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Herrera S, Pierrat V, Kaminski M, Benhammou V, Marchand-Martin L, Morgan AS, Le Norcy E, Ancel PY, Germa A. Risk Factors for High-Arched Palate and Posterior Crossbite at the Age of 5 in Children Born Very Preterm: EPIPAGE-2 Cohort Study. Front Pediatr 2022; 10:784911. [PMID: 35498807 PMCID: PMC9051072 DOI: 10.3389/fped.2022.784911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Children born very preterm have an immature sucking reflex at birth and are exposed to neonatal care that can impede proper palate growth. OBJECTIVES We aimed to describe the frequency of high-arched palate and posterior crossbite at the age of 5 in children born very preterm and to identify their respective risk factors. METHODS Our study was based on the data from EPIPAGE-2, a French national prospective cohort study, and included 2,594 children born between 24- and 31-week gestation. Outcomes were high-arched palate and posterior crossbite. Multivariable models estimated by generalized estimation equations with multiple imputation were used to study the association between the potential risk factors studied and each outcome. RESULTS Overall, 8% of children born very preterm had a high-arched palate and 15% posterior crossbite. The odds of high-arched palate were increased for children with low gestational age (24-29 vs. 30-31 weeks of gestation) [adjusted odds ratio (aOR) 1.76, 95% confidence interval (CI) 1.17, 2.66], thumb-sucking habits at the age of 2 (aOR 1.53, 95% CI 1.03, 2.28), and cerebral palsy (aOR 2.18, 95% CI 1.28, 3.69). The odds of posterior crossbite were increased for children with pacifier-sucking habits at the age of 2 (aOR 1.75, 95% CI 1.30, 2.36). CONCLUSIONS Among very preterm children, low gestational age and cerebral palsy are the specific risk factors for a high-arched palate. High-arched palate and posterior crossbite share non-nutritive sucking habits as a common risk factor. The oro-facial growth of these children should be monitored.
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Affiliation(s)
- Sandra Herrera
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France
| | - Véronique Pierrat
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.,CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France
| | - Monique Kaminski
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France
| | - Valérie Benhammou
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France
| | - Laetitia Marchand-Martin
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France
| | - Andrei S Morgan
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.,Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, United Kingdom.,Department of Neonatal Medicine, Maternité Port-Royal, Paris, France
| | | | - Pierre-Yves Ancel
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.,Clinical Research Unit, Centre for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France
| | - Alice Germa
- Université de Paris, Epidemiology and Statistics Research Center/CRESS, INSERM, INRA, Paris, France.,Department of Odontology, APHP, Charles Foix Hospital, Ivry-sur-Seine, France
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Koberova R, Radochova V, Zemankova J, Ryskova L, Broukal Z, Merglova V. Evaluation of the risk factors of dental caries in children with very low birth weight and normal birth weight. BMC Oral Health 2021; 21:11. [PMID: 33413300 PMCID: PMC7789597 DOI: 10.1186/s12903-020-01372-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 12/16/2020] [Indexed: 11/28/2022] Open
Abstract
Background Health problems of premature infants can affect both general and oral health. The enamel defects, poor dietary and oral hygiene habits may predispose these children to dental caries. This study was conducted to assess the impact of very low birth weight and prematurity on caries risk in early childhood. Methods The study cohort consists of 189 of one year old infants. Anamnestic data were obtained from hospital records, feeding practice, bed-time sugar drinks and oral hygiene onset from questionnaires. Saliva samples of children and their mothers were collected for the detection of cariogenic pathogens. Results VLBW newborns had significantly shorter gestation age (29.6 vs. 38.8)) and lower mean birthweight (1124 g vs 3315 g) compared to NBW ones (p < 0.0001). Statistical significance has been found in the presence of early morbidity (p < 0.0001) and regular medication intake (p = 0.007). VLBW children got more frequently sweetened drinks during the day and night (p = 0.007). Regular oral hygiene practice was more frequent in full term group (p = 0.002). There was statistical difference in the presence of enamel hypoplasia in VLBW children (p = 0.033) but no statistical difference in the presence of hypomineralization (p = 0.0736) in comparison to NBW individuals. Proportional representation and count of S. mutans did not reveal statistical difference neither in both groups of children (p = 0.484) nor in both groups of mothers (p = 0.385). Conclusions The study confirmed anamnestic and medical differences between both groups. The proportional representation and count of S. mutans did not reveal statistical difference neither in VLBW and NBW children, nor in their mothers.
