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Scalioni FAR, Carrada CF, Tavares MC, Abreu LG, Ribeiro RA, Paiva SM. Oral health characteristics in children and adolescents with Down syndrome. SPECIAL CARE IN DENTISTRY 2024; 44:542-549. [PMID: 37271587 DOI: 10.1111/scd.12883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 04/26/2023] [Accepted: 05/20/2023] [Indexed: 06/06/2023]
Abstract
AIM To compare oral health indicators of children/adolescents with Down syndrome (DS) with a group of children/adolescents without DS. METHODS AND RESULTS This cross-sectional study included 144 individuals with DS, ages 4 to 18 years, matched for age and sex with a group of 144 individuals without DS, and their parents/caregivers. Parents/caregivers completed a questionnaire regarding sociodemographic information and habits related to their children's oral health. Clinical examination of the children/adolescents evaluated dental caries experience (DMFT/dmft), bleeding on periodontal probing, presence of visible plaque, clinical consequences of untreated dental caries (PUFA/pufa), and malocclusion (DAI). The chi-square test, linear by linear test, and Mann-Whitney test were used to compare the variables between the groups (p < .05). Children/adolescents without DS brushed their teeth more times per day (p < .001) and had a higher frequency of daily sugar intake (p < .001). The children/adolescents in the DS group had a greater presence of gingival bleeding (p < .001) and had a greater number of cases of "severe malocclusion" and "very severe malocclusion" (p = .001). No difference was found in the prevalence of dental caries between the two groups. CONCLUSION The children/adolescents in the DS group had a greater presence of gingival bleeding during the clinical examination and had a greater need for orthodontic treatment.
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Affiliation(s)
- Flávia Almeida Ribeiro Scalioni
- Department of Social and Pediatric Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Camila Faria Carrada
- Department of Pediatric Dentistry, School of Dentistry, School of Medical Sciences - SUPREMA, Juiz de Fora, Minas Gerais, Brazil
| | - Maisa Costa Tavares
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosangela Almeida Ribeiro
- Department of Social and Pediatric Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Syed Mohamed AMF, Wei TZ, Sean CJ, Rosli TI. Comparison of the malocclusion and orthodontic treatment needs of Down syndrome and non-syndromic subjects by using the dental aesthetics index. SPECIAL CARE IN DENTISTRY 2023; 43:554-560. [PMID: 36269010 DOI: 10.1111/scd.12790] [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: 08/29/2022] [Revised: 10/19/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the prevalence and significance of the malocclusion traits and orthodontic treatment needs of Down syndrome (DS) subjects with matched non-syndromic (NS) controls. METHODOLOGY This cross-sectional study involved 222 subjects (50% DS, 50% NS) who were matched by gender and age. The casts were digitized into three-dimensional images. These images were used alongside the ten occlusal characteristics of the Dental Aesthetic Index (DAI) to determine malocclusion severity and the need for orthodontic treatment. RESULTS There were 58 (52.3%) females and 53 (47.7%) males with a mean age of 18.4 ± 8.4 years in both groups. The most common and significant (p < .05) malocclusion traits among the DS subjects were missing teeth (56.2%), incisal spacing segments (73.0%), anterior maxillary irregularity (95.5%), mandibular overjet (36.0%), and full cusp deviation of the molar relationship (61.3%). On the other hand, increased maxillary overjet (69.3%) is a more significant (p < .05) trait amongst NS subjects. There were 85 (76.6%) DS subjects who presented severe malocclusion, which implies a highly orthodontic treatment need (DAI > 30). The DS showed some impact of malocclusion traits components of the DAI. CONCLUSION The occurrence of malocclusion was higher in DS, implying a higher need for orthodontic treatments than for NS subjects.
