Craniofacial features as assessed by lateral cephalometric measurements in children with Down syndrome.

Veerasathpurush Allareddy,Richard Brunn,Eric A Macklin,Dennis Rosen,Gil Weintraub,Lauren Voelz,Nicholas Ching,Brian G Skotko,Emily Davidson,Lisa Albers Prock

doi:10.1186/s40510-016-0148-7

Abstract

ObjectiveThe objective of the present study is to examine the craniofacial development of patients with Down syndrome (DS) and compare them with a neurotypical population.MethodsThis study is a cross-sectional analysis of lateral cephalometric radiographs of participants with DS. The study population consisted of children and young adults with DS aged 3–25 years. Cephalometric data were summarized by age and sex. Raw and normalized z-scores were computed. One-sample t tests were used to test whether mean z-scores differed from zero. The demographic characteristics between those with or without lateral cephalograms among all study participants were compared by Fisher’s exact tests.ResultsThe study sample comprised of 27 participants with DS. Study subjects demonstrated a class III skeletal pattern. This was more pronounced in the older age groups as compared to younger age groups. Subjects also had an increased proportionate lower anterior face height to total facial height compared to normative standards. Gonial angles, mandibular plane angles, and airway measurements increased with age.ConclusionsPatients with Down syndrome present typically with class III skeletal pattern and long lower anterior facial heights. In patients with Down syndrome, comprehensive phase of orthodontic treatment may be best initiated following cessation of growth.

Highlights

Down syndrome (DS) is a chromosomal condition occurring in about 1 in every 792 live births [1, 2]
A total of 130 participants enrolled in the larger study, among whom a dental examination was completed on 69 participants, and 27 of these patients were able to have a lateral cephalometric radiograph exposed
Apart from the primary outcomes, our study documented more than 50 other different craniofacial cephalometric measurements for which no normative standards are currently available

Summary

Introduction

Down syndrome (DS) is a chromosomal condition occurring in about 1 in every 792 live births [1, 2]. Multiple prior reports have described the craniofacial morphological features of DS [3–12], which include a short and flat cranial base, maxillary hypoplasia, midface retrusion, skeletal class III pattern, variations in mandible (including normal or reduced gonial angle; normal, retruded, or prognathic mandible; and variations in mandibular plane angle), skeletal anterior open bites, long lower anterior facial heights, and proclination of maxillary and mandibular incisors. Whether the maxillary hypoplasia is due to reduction in overall dimensions of the head is unclear and has not been well described in previous studies. The objective of the present study is to examine the craniofacial development of patients with DS and compare them with a neurotypical population obtained from the Iowa longitudinal growth study. This study tests the hypothesis that individuals with DS demonstrate a different craniofacial pattern, measurable on a lateral cephalometric radiograph, when compared to neurotypical controls

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Results

Conclusion