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Affiliation(s)
- Romana Koberova
- Department of Dentistry, Faculty of Medicine Charles University, University Hospital in Hradec Kralove, Sokolska 581, 50005, Hradec Králové, Czech Republic.
| | - Vladimira Radochova
- Department of Dentistry, Faculty of Medicine Charles University, University Hospital in Hradec Kralove, Sokolska 581, 50005, Hradec Králové, Czech Republic
| | - Jana Zemankova
- Department of Paediatrics, Faculty of Medicine Charles University, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Lenka Ryskova
- Department of Microbiology and Clinical Immunology, Faculty of Medicine Charles University, University Hospital in Hradec Kralove, Hradec Králové, Czech Republic
| | - Zdeněk Broukal
- Institute of Clinical and Experimental Dental Medicine, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Vlasta Merglova
- Depatrment of Dentistry, Faculty of Medicine Charles University, University Hospital in Pilsen, Pilsen, Czech Republic
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Identification of oral cavity abnormalities in pre-term and full-term newborns: a cross-sectional and comparative study. Eur Arch Paediatr Dent 2019; 21:581-586. [PMID: 31811584 DOI: 10.1007/s40368-019-00499-5] [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: 05/24/2019] [Accepted: 11/26/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Compare maxillary labial frenum and lingual frenum topography, the ridges relationship and oral inclusion cysts occurrence between pre-term (PT) and full-term newborns (FT). METHODS This cross-sectional and comparative study was conducted through the evaluation of 74 PT and 100 FT. Data were collected from medical records: mother age, gestational age, gender, height, weight, and delivery type. The variables were verified by Chi-square test and Mann-Whitney U test, at 5% significance level. RESULTS Bohn's nodules and dental lamina cysts were more frequent in FT (P = 0.000). Epstein pearls occurrence was similar between FT and PT (P = 0.243). The lower alveolar ridge in distal position to the upper one was more prevalent in both groups. Abnormal upper labial frenum anatomy had been observed in 10.0% of FT. Upper labial frenum was attached in piriform papilla in 90.5% of PTG, whereas in FT, 61.0% were attached from crest of alveolar ridge to mucogingival line. CONCLUSIONS PT oral cavity presented some peculiarities when compared with FT: maxillary labial frenum insertion in the Piriform papilla and palatal cysts more prevalent than alveolar cysts.
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Cortines AAO, Costa LR. Associated factors and persistence of palatal groove in preterm infants: a cohort study. BMC Pediatr 2016; 16:143. [PMID: 27558593 PMCID: PMC4995662 DOI: 10.1186/s12887-016-0671-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a lack of evidence on the relationship between prematurity and palatal abnormalities. The aim of this study was to evaluate the incidence of palatal groove, the associated factors and the persistence time in preterm infants from birth to 24 months of age. METHODS The children's data, medical history and eating habits were collected using a questionnaire answered by the legal guardian and updated every dental visit. Natal and neonatal data were obtained from the medical records. During the orofacial examination, the presence or absence of a palatal groove was observed. In order to evaluate for associations between independent variables and the palatal groove, descriptive analyses and bivariate analyses were conducted using the Mann-Whitney, Pearson's chi-squared and Fisher's exact tests, when appropriate. The Poisson regression analysis was used to determine risk and protective factors for the occurrence of palatal groove. The significance level was 0.05. For the persistence of palatal groove, a survival analysis was used (Kaplan Meier method). RESULTS Seventy-four preterm infants were monitored. Palatal groove occurred in n = 19 (25.7 %) and persisted for an average time of 12 months. Bivariate analysis showed a significantly higher occurrence of palatal groove in girls (68.4 % vs 40 % with non-occurrence of palatal groove) as well as in infants that stayed longer in the neonatal intensive care unit (NICU) (median 37 days vs 20 days), that did not have exclusive breastfeeding (94.7 % vs 69.1 %), were intubated (median five days vs one day) or used an orogastric tube (median 33 days vs 15 days). The quantitative data for 'NICU', 'intubation' and 'orogastric tube' were correlated and estimated as risk factors for palatal groove formation in the unadjusted Poisson regression analysis. CONCLUSIONS Palatal groove occur transiently in approximately one quarter of preterm infants, especially in infants that stay longer in the NICU, are intubated or use an orogastric tube.