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Affiliation(s)
- Alizae Marny Fadzlin Syed Mohamed
- Discipline of Orthodontics, Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Tan Zhen Wei
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- T-Care Dental Clinic, Skudai, Johor, Malaysia
| | - Cheh Jing Sean
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Oasis Dentalcare Dental Clinic, Ipoh, Perak, Malaysia
| | - Tanti Irawati Rosli
- Discipline of Dental Public Health, Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Möhlhenrich SC, Schmidt P, Chhatwani S, Kniha K, Tsipkis A, Jackowski J, Schulte AG, Danesh G. Orofacial findings and orthodontic treatment conditions in patients with down syndrome - a retrospective investigation. Head Face Med 2023; 19:15. [PMID: 37149612 PMCID: PMC10163777 DOI: 10.1186/s13005-023-00362-5] [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: 02/14/2023] [Accepted: 04/24/2023] [Indexed: 05/08/2023] Open
Abstract
INTRODUCTION The most common chromosomal anomaly is Down syndrome/Trisomy 21, which can be associated with varying degrees of intellectual disability and physical malformation. Specific orofacial characteristics regarding orthodontic treatment options and features are described on the basis of a patient collective from the Witten/Herdecke University, Germany. METHODS Data of 20 patients (14 boys and 6 girls, mean age: 11.69 ± 3.94 years) who underwent orthodontic treatment between July 2011 and May 2022 were analyzed. Baseline skeletal and dental conditions were assessed, as well as the presence of hypodontia, displacements, and treatment-related root resorptions. The treatment need was evaluated based on the main findings according to the German KIG classification. In addition, treatment success was determined in relation to patient compliance. RESULTS The patient group was characterized predominantly by a class III relationship (ΔANB: -2.07 ± 3.90°; ΔWITS: -3.91 ± 4.33 mm) and a brachyfacial cranial configuration (ΔML-NL: -4.38 ± 7.05°, ΔArGoMe: - 8.45 ± 10.06°). The transversal discrepancy of the dental arch width from maxilla to mandible was -0.91 ± 3.44 mm anteriorly and -4.4 ± 4.12 mm posteriorly. Considering the orthodontic indication groups, the most frequent initial finding and treatment indication represented hypodontia (85%), followed by frontal (75%) and unilateral lateral (35%) crossbite. In 55% of the cases, the teeth had a regular shape, but in 35% a generalized and in 15% an isolated hypoplasia. Only 25% of the patients could be treated with a fixed multiband appliance due to sufficient cooperation. In each of these patients, varying degrees of root resorptions were detected during treatment, and 45% of all treatments had to be terminated prematurely due to a lack of cooperation by patients or parents. CONCLUSION The extent of dental and skeletal malformations and the high rate of findings requiring treatment in patients with Down syndrome represent a significant indication for orthodontic therapy, which can be well illustrated by the KIG classification. However, this is in contrast to the eventually increased risk of root resorption, with significantly reduced patient cooperation. A compromised treatment outcome and process must be expected. Consequently, the orthodontic treatment must be simple and realistic to achieve fast and therapeutically satisfactory treatment result.
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Affiliation(s)
| | - Peter Schmidt
- Department for Special Care Dentistry, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Sachin Chhatwani
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Alan Tsipkis
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Joachim Jackowski
- Department of Oral Surgery, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Andreas G Schulte
- Department for Special Care Dentistry, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Gholamreza Danesh
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
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Wintergerst A, López-Morales MP. Masticatory function in children with Down syndrome. Physiol Behav 2021; 235:113390. [PMID: 33736969 DOI: 10.1016/j.physbeh.2021.113390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/07/2021] [Accepted: 03/13/2021] [Indexed: 11/27/2022]
Abstract
The objective was to study masticatory function of 8 to 10-year-old children with Down syndrome (DS) through the evaluation of maximum occlusal force and masticatory performance (via medium particle size) and compare it to that of children of the same age without DS. METHODS A convenience sample of eight, 8-10-year-old children with DS were included in this cross-sectional study. The study had ethical approval and parents provided informed consent. Exclusion criteria were large carious lesions, dental pain or previous orthodontic/orthopedic treatment. Masticatory performance was evaluated with an artificial test food (Optosil Comfort®) after 20 cycles and at swallowing threshold. The chewed material was collected, dried and sieved. The material on each sieve was weighed; the weights were used to calculate medium particle size. Maximum occlusal force (1st permanent molars) was determined using the GM10 Nagano Keiki Co.™ portable transducer. The number of cycles until swallowing threshold, cycle and sequence durations were also compared. The data for the reference group (n = 32) came from a previous study in children of the same age. Descriptive statistics as well as comparisons with Mann-Whitney tests and simple and multiple regression analysis were performed. Cutoff was set at p≤.05. RESULTS Medium particle size is larger by 44% after 20 chewing cycles and 75% at swallowing threshold (p<.05) in children with DS. Median maximum occlusal force was 254 kN in DS children and 499 kN in children without the syndrome (p<.001). 48% of the variance in maximum occlusal force is explained by having DS. There were also significant differences in sequence and cycle durations. All significant differences had large effect sizes (˃1). Although the children with DS chewed more cycles before swallowing threshold the difference was not significant. CONCLUSIONS Children with DS have approximately 50% of the masticatory performance and maximum occlusal force of children of the same age without DS. These findings can be associated to the feeding problems reported in children with DS.
