Craniofacial features of children with spinal deformities (original) (raw)
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Orofacial characteristics of adolescents with diagnosed spinal disorders
Biomedizinische Technik/Biomedical Engineering, 2012
The objective of the current epidemiological study is to show the correlation of various postural abnormalities and spinal deformities and the clinically identifi able dentofacial anomalies by orthodontic examination. Twenty-three children with Scheuermann ' s disease [mean age: 14 years 8 months; standard deviation (SD): 1 year 8 months] and 28 with scoliosis (mean age: 14 years 7 months; SD: 2 years 3 months) participated in the study. Standardized orthodontic screening protocols were used to map the occlusal relations in the sagittal, vertical, and horizontal dimensions; the space relations of the maxillary and mandibular frontal segment; the temporomandibular joint (TMJ) status; and the facial asymmetries. Statistically signifi cant differences (p < 0.05) were found between the values of the examined groups of patients for the following measurements: incisal overjet and overbite, upper and lower midline deviation, mandibular frontal spacing, TMJ pathological symptoms and functional characteristics, and frequency of facial asymmetries. A large percentage of patients with pre-pubertal developments of spinal deformities have various dentofacial anomalies. The majority of these anomalies are present in patients with Scheuermann ' s disease. Early treatment of the malocclusions closely correlated to postural disorders should minimize the progression of the dentofacial anomalies, making necessary performing orthodontic screening of these patients as early as possible.
Craniofacial and Cervical Morphology Related to Sagittal Spinal Posture in Children and Adolescents
BioMed Research International, 2014
Studies on the relationship between body posture and craniofacial parameters often focus on the cervical spine. Thus, less attention has been paid to the morphology of the vertebra C2 that serves as both a structural and functional link between the craniofacial area and the other part of the spine. The objective of this study was to assess the relation of craniofacial features to certain morphological and positional characteristics of the cervical vertebrae and the spine during growth. We determined body posture indices for 69 children and adolescents by means of a radiation-free method (rasterstereography). The morphological and positional analysis of the craniofacial area and the cervical vertebrae was based on standardized lateral X-ray cephalograms. Medium to strong correlations were found between body posture, C2 morphology, and craniofacial parameters. We found significant correlations between the C2 dens axis height and maxillary indices as well as between the C2 dens axis inclination and cephalometrical values of the mandibular area. Similarly the correlation between the C2 dens axis inclination and the postural index flèche cervicale was highly significant ( < 0.05, = 0.333). These results suggest that morphological features of the odontoid process may serve as valuable predictive markers in interdisciplinary orthopedic-orthodontic diagnostics.
ORAL & implantology
The aim of this retrospective case-control study was to identify, in a group of growing children and adolescents affected by malocclusion, specific dento-skeletal characteristics which could be correlated to the onset, in the above-mentioned subjects, of craniomandibular disorders (CMD). Among the patients treated at the Paedodontics and Orthodontics department of Bari Dental School, we recruited a group of patients with malocclusion and symptoms of temporomandibular disorders, as an experimental group. We considered as controls those patients who, match-paired to their skeletal class depending on the ANB angle, did not show any CMD sign or symptom. Of the 128 examined patients, 15 showed signs and/or symptoms of CMD (11.7%). When compared to 15 patients non-affected by CMD, we could not detect statistically significant differences in both skeletal and occlusal characteristics. It is still interesting to notice how in CMD patients, characteristics of skeletal hyperdivergence are oft...
Occlusal patterns in patients with idiopathic scoliosis
American Journal of Orthodontics and Dentofacial Orthopedics, 2006
Introduction: Idiopathic scoliosis is an orthopedic condition characterized by faulty posture. It might also be associated with some mild forms of facial asymmetry or dental deviations. The aim of the study was to clinically examine the occlusions of patients with idiopathic scoliosis. Methods: Ninety-six consecutive orthopedic patients with idiopathic scoliosis were examined. The orthopedic data of this group were recorded from their hospital files. The occlusal features of a random group of 705 Ashkenazi children served as the control. Frequency distributions were compared with the chi-square test. Results: The distribution of the Angle classes of malocclusion was significantly different in the 2 groups (P ϭ .0001) because of many Class II subdivision patients in the orthopedic group. Other evidence of asymmetrical malocclusion was found in upper (P ϭ.002) and lower midline deviations (P ϭ.0001), and a higher frequency of anterior (P ϭ .024) and posterior (P ϭ.020) crossbites. In the experimental group, no association was found between site, side, or severity of scoliosis and the appearance or site of the malocclusion features examined. Conclusions: Patients with idiopathic scoliosis have asymmetric features of malocclusion compared with a random population. (Am J Orthod Dentofacial Orthop 2006;130:629-33) Clinical instructor,
Correlations between Malocclusion and Postural Anomalies in Children with Mixed Dentition
Journal of Functional Morphology and Kinesiology, 2019
The aim of this study was to investigate the possible relationship between malocclusion and body posture anomalies. The original sample involved 127 children (45 males and 82 females) with mixed dentition. Clinical examination of oral cavity was performed by an orthodontist, who recorded molar and canine relationship, cross-bite, lower middle-line deviation, and centric relation (CR) considering mono or bilateral contacts in CR. Orthopedic examination of the body posture was clinically carried out by an orthopedist who detected anomalies such as scoliosis, false scoliosis or paramorphism, kyphosis and lordosis. Of the 127 subjects of the sample, 18 children were orthopedically normal, 80 patients had false scoliosis, 22 scoliosis and 7 showed kyphosis. In our study, we don’t consider the 7 patients with kyphosis for the exiguity of the sample; so, our analysis was performed on 120 children (42 males and 78 females). The results obtained revealed that the cross-bite was more frequent...