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Affiliation(s)
| | - Luciane R Costa
- Faculty of Dentistry, Universidade Federal de Goias, Primeira Avenida, s/n, Setor Universitario, Goiania, Goias, 74605-220, Brazil.
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Germa A, Marret S, Thiriez G, Rousseau S, Hascoët JM, Paulsson-Björnsson L, Söderfeldt B, Ancel PY, Larroque B, Kaminski M, Nabet C. Neonatal factors associated with alteration of palatal morphology in very preterm children: the EPIPAGE cohort study. Early Hum Dev 2012; 88:413-20. [PMID: 22088785 DOI: 10.1016/j.earlhumdev.2011.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 09/14/2011] [Accepted: 10/01/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Altered palatal morphology has been observed among some preterm children, with possible consequences on chewing, speaking and esthetics, but determinants remain unknown. AIM To explore the role of neonatal characteristics and neuromotor dysfunction in alteration of palatal morphology at 5 years of age in very preterm children. STUDY DESIGN Prospective population-based cohort study. SUBJECTS 1711 children born between 22 and 32 weeks of gestation in 1997 or born between 22 and 26 weeks of gestation in 1998 were included in the study. They all had a medical examination at 5 years of age. OUTCOME MEASURES Alteration of palatal morphology. RESULTS The prevalence of altered palatal morphology was 3.7% in the overall sample, 5.1% among boys and 2.2% among girls (adj OR: 2.52; 95%CI: 1.44-4.42). The risk for altered palatal morphology was higher for lower gestational age (adj OR: 0.85; 95%CI: 0.74-0.97 per week), small-for-gestational age children (adj OR: 2.11; 95%CI: 1.20-3.72) or children intubated for more than 28 days (adj OR: 3.16; 95%CI: 1.11-8.98). Altered palatal morphology was more common in case of cerebral palsy or moderate neuromotor dysfunction assessed at 5 years. Results were basically the same when neuromotor dysfunction was taken into account, except for intubation. CONCLUSION Male sex, low gestational age, small-for-gestational age and long intubation have been identified as probable neonatal risk factors for alteration of palatal morphology at 5 years of age in very preterm children. Further studies are needed to confirm these results.
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Affiliation(s)
- Alice Germa
- Institut National de la Santé et de la Recherche Médicale Unit 953, Epidemiological Research Unit in Perinatal Health, Children and Women's Health, Villejuif, France.
