Goldrat AS, Le Merrer MF. [Osteogenesis imperfecta and dentinogenesis imperfecta: diagnostic frontiers and importance in dentofacial orthopedics]. Orthod Fr 2007; 78:89-99. [PMID: 17580062 DOI: 10.1051/orthodfr:2007010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Osteogenesis imperfecta is a genetic disease that varies in severity and is characterized by fragile bones that fracture easily. Many extra-skeletal manifestations can be noted such as blue sclerotic markings, dentinogenesis imperfecta and impaired hearing or deafness. In most cases, an anomaly of collagen is the cause. It is usually accompanied by a specific Class III type cranio-facial morphology with open bite and increased incidence of impacted permanent molars. Orthodontists called upon to treat the dental aspects of this malady, should be careful to protect their patients against bacterial infection and hemorrhages, and to be well aware of the side affects that can be caused by the biophosphanates that constitute the basis of current medical treatment of osteogenesis imperfecta.
Collapse
Affiliation(s)
- Agnès S Kamoun-Goldrat
- Département d'Orthopédie Dento-Faciale, Faculté de Chirurgie Dentaire, Université Paris-Descartes, 1 rue Maurice Arnoux, 92120 Montrouge, France.
| | | |
Collapse
|
16
|
Huber MA. Osteogenesis imperfecta. ACTA ACUST UNITED AC 2007; 103:314-20. [PMID: 17223585 DOI: 10.1016/j.tripleo.2006.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Revised: 09/27/2006] [Accepted: 10/04/2006] [Indexed: 11/17/2022]
Abstract
Osteogenesis imperfecta is a relatively common hereditary connective tissue disorder characterized by bone fragility and fractures. Other frequently affected tissues include tendons, ligaments, skin, sclera, teeth, and middle and inner ear. Molecular studies have demonstrated that most cases result from mutations affecting the genes responsible for the formation of type 1 collagen. The phenotypic presentation varies from mild to lethal. Commonly observed dental abnormalities include dentinogenesis imperfecta and malocclusion. Medical therapies using bisphosphonates have resulted in reduced fracture risk and decreased bone pain. To date, no cases of bisphosphonate-associated osteonecrosis have been reported. With appropriate precautions, the patient with osteogenesis imperfecta can tolerate and benefit from the delivery of necessary dental care to control oral disease, improve function, and improve esthetics.
Collapse
Affiliation(s)
- Michaell A Huber
- Division of Oral Medicine, Department of Dental Diagnostic Science, University of Texas Health Science Center at San Antonio, Dental School, San Antonio, TX 78229, USA.
| |
Collapse
|
17
|
Binger T, Rücker M, Spitzer WJ. Dentofacial rehabilitation by osteodistraction, augmentation and implantation despite osteogenesis imperfecta. Int J Oral Maxillofac Surg 2006; 35:559-62. [PMID: 16520021 DOI: 10.1016/j.ijom.2006.01.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Revised: 10/18/2005] [Accepted: 01/19/2006] [Indexed: 11/21/2022]
Abstract
Osteogenesis imperfecta-- a heritable systemic disorder characterized by enhanced bone fragility-- is frequently associated with a Class III malocclusion and distinct dental disorders. This patient, suffering from a late form of osteogenesis imperfecta, displayed early loss of teeth and severe maxillary hypoplasia. Bone grafting of the alveolar ridge was assumed not to guarantee a neutral basal relation before dental implantation. Due to the risk of atypical fractures conventional orthognathic surgery was excluded in the atrophic maxilla. In contrast to a conventional Le Fort I osteotomy, osteodistraction of the maxilla can be performed omitting the precarious down-fracture procedure. Despite a lack of reports on this technique in patients with osteogenesis imperfecta, dysgnathia was corrected by osteodistraction of the upper jaw. The loss of teeth was treated by augmentation of the alveolar crest using autogenous bone from the iliac crest followed by placement of dental implants. Stable normocclusion of the implant-supported overdentures was achieved without any detectable relapse over 4 years. For the first time it has been demonstrated that advanced surgical techniques like osteodistraction, alveolar crest augmentation and dental implantation can successfully be combined for dentofacial rehabilitation even in patients suffering from osteogenesis imperfecta.
Collapse
Affiliation(s)
- T Binger
- Clinic for Oral and Maxillofacial Surgery, University Clinic of Saarland, D-66421 Homburg/Saar, Germany
| | | | | |
Collapse
|
18
|
Waltimo-Sirén J, Kolkka M, Pynnönen S, Kuurila K, Kaitila I, Kovero O. Craniofacial features in osteogenesis imperfecta: A cephalometric study. Am J Med Genet A 2005; 133A:142-50. [PMID: 15666304 DOI: 10.1002/ajmg.a.30523] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Osteogenesis imperfecta (OI) is a heterogeneous group of connective tissue diseases that mainly manifest as bone fragility and skeletal deformity. In most families it segregates as a dominant trait and results from mutations in type I collagen genes. In this study we analyzed the size and form of the bony structures in heads of 59 consecutive patients with OI types I, III, or IV (Sillence classification), using lateral radiographs. Paired controls were matched for gender and age. The purpose was to obtain baseline information of craniofacial development in OI patients that have not received bisphosphonate treatment. In OI type I we found smaller than normal linear measurements, indicating a general growth deficiency, but no remarkable craniofacial deformity. In OI types III and IV, the growth impairment was pronounced, and the craniofacial form was altered as a result of differential growth deficiency and bending of the skeletal head structures. We found strong support both for an abnormally ventral position of the sella region due to bending of the cranial base, and for a closing mandibular growth rotation. Vertical underdevelopment of the dentoalveolar structures and the condylar process were identified as the main reasons for the relative mandibular prognathism in OI. Despite of the widespread intervention with bisphosphonates, the facial growth impairment will probably remain characteristic for many OI patients, and their orthodontic treatment should be further developed.
Collapse
Affiliation(s)
- Janna Waltimo-Sirén
- Department of Pedodontics and Orthodontics, Institute of Dentistry, University of Helsinki, FIN-00014 Helsinki, Finland.
| | | | | | | | | | | |
Collapse
|