Dental development in Apert syndrome.

Abstract

Apert syndrome has been extensively studied and described. However, an area that has not been studied is the dental development of these individuals. The purpose of this study was to evaluate the development of the dentition and compare it with that of unaffected children. There appears to be clinical observations indicating delayed eruption of the permanent teeth in the Apert child. This retrospective study examined all Apert syndrome patients from four craniofacial centers who had a panoramic radiograph taken before the age of 16 years. Thirty-six individuals, 19 boys and 17 girls ranging in age from 4.1 to 15.8 (mean = 9.3) years were examined. The seven left mandibular permanent teeth, second molar to central incisor, were rated on an eight-stage scale (A-H) using methods described by Demirjian and Goldstein (1976). The stage of each tooth was converted to the corresponding numeric value, and then all seven values were added to obtain a dental maturity score, which corresponded to a dental age, based on the sample of 4500+ normal children of the Demirjian et al. study. The dental age and chronologic age were length of delay was also determined. Thirty-one of 36 individuals had a dental age lower than their chronologic age. Compared to the normal sample, the mean developmental dental delay was 0.96 years (p < .001). The range in delay was 0.5 years advanced to 2.9 years delayed. There was a positive correlation to increased age with greater delay in dental development (p < .05). Our study confirmed our clinical impressions: The results showed a mean developmental delay of 0.96 years, with a trend of increasing delay with increased age. This positive correlation found between increased age and increased delay parallels the general growth of Apert children, with a greater degree of delay as the child grows older.