Occlusal Relations in Patients With Scaphocephaly

Abstract

Scaphocephaly results from a premature fusion of the sagittal suture. Usually, cranial vault corrective surgery is performed during the first year of life. There is currently no scientific data regarding occlusion of scaphocephalic patients, or the potential effect of craniovault surgery on the occlusion. The aims were to describe occlusion in scaphocephalic patients and compare with a general pediatric population, and to compare the difference in occlusion of surgically versus unoperated treated scaphocephalic subgroup. A total of 91 scaphocephalic patients (71 boys aged between 2 and 11 y) seen at the Craniofacial Clinic of CHU Ste-Justine's formed the experimental group. All patients received an orthodontic assessment. Among them, 44 underwent craniovault surgery, whereas 47 remained unoperated. Thirty-eight (33 boys; 17 operated) had lateral cephalometric radiographies, some of them also had cephalometric growth follow-ups. Clinical values for dental classification and overjet indicate an increased prevalence of class II malocclusions in scaphocephalic patients. However, interestingly enough, cephalometric values indicative of skeletal class II malocclusions (ie, N-A perp HP, N-B perp HP, N-Pog perp HP, Wits, N-A-Pog) remained within normal limits. Some cephalometric values present statistically significant differences between operated and unoperated patients (ANS-PNS t2, P = 0.025; /1-FH t2, P = 0.028), but these are individual variations not related to scaphocephaly. Maxillary width of scaphocephalic children remains within normal limits. Scaphocephalic patients clinically presented more class II malocclusions compared with normal children. Radiographic values remain, however, within normal limits for both anteroposterior and transverse dimensions. Corrective craniovault surgery did not affect occlusion in these patients.

Facial asymmetry in children with either unilateral lambdoid craniosynostosis or positional posterior plagiocephaly

“…Children affected with non‐syndromic single suture synostosis show maxillary asymmetry, class II occlusion and occlusal canting 28–30 . Scaphocephalic craniosynostosis results in retrognathic mandibles, labially inclined lower incisors and slightly more cross‐bite occlusion than the normal population 31,32 …”

“…[28][29][30] Scaphocephalic craniosynostosis results in retrognathic mandibles, labially inclined lower incisors and slightly more cross-bite occlusion than the normal population. 31,32 Posterior plagiocephaly causes asymmetry of the cranium, cranial base, maxilla and mandibula, and it may also cause dental occlusal problems. Presumptions that plagiocephaly influences the jaws and dental occlusion are based on the fact that plagiocephaly has asymmetric effects on the cranial base and, consequently, on the glenoid fossa.…”

Dental Age, Agenesis, and Morphology in Patients With Operated Single-Suture Craniosynostoses

“…Patients with isolated craniosynostosis require multidisciplinary care for treating the craniosynostosis itself and the other health issues these patients may present with (Vargervik et al, 2012). Dental and orthodontic care should be considered important in patients with isolated craniosynostosis, with studies revealing possible increased need for care in the dentition and occlusion (Mustafa et al, 2001; Dalben et al, 2006; Pelo et al, 2011; Heliövaara et al, 2015; Lebuis et al, 2015). Studies have reported higher decayed, missing, or filled teeth and plaque scores in patients with craniosynostosis, putting more pressure on delivering enhanced dental follow-up programs and aiding in achieving proper oral hygiene (Mustafa et al, 2001; Dalben et al, 2006; Vargervik et al, 2012).…”

“…Similar gene networks regulate skull and tooth morphogenesis (Yuan and Chai, 2019). Occlusal characteristics are been studied in patients with isolated craniosynostosis, proposing interesting results in alterations in craniofacial growth patterns (Pelo et al, 2011; Heliövaara et al, 2015; Lebuis et al, 2015). Retrognathic mandibles in patients with scaphocephaly and dentoskeletal asymmetry occurring in tandem with coronal synostosis have been reported (Pelo et al, 2011; Heliövaara et al, 2015; Lebuis et al, 2015).…”

“…Occlusal characteristics are been studied in patients with isolated craniosynostosis, proposing interesting results in alterations in craniofacial growth patterns (Pelo et al, 2011; Heliövaara et al, 2015; Lebuis et al, 2015). Retrognathic mandibles in patients with scaphocephaly and dentoskeletal asymmetry occurring in tandem with coronal synostosis have been reported (Pelo et al, 2011; Heliövaara et al, 2015; Lebuis et al, 2015). Considering dental development, there has been reports of altered dental maturation and morphology in syndromic cases of craniosynostosis (Reitsma et al, 2014a; Reitsma et al, 2014b; Woods et al, 2015).…”