Resting position of the head and malocclusion in a group of patients with cerebral palsy

Abstract

Cerebral palsy are found as a result of these disorders, along with associated neuromuscular functional alterations that affect the resting position of the head. In this context, the resting position of the head could be responsible for several skeletal and dental occlusal disorders among patients with cerebral palsy. Objective: To assess the presence of malocclusions in patients with cerebral palsy, define the most frequent types of malocclusions, and evaluate how the resting position of the head may be implicated in the development of such malocclusions. Study design: Forty-four patients aged between 12-55 years (18 males and 26 females) were studied. Occlusal conditions, the Dental Aesthetic Index (DAI), changes in the resting position of the head, and breathing and swallowing functions were assessed. Results: Orthodontic treatment was required by 70.8% of the patients, the most frequent malocclusions being molar class II, open bite and high overjet. These individuals showed altered breathing and swallowing functions, as well as habit and postural disorders. The resting position of the head, especially the hyperextended presentation, was significantly correlated to high DAI scores. Conclusions: The results obtained suggest that patients with cerebral palsy are more susceptible to present malocclusions, particularly molar class II malocclusion, increased open bite, and high overjet. Such alterations in turn are more common in patients with a hyperextended position of the head. Key words:Cerebral palsy, malocclusion, head position, disabled patients.

Factors associated with anterior open bite in children with developmental disabilities

“…For Martinez‐Mihi et al. , anterior open bite (or at least their severity) could be reduced avoiding hyperextended patterns gaining control or modifying the resting posture of the head from an early age.…”

“…3 In relation to the presence of involuntary movement, the compromised neurological condition of these individuals could explain why we found results similar to those found by Carmagnani et al 8 For those authors, spasticity leads to neuromuscular involvement with bone consequences modifying facial growth and occlusal development patterns. For Martinez-Mihi et al , 4 anterior open bite (or at least their severity) could be reduced avoiding hyperextended patterns gaining control or modifying the resting posture of the head from an early age.…”

“…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 .…”

“…These factors play a role in the pressure of the tongue on the palate and in its interposition between the jaws during swallowing . Other authors speculate that anterior open bite in these patients may be also due to an inefficient salivation reflex and frequent mouth breathing . Spastic patients present a higher incidence of anterior open bite, especially in patients with clinical patterns of quadriplegia, diplegia, and double hemiplegia…”

Sudanese Individuals with Special Need

“…The majority of the children with cerebral palsy (52.6%) in the present study had Class II malocclusion which was in accordance to Rosenstein et al, . According to Victoria et al hyper extended resting position of the head could influence the lower facial third causing malocclusion [36].…”