A Radiographic Study of the Dental and Orofacial Manifestations of Down's Syndrome in Saudi Patients

Abstract

Objective: To study the dental and orofacial radiographic manifestations if any in the Saudi Down's syndrome patients in comparison with those in normal subjects. Subjects and Methods: The radiographic dental and craniofacial manifestations were studied in 30 Down's syndrome patients and 30 control subjects. The radiographic findings were supported by case history and physical examination. The prevalence of dental and orofacial aberrations was determined and compared to the findings of healthy controls using the appropriate statistical descriptive analysis. Results: Among the Down's syndrome group several craniofacial manifestations were observed including brachycephaly, depressed nose, slanting of the eyes, epicanthic folds and strabismus. Oral manifestations included incompetent lips, macroglossia, fissured tongue and a high arched narrow palate. Hypodontia (excluding third molars), was diagnosed in 17 (56.7%) of the Down' syndrome patients. Third molars were congenitally missing in 76.7%. Microdontia was observed in 16.7% of the cases. In addition, in 60% of the cases the upper lateral incisor presented with a variation of morphology. Taurodontism was found in 46.4%. Delayed eruption, retained deciduous teeth and impaction were found in 30%, 33% and 40% of the Down's syndrome group respectively. Many disharmonies of occlusion were frequently observed in the Down's syndrome group. Anterior open bite, anterior cross bite and posterior cross bites were found in 46.7%, 30% and 53.3% of the Down's syndrome patients respectively. Crowding was observed in 13 (43.3%) and spacing in 14 (46.7%) of the patients. The most common occlusal arch relationship was the class III found in 70% of the patients. Based on cephalometric analysis, the most common skeletal arch relationship in Down's syndrome was the Class III skeletal arch relationship as it was found in 15 (51.7%). Thinning of the cranial vault and delayed closure of the sutures were observed radiographically in16 (59.3%) and 10 (37%) respectively. Absent frontal air sinuses were found in 86.2%. There was a significant difference between the Down's syndrome group and the normal control regarding the radiographic dental and orofacial manifestations except for dilaceration, crowding of teeth and hypoplastic Maxillary sinus. Conclusion: There is a significantly high prevalence of dental and orofacial aberrations among Saudi Down's syndrome patients when compared to normal controls of the same population.