Spine deviations and orthodontic treatment of asymmetric malocclusions in children
BMC Musculoskeletal Disorders, 2012
Background: The aim of this randomized clinical trial was to assess the effect of early orthodontic treatment for unilateral posterior cross bite in the late deciduous and early mixed dentition using orthopedic parameters. Methods: Early orthodontic treatment was performed by initial maxillary expansion and subsequent activator therapy (Münster treatment concept). The patient sample was initially comprised of 80 patients with unilateral posterior cross bite (mean age 7.3 years, SD 2.1 years). After randomization, 77 children attended the initial examination appointment (therapy = 37, control = 40); 31 children in the therapy group and 35 children in the control group were monitored at the follow-up examination (T2). The mean interval between T1 and T2 was 1.1 years (SD 0.2 years). Rasterstereography was used for back shape analysis at T1 and T2. Using the profile, the kyphotic and lordotic angle, the surface rotation, the lateral deviation, pelvic tilt and pelvic torsion, statistical differences at T1 and T2 between the therapy and control groups were calculated (t-test). Our working hypothesis was, that early orthodontic treatment can induce negative therapeutic changes in body posture through thoracic and lumbar position changes in preadolescents with uniltaral cross bite. Results: No clinically relevant differences between the control and the therapy groups at T1 and T2 were found for the parameters of kyphotic and lordotic angle, the surface rotation, lateral deviation, pelvic tilt, and pelvic torsion. Conclusions: Our working hypothesis was tested to be not correct (within the limitations of this study). This randomized clinical trial demonstrates that in a juvenile population with unilateral posterior cross bite the selected early orthodontic treatment protocol does not affect negatively the postural parameters.
Bilateral dentoalveolar asymmetries in female patients with adolescent idiopathic scoliosis
Acta of Bioengineering and Biomechanics
The aim of this cross-sectional research was to quantify left-right dentoalveolar fluctuating (FA) and directional asymmetries (DA) in patients with adolescent idiopathic scoliosis and to assess the relationship between these asymmetries and the side, location, and severity of scoliosis. Materials and methods: The study group comprised of 60 females aged 12-16 years, with idiopathic scoliosis, and 54 healthy controls. Measurements were made with the use of digital caliper on full-mouth dental casts. The following variables were measured from each subject: a shift of the incisor midline, left and right incisor overjet, deviation of canine and buccal segment relation as well as maxillary and mandibular arch chords. The data were statistically analyzed with significance taken as p < 0.05. Results: Statistically significant differences in the mean shift of the incisor midline, buccal segment relation on the left and canine deviation on the left between the control group and the study group were detected (p = 0.0419, p = 0.0.458 and p = 0.0204, respectively). FA of the midline deviation and canine deviation were statistically significantly higher for subjects with IS, compared to healthy controls (p = 0.0315 and p = 0.0415, respectively). Neither direction of the curve nor apical vertebra's location or apical translation significantly affected the magnitude of dentoalveolar asymmetries. Conclusions: Our results confirmed that bilateral asymmetries are a common feature of the young females' occlusion. Individuals with IS show higher tendency to Angle Class II malocclusion, as well as higher FA of incisor midline discrepancy and canine deviation, compared to the controls.
Pedicle morphometry in patients with adolescent idiopathic scoliosis
Indian Journal of Orthopaedics, 2010
Background: The key to the safe and effective use of thoracic pedicle screws in the deformed spine is to thoroughly understand pedicle anatomy. There are a few studies related to pedicle anatomy in the Indian population and no pedicle morphometric studies in scoliosis patients. The present study aims to highlight the differential features of pedicle morphometry, including pedicle width, transverse pedicle angle and the depth to anterior cortex on the concave and convex side, in a group of Indian patients with adolescent idiopathic scoliosis and compare this to that of a western population. Materials and Methods: This is a prospective study of 24 patients with adolescent idiopathic scoliosis. The average age is 14.6 years (12.3-18.3 years) of which 14 were females and 10 were males. All the patients underwent CT scan using Siemens 4 th generation scanner. The scans were analyzed by measuring the transverse pedicle width, transverse pedicle angle and the chord length; all the measurements being made both on the convex as well as the concave pedicle. Statistical analysis was performed with unpaired 't' test. Results: A total of 1295 measurements were performed from 24 patients and an average of 215 pedicles were assessed for each set of the measurements made. The transverse pedicle width was consistently found to be smaller on concave side in comparison with the convex side at all levels except at T1. The transverse pedicle angle was greater on the concave side at all levels as compared to the convex side, though there was wide individual variation. The depth to anterior cortex was lesser on convex side in comparison to the concave side except at T1. Conclusions: The concave pedicle is much thinner and directed more medially than the convex side, especially at the apical region of the scoliotic curve. The pedicle anatomy in scoliosis patients shows very high individual variations and a careful study of pre-operative CT scans is essential for planning proper pedicle screw placement. Slightly longer screws can be accommodated on the concave side as compared to the convex side, though the difference in the chord length is not statistically signifi cant at most levels.
Functional correlations between scoliosis and interdental occlusal disharmony
The Pain Clinic, 2005
The authors have analysed functional correlations between orthodontic occlusal disharmonies and postural and structural scoliosis. To diagnose scoliosis at an early stage, they performed electromyographic tests (EMGs) on two thousand 10-year-old children in order to screen them for occlusal disharmonies and establish whether these were correlated with different scoliotic curvature levels and/or degrees of positivity of the EMG tests. Based on their results, they were able to confirm such correlations in many of the children screened.