Abstract

Objective. To quantify the severity of malocclusion and dental esthetic problems in untreated Down syndrome (DS) and untreated non-Down syndrome children age 8–14 years old using the PAR and ICON Indices. Materials and Methods. This retrospective study evaluated pretreatment study models, intraoral photographs, and panoramic radiographs of 30 Down syndrome and two groups of 30 non-Down syndrome patients (private practice and university clinic) age 8–14 years. The models were scored via PAR and ICON Indices, and descriptive characteristics such as Angle classification, missing or impacted teeth, crossbites, open bites, and other dental anomalies were recorded. Results. The DS group had significantly greater PAR and ICON scores, as well as 10 times more missing teeth than the non-DS group. The DS group possessed predominantly Class III malocclusions, with the presence of both anterior and posterior crossbites in a majority of the patients. The non-DS group had mostly Class I or II malocclusion with markedly fewer missing teeth and crossbites. The DS group also had more severe malocclusions based upon occlusal traits such as open bite and type of malocclusion. Conclusion. The DS group had very severe malocclusions, while the control group from the university clinic had more severe malocclusions than a control group from a private practice.

Highlights

  • Down syndrome (DS) was first described in 1866 by John Langdon Down and affects 1 in every 600–1000 live births; DS is the most common genetic cause of intellectual disabilities [1]

  • (2) Control group 1: subjects group were chosen from a pool of orthodontic patients in the same private office, age 8–14 years old with no significant medical history, no genetic malformations, no cleft lip or palate, and no previous surgery involving the head and neck

  • The peer assessment rating (PAR) index has been used as a tool to provide a single summary score for all the occlusal anomalies which may be found in a malocclusion

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Summary

Introduction

Down syndrome (DS) was first described in 1866 by John Langdon Down and affects 1 in every 600–1000 live births; DS is the most common genetic cause of intellectual disabilities [1]. Specific features of Down syndrome include reduced muscle tone, hypoplastic maxilla, compromised immune system, mouth breathing, mental impairment and malocclusion. These individuals display characteristic facial features, including oblique eye fissures, protruding tongue, Brushfields spots, a flat nasal bridge, and hypotonia [2]. Striking orofacial features in a DS patient are an underdeveloped midface, resulting in a flattened bridge of the nose and bones of the midface, and the appearance of a prognathic mandible, together causing Class III dental and skeletal relationships

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