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. 2023 May 6;19(1):15.
doi: 10.1186/s13005-023-00362-5.

Orofacial findings and orthodontic treatment conditions in patients with down syndrome - a retrospective investigation

Stephan Christian Möhlhenrich  1 , Peter Schmidt  2 , Sachin Chhatwani  3 , Kristian Kniha  4 , Alan Tsipkis  3 , Joachim Jackowski  5 , Andreas G Schulte  2 , Gholamreza Danesh  3
Affiliations

Orofacial findings and orthodontic treatment conditions in patients with down syndrome - a retrospective investigation

Stephan Christian Möhlhenrich et al. Head Face Med. .

Abstract

Introduction: The most common chromosomal anomaly is Down syndrome/Trisomy 21, which can be associated with varying degrees of intellectual disability and physical malformation. Specific orofacial characteristics regarding orthodontic treatment options and features are described on the basis of a patient collective from the Witten/Herdecke University, Germany.

Methods: Data of 20 patients (14 boys and 6 girls, mean age: 11.69 ± 3.94 years) who underwent orthodontic treatment between July 2011 and May 2022 were analyzed. Baseline skeletal and dental conditions were assessed, as well as the presence of hypodontia, displacements, and treatment-related root resorptions. The treatment need was evaluated based on the main findings according to the German KIG classification. In addition, treatment success was determined in relation to patient compliance.

Results: The patient group was characterized predominantly by a class III relationship (ΔANB: -2.07 ± 3.90°; ΔWITS: -3.91 ± 4.33 mm) and a brachyfacial cranial configuration (ΔML-NL: -4.38 ± 7.05°, ΔArGoMe: - 8.45 ± 10.06°). The transversal discrepancy of the dental arch width from maxilla to mandible was -0.91 ± 3.44 mm anteriorly and -4.4 ± 4.12 mm posteriorly. Considering the orthodontic indication groups, the most frequent initial finding and treatment indication represented hypodontia (85%), followed by frontal (75%) and unilateral lateral (35%) crossbite. In 55% of the cases, the teeth had a regular shape, but in 35% a generalized and in 15% an isolated hypoplasia. Only 25% of the patients could be treated with a fixed multiband appliance due to sufficient cooperation. In each of these patients, varying degrees of root resorptions were detected during treatment, and 45% of all treatments had to be terminated prematurely due to a lack of cooperation by patients or parents.

Conclusion: The extent of dental and skeletal malformations and the high rate of findings requiring treatment in patients with Down syndrome represent a significant indication for orthodontic therapy, which can be well illustrated by the KIG classification. However, this is in contrast to the eventually increased risk of root resorption, with significantly reduced patient cooperation. A compromised treatment outcome and process must be expected. Consequently, the orthodontic treatment must be simple and realistic to achieve fast and therapeutically satisfactory treatment result.

Keywords: Down syndrome; Malocclusion; Orthodontic therapy; Orthodontic treatment need; Trisomy 21.

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Conflict of interest statement

Not applicable.

Figures

Fig. 1
Fig. 1
A) Percentage distribution of all orthodontic findings (100%) within the study group. B) Percentage distribution of individual orthodontic findings in relation to the study group (100%)
Fig. 2
Fig. 2
Treatment-related percentage distributions with regard to treatment goals, reasons for discontinuation, used treatment devices, and incidence of treatment-related root resorptions in 20 patients with a diagnosis of Down syndrome
Fig. 3
Fig. 3
Systematic illustration of the affected teeth concerning the occurrence of root resorptions and hypodontia in the study group
See this image and copyright information in PMC

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