Anatomical alterations of the tongue, lips and jaws present in patients with Down syndrome.
Description
Anatomical alterations in tongue, lips and jaws present in patients with Down syndrome. Down syndrome is a genetic alteration that brings with it certain physical, systemic, functional and intellectual alterations, including oral and maxillofacial alterations. The objective of the research was to analyze the prevalence of tongue, lip and maxillary alterations in Down syndrome patients attending the Dominican Down Syndrome Association. This descriptive, cross-sectional study included 24 participants, divided into two groups: 12 with Down syndrome and 12 controls, matched for age and sex, to be compared. Questions were asked about personal data and medical-dental history, clinical and radiographic examination was performed, as well as sialometry to measure salivary flow, also extraoral and intraoral photographs and dental impressions were taken, for later measurements and cephalometric analysis. The results revealed a high frequency of cleft tongue (89%), macroglossia (56%), ankyloglossia (56%), tongue protrusion (33%) and everted lips (42%) compared to the control group. Significant maxillary hypoplasia was also identified according to cephalometric analysis and measurements taken from study models. The type of clinical macroglossia found was true, as no case of mandibular hypoplasia was found. Clinical macroglossia showed an association with other lingual and labial alterations such as cleft tongue, ankyloglossia and everted lower lip. In addition, hyposalivation was associated with the presence of cleft tongue in the Down syndrome group.
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Steps to reproduce
Once the participants were selected, information was collected through clinical observation, questions to the patient and guardian, medical records, photographs, X-rays, and impressions of the jaws. The medical records were prepared by the participants and included the following sections: Personal data, Medical history, Medication, Oral hygiene (frequency of brushing, use of mouthwash, and tongue cleaning), Diet (consumption of acidic foods), Oral habits (such as mouth breathing), Clinical examination (facial profile, tongue, and lips), Patient observations (reported discomfort), Tests and analyses (sialometry, impressions, and X-rays), and Conclusions (summary of findings). An iPhone 13 (ƒ/1.6 wide-angle camera and ƒ/2.4 ultra-wide-angle camera, 12 MP) with a ring light was used. Lateral and frontal X-rays were taken at the Pedro Henríquez Ureña National University using a digital orthopantomograph. Cephalometric analysis was performed using the points: S, N, Ba, Ena, Pm, Xi, A, B, and D, to calculate SNA, SNB, SND angles, lower and total facial height, and mandibular length. In the frontal norm, points J and AG were analyzed, evaluating the JR-JL and AG-GA planes, comparing them with the standards to detect alterations. Manual impressions were taken by the students and measured to obtain the bicuspid and bimolar width (upper and lower). The clinical protocol consisted of filling out the form, placing the patient in a comfortable chair for the anamnesis, and performing an extraoral examination with natural light and an intraoral examination in a dental chair with a tongue depressor and artificial light, following biosafety measures. Extraoral and intraoral photos were taken. Sialometry was performed by asking the patient, guided by the tutor, to deposit saliva in a container for 5 minutes. Impressions were made with a suitable tray and alginate, mixed and placed in the mouth, removing it after gelation. X-rays were taken by the technician in the corresponding area, following established protocols. Finally, all the information was grouped and processed with the appropriate software for analysis and to draw conclusions.
Institutions
- Universidad Nacional Pedro Henriquez Urena