Orofacial Findings in Conjunction with Infantile Cerebral Paralysis in Adults of Two Different Age Groups – a Cross-sectional Study

Abstract

The objective of this cross-sectional study was to assess differentiated malocclusion symptoms and dental findings such as caries prevalence in patients suffering from infantile cerebral paralysis (CP, ICP), as well as the amount of dental and orthodontic treatment. Sixty-two patients suffering from infantile cerebral paralysis (ICP) aged from 18 to 78 years were included in the study and assigned to one of two groups according to age. The analysis was carried out on study models that had been measured using a caliper gauge and an electronic model-measuring procedure. Clinical caries status and sociological data were evaluated and statistically analyzed. While the group of older patients underwent no orthodontic treatment, we observed a statistically-significant increase in orthodontic treatment in the younger group with infantile cerebral paralysis. The model analysis revealed a mean overjet of 4.8 mm (SD+/-3.9 mm). There was a tendency toward open bite in terms of the vertical relation, with the mean overbite measuring 1.6 mm (+/-3.7 mm). Comparing the two age groups, we noted that greater age correlated significantly with reduced dental crowding symptoms in the lower jaw, contrary to the more common development of crowding in the normal population. The resulting value of the palatal height index was 40.8%, with no differences between the age groups. Compared to the index of 42.0% (according to the average data in the literature), those participating in this study and suffering from ICP had a flatter palatal vault. Our study parameter "dental intervention per year" revealed that 2/3 of the patients had three dentist appointments per year with no significant difference between the age groups. The ICP patients' mean DMF/T index value was 13.4, which appears to be generally lower than the published values concerning disabled persons in Germany and the healthy population. We observed an overall correlation between the frequency of malocclusions and severity of mental retardation. The amount of orthodontic treatment was significantly higher in the younger group (32.3%) than the older group (0%). In diagnostic terms, orthodontic treatment should follow the general guidelines, namely, the recommendation of removable devices as treatment appliances, and multidisciplinarily speaking, modified sequences of myofunctional therapy in consideration of the individual compliance prognosis and parental cooperation. In the multidisciplinary coordination of rehabilitation under general anesthesia, specific orthodontic measures may be undertaken (such as taking impressions, limited fixed appliance insertions, controlled extractions). An early treatment start in combination with the appropriate orthodontic device is desirable because of the improved, trainable reflex pattern. The dental therapy results are generally positive due to the fact that our patients met a tight dental recall schedule.