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Nouette-Gaulain K, Lenfant F, Jacquet-Francillon D, Belbachir A, Bournigault-Nuquet A, Choquet O, Claisse A, Dujarric F, Francon D, Gentili M, Majoufre-Lefebvre C, Marciniack B, Péan D, Yavordios PG, Leone M. [French clinical guidelines for prevention of perianaesthetic dental injuries: long text]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2012; 31:213-23. [PMID: 22377414 DOI: 10.1016/j.annfar.2012.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Dental injuries represent the most common claims against the anaesthesiologists. Dental lesions are frequent complications of orotracheal intubation and major causal factors are, firstly, preexisting poor dentition, and, secondly, difficult laryngoscopy and tracheal intubation. The aim of this work was to prioritize propositions for prevention in perianaesthetic dental injury and for care in case of dental trauma. METHOD A GRADE consensus procedure consisting of three rounds was conducted. A purposively selected heterogeneous panel (n=15) of experts, comprising 10 practitioners in anesthesiology, one practitioner who is jurist and anaesthesiologist, two practitioners in maxillofacial surgery, and two practitioners in dentist surgery. In cases where the data did not appear conclusive, recommendations were based on the consensus opinion of the board members. The guidelines represent the best current evidence based on literature search and professional opinion. RESULTS The entire panel completed all three rounds and 31 plus six propositions were written for adult and paediatric clinical practice in anaesthesiology, respectively. The experts highlight the interest of preoperative visit for minimizing dental injuries: the practitioner must identify risk factors for difficult intubation and ventilation, describe precisely patient's preoperative dental condition, including upper incisor most commonly involved teeth in dental trauma. Patients have to be informed by practitioner for risk dental injury and anaesthesiology staff must choose his anesthesia protocol before the induction of intubation narcosis, avoiding insufficient anaesthesia and lack of experience by the anaesthesiologist. The choice of accurate proceeding during laryngoscopy, tracheal intubation and extubation for example, can aid in the prevention of dental injury, reduce the number of claims and the cost of litigation process. DISCUSSION These guidelines delineate an approach for the prevention of perianaesthetic dental trauma and for the immediate or urgent care in case of perianaesthetic dental injury.
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Affiliation(s)
- K Nouette-Gaulain
- Pôle d'anesthésie réanimation, service d'anesthésie-réanimation III, université Bordeaux-Segalen, hôpital des enfants, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France.
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Cohen-Levy J, Berdal A. [Twins: a response to the question of genetic/environmental influence on development?]. Orthod Fr 2007; 78:63-7. [PMID: 17571533 DOI: 10.1051/orthodfr:2007002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This article presents recent data about human twinning and explains how twin studies can bring precious informations about craniofacial growth. These natural experiences of growth phenomenon can give clues about genetic/environment interactions during development.
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Affiliation(s)
- Julia Cohen-Levy
- Faculté de chirurgie dentaire Université Paris VII, 5 rue GaranciBre, 75006 Paris, France.
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Wiechmann D, Meyer U, Büchter A. Success rate of mini- and micro-implants used for orthodontic anchorage: a prospective clinical study. Clin Oral Implants Res 2007; 18:263-7. [PMID: 17348892 DOI: 10.1111/j.1600-0501.2006.01325.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Whereas micro-implants have become a useful alternative as orthodontic anchorage elements in orthodontics, less is known about the clinical effectiveness of micro-implants. The aim of this prospective clinical study was to evaluate the success rate of micro-implants used for orthodontic anchorage. MATERIAL AND METHODS A total of 133 mini-implants (79 Abso Anchor, 54 Dual Top implants) placed in 49 patients to support orthodontic tooth movements were examined in the study. The majority of the implants were placed in the maxilla (82), followed by the vestibular (42) and lingual (nine) aspect of the mandible. RESULTS An overall cumulative survival rate of 86.8% (102/133) was found by Kaplan-Meier analysis. The failure rate between Dual Top implants (13%) and Abso Anchor implants (30.4%) differed significantly (P=0.0196; log-rank test). The cumulative failure rate of implants was found to be significantly higher when implants were placed in the lingual aspect of the mandible compared with the other localizations (P=0.0011; log-rank test). Clinical evaluation revealed successful dental movements when implants remained stable during the orthodontic therapy. CONCLUSIONS The present results confirm the effectiveness of orthodontic micro-implants used as anchorage elements.
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Affiliation(s)
- Dirk Wiechmann
- Department of Cranio-Maxillofacial Surgery, University of Münster, Münster, Germany
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