Plagiocephaly and malocclusion

Abstract

The term plagiocephaly means oblique head. Most skull deformities are a result of intrapartum or utero molding but can be caused by congenital torticollis and after birth due to persistent head position of newborns staying in one head position for a long time and abusive use of strollers, car seats, car seats, swings. Its prevalence is growing fast, in 30 years it passes from 1 in each 300 babies in early nineties to 16 to 48 % in 2020. The aim of this paper is bringing the light to some serious conditions of treatment protocols in individuals with plagiocephaly. The skull deformity causes facial asymmetry that are not treatable by orthopedic or orthodontic intra or extra oral appliances, nor orthognathic surgery. Well, despite the fact that the patient or the tutors have to be notified of the facial asymmetry that persists, functional limitations will be presented. In more than 30 years of clinical experience treating these patients it was never sought the 4 first permanent molars and the 4 canines in the same Angle’s Class. In one side can be seen Class 1, but on the other it will be finding class 2 or class 3, the case reported exemplifies it, and the worst, mastication guidance will have to be very carefully done since, in most cases if it is tried to adjust the inferior and superior dental midline the vertical asymmetry of the occlusal plane (minimum vertical dimension) will worsen. Really there is no unique treatment protocol and it has to be considered case by case. It is time to deepen the knowledge in this area since the prevalence is growing. Based on the case reported, non-treated plagiocephaly can bring serious limitations to malocclusion treatment results. Further studies are necessary to a better understanding of the situation plagiocephaly versus malocclusion.