Publication: Diagnóstico y tratamiento multidisciplinar de un paciente con alteración respiratoria, mordida cruzada posterior y alteraciones del esmalte.
Loading...
Official URL
Full text at PDC
Publication Date
2021
Authors
Advisors (or tutors)
Editors
Journal Title
Journal ISSN
Volume Title
Publisher
Citations
Exportar
Abstract
Paciente varón de 10 años y 1 mes de edad con padres divorciados. El paciente presenta hábito de respiración oral y facies adenoidea. Intraoralmente, presenta una dentición mixta segunda fase, Clase II molar incompleta bilateral y Clase canina no valorable. Además, destaca una mordida cruzada posterior unilateral izquierda debido a una compresión dentoalveolar izquierda. A nivel dentario presenta Síndrome de hipomineralización incisivo molar e Hipomineralización del segundo molar temporal. Durante la anamnesis, la madre del paciente refirió que el paciente había sufrido dos cuadros respiratorios infecciosos uno a los 8 meses de edad y otro a los 3 años. Una revisión sistemática con la siguiente pregunta PICO fue planteada: ¿Existe relación entre alteraciones respiratorias y riesgo de desarrollo de defectos del esmalte?. Esta revisión sistemática fue publicada en la revista Científica Dental, editada por el Ilustre Colegio Oficial de Odontólogos y Estomatólogos de la I Región. Los estudios analizados en esta revisión sistemática muestran que distintos problemas respiratorios en la infancia y los fármacos empleados para su tratamiento pueden ser un posible factor etiopatogénico de las alteraciones del esmalte. A nivel cefalométrico, el paciente presenta una Clase I ósea y patrón de crecimiento meso-dólicofacial. El tratamiento propuesto comenzó con la instauración de un correcto protocolo preventivo, debido al riesgo aumentado de caries por presencia de alteraciones del esmalte. Además, se optó por una placa activa de Hawley con tornillo central de expansión para el tratamiento de la maloclusión transversal. Los índices de salud oral mejoraron durante el trascurso del tratamiento. Con respecto a la mordida cruzada posterior, se observó una mejoría en la maloclusión transversal. Sin embargo, esta mejoría no fue completa debido a la falta de cooperación en cuanto a la activación del aparato. Como conclusión, los factores intrapersonales e interpersonales tienen una gran repercusión en el grado de colaboración que presentan los pacientes infantiles. Asimismo, debido a la complejidad inherente de todo proceso diagnóstico, una anamnesis exhaustiva es un primer paso fundamental para alcanzar un correcto plan de tratamiento.
Male patient aged 10 years 1 month with divorced parents. The patient has an oral breathing habit and adenoid facies. Intraorally, he presents a second phase mixed dentition, bilateral incomplete molar Class II, and the canine Class is not assessable. In addition, a left unilateral posterior crossbite stands out due to a left dentoalveolar compression. Intraoral analysis also revealed Molar incisor hypomineralization and Hipomineralized second primary molar. During the anamnesis, the patient's mother reported that the patient had experienced two infectious respiratory episodes, one at 8 months of age and the other at 3 years. A systematic review with the following PICO question was raised: Is there a relationship between respiratory disorders and the risk of developing enamel defects? This systematic review was published in Científica Dental, edited by Ilustre Colegio Oficial de Odontólogos y Estomatólogos de la I Región. The studies analyzed in this systematic review show that different respiratory problems in childhood and the drugs used for their treatment may be a possible etiopathogenic factor of enamel alterations. Cephalometric analysis revealed skeletal Class I and a meso-dolichofacial growth pattern. The proposed treatment began with the establishment of a correct preventive protocol, due to the increased risk of caries associated with the presence of enamel alterations. In addition, an active Hawley appliance with a central expansion screw was chosen for the treatment of transverse malocclusion. Oral health indices improved over the course of treatment. Regarding the posterior crossbite, an improvement was observed in the transverse malocclusion. However, this improvement was not complete due to the lack of cooperation regarding the activation of the device. In conclusion, intrapersonal and interpersonal factors have a great impact on the degree of collaboration of pediatric patients. Likewise, due to the inherent complexity of any diagnostic process, an exhaustive anamnesis is a fundamental first step to achieve a correct treatment plan.
Male patient aged 10 years 1 month with divorced parents. The patient has an oral breathing habit and adenoid facies. Intraorally, he presents a second phase mixed dentition, bilateral incomplete molar Class II, and the canine Class is not assessable. In addition, a left unilateral posterior crossbite stands out due to a left dentoalveolar compression. Intraoral analysis also revealed Molar incisor hypomineralization and Hipomineralized second primary molar. During the anamnesis, the patient's mother reported that the patient had experienced two infectious respiratory episodes, one at 8 months of age and the other at 3 years. A systematic review with the following PICO question was raised: Is there a relationship between respiratory disorders and the risk of developing enamel defects? This systematic review was published in Científica Dental, edited by Ilustre Colegio Oficial de Odontólogos y Estomatólogos de la I Región. The studies analyzed in this systematic review show that different respiratory problems in childhood and the drugs used for their treatment may be a possible etiopathogenic factor of enamel alterations. Cephalometric analysis revealed skeletal Class I and a meso-dolichofacial growth pattern. The proposed treatment began with the establishment of a correct preventive protocol, due to the increased risk of caries associated with the presence of enamel alterations. In addition, an active Hawley appliance with a central expansion screw was chosen for the treatment of transverse malocclusion. Oral health indices improved over the course of treatment. Regarding the posterior crossbite, an improvement was observed in the transverse malocclusion. However, this improvement was not complete due to the lack of cooperation regarding the activation of the device. In conclusion, intrapersonal and interpersonal factors have a great impact on the degree of collaboration of pediatric patients. Likewise, due to the inherent complexity of any diagnostic process, an exhaustive anamnesis is a fundamental first step to achieve a correct treatment plan.
Description
UCM subjects
Unesco subjects
Keywords
Citation
1.Fernández C, Lorenzo H, Vrotsou K, Aresti U, Rica I, Sánchez E. Estudio de Crecimiento de Bilbao. Curvas y tablas de crecimiento. Estudio Transversal. Instituto
de Investigación sobre Cremiento y Desarrollo. Fundación Faustino Orbegozo. 2011.
2. