Down syndrome: a risk factor for malocclusion severity?

Leandro Silva Marques,Carlos Eduardo Pinto Alcântara,Luciano José Pereira,Maria Letícia Ramos-Jorge

doi:10.1590/1807-3107bor-2015.vol29.0044

Abstract

The aims of the present study were to compare aspects related to malocclusion between individuals with Down syndrome (DS) and a control group, establish malocclusion severity, and identify determinant factors. A total of 120 individuals (60 with DS and 60 with no physical or mental impairment), were included in the study. Data were collected through interviews, analyses of the medical charts, and oral examinations. The criteria of the Dental Aesthetic Index were used for the diagnosis of malocclusion. Chi-square test (p ≤ 0.05) and multivariate logistic regression were used for comparisons between the two groups and to determine the association between the dependent (malocclusion severity) and independent variables. Statistically significant differences were found between the two groups for the following variables: missing teeth, diastema, overjet, mandibular protrusion, anterior open bite, posterior crossbite, facial type, lip incompetence, and Angle classification. DS, a history of premature birth, and long face pattern were found to be associated with malocclusion severity. Individuals with DS exhibited more occlusal problems than those in the control group.

Highlights

Prior to the assessment and diagnosis of malocclusion based on the criteria of the Dental Aesthetic Index (DAI), the orthodontist participated in a calibration exercise involving 12 individuals who did not belong to the main study and achieved high agreement values
Short face pattern and Angle Class III malocclusion were more frequent among the individuals with Down syndrome (DS), whereas long face pattern and Angle Class II malocclusion were more frequent among the individuals in the control group (Table 1)
Malocclusion severity was greater among the individuals with DS than among those in the control group (p = 0.028)

Summary

Introduction

Down syndrome (DS), known as Trisomy 21, is the most common chromosomal disorder in humans, affecting 1–2 individuals out of every 1000 live births.[1,2,3] Patients with this syndrome exhibit cognitive impairment as well as bone growth disorders and generalized muscle hypotonia.[4,5] oral health problems, such as inadequate oral hygiene, periodontal disease, caries, malocclusion, and tooth loss, are more prevalent in this group of individuals than in the general population.[6,7,8,9] Malocclusion, in particular, exerts a considerable negative impact on the quality of life, causing problems related to the performance of daily activities, such as speech, swallowing, and chewing, and discrimination based on physical appearance.[10,11]Patients with DS exhibit alterations such as an abnormal positioning of the tongue, craniofacial deformities (reduction in maxilla and mandible size, and narrow oropharynx), dental alterations (number and size of teeth), and muscle disorders.[12,13,14] All these factors contribute toward the development of transversal and vertical alterations in the occlusion, such.

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