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Affiliation(s)
- Ana Wintergerst
- División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Av. Universidad 3000, Col. Universidad Nacional Autónoma de México, CP 04510 Ciudad de México, México.
| | - Marcela Patricia López-Morales
- División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Av. Universidad 3000, Col. Universidad Nacional Autónoma de México, CP 04510 Ciudad de México, México
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Doriguêtto PVT, Carrada CF, Scalioni FAR, Abreu LG, Devito KL, Paiva SM, Ribeiro RA. Malocclusion in children and adolescents with Down syndrome: A systematic review and meta-analysis. Int J Paediatr Dent 2019; 29:524-541. [PMID: 30834602 DOI: 10.1111/ipd.12491] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/13/2018] [Accepted: 01/10/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Previous studies have shown a high prevalence of malocclusion in people with Down syndrome (DS) compared to individuals without DS, but no systematic review to summarize the evidence on this topic has been performed thus far. AIM To evaluate whether children/adolescents with DS are more affected by malocclusion than those without DS. DESIGN A search was performed in seven electronic databases. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The strength of the evidence from the selected studies was evaluated by the Grading of Recommendations Assessment, Development and Evaluation system. RESULTS Eleven publications were included in the systematic review and eight were meta-analysed. The meta-analysis showed that malocclusion was more prevalent in children/adolescents with DS for Angle Class III (risk difference [RD] = 0.40; confidence interval [CI] = 0.33, 0.46), posterior crossbite (risk ratio [RR] = 3.09; CI = 2.02, 4.73), anterior crossbite (RR = 2.18; CI = 1.41, 3.39), and anterior open bite (RD = 0.21; CI = 0.06, 0.36). CONCLUSION The occurrence of malocclusion was higher in children/adolescents with DS compared to individuals without the syndrome. The strength of the evidence of the studies analysed, however, was considered moderate and low.
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Affiliation(s)
- Paulo Victor T Doriguêtto
- Department of Social and Paediatric Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Camila F Carrada
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Flávia A R Scalioni
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas G Abreu
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Karina L Devito
- Department of Dental Clinic, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Saul M Paiva
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Rosangela A Ribeiro
- Department of Social and Paediatric Dentistry, School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
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Scalioni F, Carrada CF, Abreu L, Ribeiro RA, Paiva SM. Perception of parents/caregivers on the oral health of children/adolescents with Down syndrome. SPECIAL CARE IN DENTISTRY 2018; 38:382-390. [DOI: 10.1111/scd.12321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 07/19/2018] [Accepted: 08/09/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Flávia Scalioni
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte MG Brazil
| | - Camila Faria Carrada
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte MG Brazil
| | - Lucas Abreu
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte MG Brazil
| | - Rosangela Almeida Ribeiro
- Department of Pediatric Dentistry; School of Dentistry; Universidade Federal de Juiz de Fora; Juiz de Fora MG Brazil
| | - Saul Martins Paiva
- Department of Pediatric Dentistry and Orthodontics; School of Dentistry; Universidade Federal de Minas Gerais; Belo Horizonte MG Brazil
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Javed F, Akram Z, Barillas AP, Kellesarian SV, Ahmed HB, Khan J, Almas K. Outcome of orthodontic palatal plate therapy for orofacial dysfunction in children with Down syndrome: A systematic review. Orthod Craniofac Res 2017; 21:20-26. [DOI: 10.1111/ocr.12211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 12/18/2022]
Affiliation(s)
- F. Javed
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - Z. Akram
- Faculty of Dentistry; Department of Periodontology; Ziauddin University; Karachi Pakistan
| | - A. P. Barillas
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - S. V. Kellesarian
- Department of General Dentistry; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | | | - J. Khan
- Department of Orofacial Pain and Temporomandibular Joint Disorders; Eastman Institute for Oral Health; University of Rochester; Rochester NY USA
| | - K. Almas
- Department of Preventive Dental Sciences; College of Dentistry; Imam Abdulrahman Bin Faisal University; Dammam Kingdom of Saudi Arabia
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