3-D Evaluation Of Dental Arches in syndromic craniosynostosis for better prognosis: IJD

A study has been published in the International Journal Of Dentistry establishing the main characteristic features of dental arches in individuals suffering from a condition known as craniosynostosis, which is characterized by the early closure of the craniomaxillary sutures. It may or may not be associated with the syndromes, i.e., Crouzon Syndrome & Apert Syndrome. Previous studies revealed that these syndromes are included in the autosomal dominant congenital anomalies occurring due to mutations in the genes, i.e., FRFR2/TWIST, present in the fibroblast growth factor receptor.

The presence of either or both the syndromes and craniosynostosis is noted to be syndromic craniosynostosis- with symptoms including midfacial retrusion, exorbitism, orbital anomalies, respiratory issues, anomalies associated with the shape of cranial bone & its extremities.

The current research compares the interdental dimensions between individuals with Apert (AS) & Crouzon Syndromes (CS) and non-syndromic individuals. It was carried out to find out the preventive & curative measures (Rehabilitative treatment) of craniofacial anomalies that included patients of both genders aged between 5-26 years. The study included two groups-the first group involved 34 patients with the respective syndromes ( AS - 18 & CS - 16) & the second group included non-syndromic individuals. Measurements of perimeter, length, intercanine & intermolar distances of the upper & lower arches, overjet, overbite, and molar relationship were recorded

The research revealed some novel facts:

Patients with syndromic craniosynostosis revealed highly compromised dental arches (both upper & lower).

The study confirmed the alteration in morphology of sphenoid bone & maxilla being the cause for retrusion of the face (middle) in both the syndromes.

Low postural tongue, mouth breathing, and class III dental malocclusion were the significant problems reported due to alteration in the morphology of maxillary growth.

Highly decreased perimeter value & length of upper & lower arch in patients with Apert Syndrome have been noted. The presence of overjet with anterior crossbite has been observed. Decreased value of perimeter & length of the upper arch in patients with Crouzon Syndrome, with no change in the size of the lower angle, has been observed.

On further comparative analysis between Apert Syndrome v/s Crouzon Syndrome, results revealed-Decreased perimeter value of the upper arch in patients with AS than CS and the presence of crossbite in AS & overjet and edge-to-edge bite in CS patients.

Based on the facial deformities, suggested rehabilitative treatment includes :

1. Intracranial decompression surgery & tracheostomy - after birth if compulsory

2. Frontofacial advancement & syndactyly correction - 6-12 months of age.

3. Palatoplasty - 1-2 years of age.

4. Monitoring of the development of dentition - 2-7 years of age.

5. Frontofacial advancement and orthodontic correction - 7-9 years of age.

The current study has established a clear picture of the maxillofacial dimensions associated with syndromic craniosynostosis and suggested a better understanding of changes occurring between the maxillary & mandibular dentition. This will help to find out the preventive steps at an early age that can be useful in handling these cases with a better prognosis.

For the full article, visit the given link below:

https://www.hindawi.com/journals/ijd/2023/1043369/

Source: International Journal Of Dentistry