| 2. |
- Stavropoulos, Dimitrios, et al.
(author)
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Comparing patients with Apert and Crouzon syndromes--clinical features and cranio-maxillofacial surgical reconstruction.
- 2012
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In: Swedish dental journal. - 0347-9994. ; 36:1, s. 25-34
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Journal article (peer-reviewed)abstract
- Cranio-maxillofacial malformations, as seen in Crouzon and Apert syndromes, may impose an immense distress on both function and aesthetics of the person affected. The aims of this study were to describe and compare the main facial and intraoral features of patients with Apert and Crouzon syndromes, the clinical manifestations that may be present, additionally to the main syndromic traits, as well as the cranio-maxillofacial surgical treatment protocols followed.Twenty-three patients with Apert syndrome (6 males, 17 females), and 28 patients with Crouzon syndrome (20 males, 8 females) were evaluated for general medical aspects, craniofacial characteristics, dentoalveolar traits before and after the final orthognathic surgery, and types and timing of cranio-maxillofacial operations. Mental retardation, associated additional malformations, cleft palate, and extensive lateral palatal soft tissue swellings were more common in children with Apert syndrome. In both syndromes, clinical findings included concave profile, negative overjet, posterior crossbites, anterior openbite, and dental midline deviation, which were corrected in almost all cases with the final orthognathic surgery, with the exception of the lateral crossbites, including more than one tooth pair, which were persisting in about half of the cases. Cranial vault decompression and/or reshaping, midfacial and orbital advancement procedures, often in conjunction with a mandibular setback, were the most frequent cranio-maxillofacial operations performed. In conclusion, Apert syndrome is more asymmetric in nature and a more severe clinical entity than Crouzon syndrome. The syndromic dentofacial features of both conditions could be significantly improved after a series of surgical procedures in almost all cases with the exception of the posterior crossbites, with haIf of them persisting post-surgically.
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| 3. |
- Stavropoulos, Dimitrios, et al.
(author)
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Dental agenesis patterns in Crouzon syndrome
- 2011
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In: Swedish Dental Journal. - 0347-9994. ; 35:4, s. 195-201
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Journal article (peer-reviewed)abstract
- Dental agenesis may be present in an isolated familiar manner, or occur as a part of a syndrome.To date, this clinical trait seems to have been overlooked in patients with Crouzon syndrome.The aim of the present study was to investigate dental agenesis and dental agenesis patterns in a population of persons with Crouzon syndrome in Sweden. Serial panoramic radiographs of 26 individuals with Crouzon syndrome (20 males, 6 females) were examined.Third molars were excluded from the assessment. The prevalence of agenesis for at least one tooth was 42.3%. Each affected patient was found to have up to 5 missing teeth. Upper and lower second premolars were the most frequently congenitally missing teeth. Eleven dental agenesis patterns of the entire dentition were identified, as described by the tooth agenesis code (TAC). All patterns were unique and asymmetric,with only one exception, a symmetric pattern of the maxillary and mandibular second premolars. In conclusion, persons with Crouzon syndrome were found to have a high prevalence of dental agenesis and a remarkable variability of dental agenesis patterns. It is important to be aware of this clinical situation, especially when orthodontic treatment planning for these patients is performed as early as in the mixed dentition.
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| 4. |
- Trulsson, Ulrika, et al.
(author)
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Age dependence of compliance with orthodontic treatment in children with large overjet. An interview study.
- 2004
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In: Swedish dental journal. - 0347-9994. ; 28:2, s. 101-9
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Journal article (peer-reviewed)abstract
- Large overjet has been associated with an increased risk of trauma of the permanent maxillary incisors, especially before 10 years of age. The prevalence of an overjet of more than 6 mm in 10-year-old Swedish children is about 15%. To prevent trauma by reducing the overjet, this treatment be set in early in life. However, compliance with orthodontic treatment is a significant and well known problem and may be associated with the age of the patient. This study concerns children treated with an open activator with built in headgear (HG activator). The aim of treatment was to reduce the trauma risk in these patients as early as possible, and an objective of the study was to gain better knowledge of young children's (6-13 years of age) motivation for and response to correction of large overjet. In-depth interviews focusing on motivation were held with 18 children. Interviews were transcribed verbatim and analysed according to Grounded Theory, a qualitative method. The results indicate the importance of parental involvement for younger children's compliance. Older children seem to have a higher degree of internal motivation for treatment and less need for parental support for compliance with treatment. If treatment compliance can not be ensured through parents' wholehearted involvement and control it seems to be better to delay treatment until the child is older.
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