Craniofacial morphological differences between Down syndrome and maxillary deficiency children

Abstract

Maxillary deficiency is one of the facial features of Down syndrome (DS). Differences in craniofacial morphology between DS and nonsyndromic skeletal Class III malocclusion with maxillary deficiency remain unclear. This study compared the craniofacial differences of white male children from Central-Western Brazil with DS (n = 30, mean age: 8 years 3 months), skeletal Class III profile with maxillary deficiency (n = 30, mean age: 7 years 9 months), and skeletal Class I profile (n = 30, mean age: 8 years 2 months), using lateral cephalometric radiographs. The differences among the three groups were compared with analysis of variance and Tukey's tests. The DS group showed reduced anterior cranial base (S-N, P < 0.001] and facial dimensions (Co-Gn, N-Me, N-ANS, and ANS-Me, P < 0.001), except in posterior dimensions (S-Go, P < 0.005; Ar-Go, P > 0.005). Maxillary length (Co-A, P < 0.001) and facial convexity (NAP, P < 0.005) were reduced when compared with the control group, although maxillary position to cranial base (SNA, P < 0.005) was within the normal range. A flattened cranial base (BaSN, P < 0.001) also contributed to differentiating DS from nonsyndromic groups. The group with maxillary deficiency showed a more unfavourable maxillomandibular relationship (MMD, P < 0.001) and a mandibular protrusion (SNB, P < 0.001). Subjects with DS differed from Class III with maxillary deficiency with respect to the flatter cranial base and reduced maxillary length. Maxillary deficiency was not so expressive in the face of DS subjects because of the overall reduction in craniofacial dimensions.

Malocclusion in children and adolescents with Down syndrome: A systematic review and meta‐analysis

“…The 11 articles included in this systematic review were cross‐sectional studies. The papers were from Norway, Saudi Arabia, Brazil, USA, Jordan, Mexico, Nigeria, Argentina, Denmark, and Canada . Publication dates ranged from 1985 to 2016 .…”

“…Among the included studies, seven recruited participants with DS from specialized centres, two sought participants through the public hospitals, one from private offices, and one study did not report selection process of the participants . In relation to the control group, four studies included participants recruited in regular schools, five studies approached students of dental colleges, one in private office, and two studies did not report how the selection was carried out …”

Skeletal Malocclusion: A Developmental Disorder With a Life-Long Morbidity

“…Facial features are usually characterized by small round face with pointed retrognathic chin giving it a triangular shape, a broad, wide tipped nose, shallow supraorbital ridge with drooping eyelids, and posteriorly angulated low set ears [62]. In the same vein, Down syndrome is a common genetic disorder that has a significantly higher risk for leukaemia [63] and is characterized with craniofacial dysmorphology and maxillary deficiencies [64]. These syndromic disorders indicate the need for significant research focussing on craniofacial anomalies and its relevance with leukaemia and lymphoma.…”

Facial analysis in Down's Syndrome patients

“…Considering those with orthodontic objectives, their own facial characteristics must be considered, so that the orthodontic goals are not mistaken. Jesuíno and Valadares Neto 20 verified that patients with Down Syndrome differed from patients with Class III malocclusion and maxillary deficiency, with regard to the base of the skull being flat and the length of the maxilla being reduced. However, this maxillary deficiency is not so expressive in the face of syndromic patients, due to the generalized reduction in craniofacial dimensions.…”