Anomalías dentó maxilares y factores asociados en niños con parálisis cerebral

Abstract

Dento-maxillary analysis and related factors in children with Cerebral PalsyBackground: Patients with cerebral palsy attending the Children Rehabilitation Institute (Teleton) at Santiago-Chile present open bite and oral disfunctions. Objective: Determine dento-maxillary anomalies related to cerebral palsy and factors associated to feeding, breathing and parafunctional habits. Method: Descriptive study including 80 children of both sex, between 4-12 years-old, with cerebral palsy. A revision of clinical files, extra and intraoral exams and a parents investigation was performed. Results: 83% of children have severe spastic tetraparesis. A high incidence of open bite incisors was found, long faces compatible with dolicofacial growing and labial incompetence. Associated to this facial biotype, mixed breathing with bucal predominance and absence of lateral movements were found in these children. The intermaxillary relation is type I and the Angle's classification is neutron occlusion. In relation to feeding habits, 50% of patiens with tetraparesis eat their food cut in very small pieces, whereas 60% with diplegia and hemiparesia eat their food in a normal way. The parafunctional habits were significant (47%). Conclusions: Cerebral palsy is an important condition in the development of a dento-maxillary disarmony, like open bite and dysfunctional sthomatognatic system. (Key words: Cerebral palsy, dysfunctional sthomatognatic system, parafunctional habits, dento-maxillary anomalies). Rev Chil Pediatr 2008; 79 (3): 272-280 RESUMEN Introducción: Los pacientes con parálisis cerebral atendidos en el Instituto de Rehabilitación Infantil de Santiago, presentan mordidas abiertas y disfunción oral. Objetivos: Determinar anomalías dento maxilares y relacionarlas con diagnóstico de parálisis cerebral y factores asociados de alimentación, respiración y hábitos parafuncionales. Pacientes y Método: Estudio descriptivo transversal, que incluyó revisión de fichas clínicas [2005][2006], examen extra e intraoral y encuesta a los padres de 80 niños, ambos sexos, con diagnóstico de parálisis cerebral entre 4 y 12 años de edad. Resultados: 83% de los niños, presentó ARTÍCULO ORIGINAL RESEARCH REPORT Rev Chil Pediatr 2008; 79 (3): 272-280

Factors associated with anterior open bite in children with developmental disabilities

“…The tongue stimulates the growth and development of the maxilla. If it does not come into contact with the palate, as a consequence, it has an atrophied palate (maxillary compression) and an increase in the open bite …”

“…Our results are similar to those found previously and the considerations about their consequences on atypical lingual positioning should be emphasized. Children with cerebral palsy are at risk of developing significant respiratory problems due to insufficient respiratory muscle strength .…”

“…Patients with cerebral palsy are more likely to have an anterior open bite when compared to individuals with mental disabilities or individuals with Down syndrome . Among these individuals, there are other causes for this problem, such as: thumb sucking, the use of pacifiers, the resting position of the head in hyperextension, atypical swallowing, and the child's neurological status . These factors play a role in the pressure of the tongue on the palate and in its interposition between the jaws during swallowing .…”

Anomalías dentales y su relación con la malnutrición en la primera infancia: un análisis crítico de literatura

“…Otros autores referenciaron que los niños con problemas de malnutrición por defecto a edad temprana presentaron alteraciones del esmalte desde el nacimiento, como dens in dente, agenesias, taurodontismo, macrodoncia, dientes en forma cónica, supernumerarios, microdoncias, transposiciones, fusiones, mesiodens, dientes retenidos e hipoplasia del esmalte [10,11,13,17].…”

“…Sobre la influencia de la desnutrición en el crecimiento y desarrollo craneofacial e intrabucal, muchos estudios afirman que este no es favorable, dado que puede causar cambios en el tejido estructural que pueden afectar el funcionamiento del aparato masticatorio [15][16][17][18][19][20]. Algunos autores han referido que los niños con desnutrición presentan hábitos de deglución atípica o deglución infantil, succión digital, respiración oral y uso del biberón en mayor porcentaje y frecuencia que los niños mejor nutridos [6,12,13].…”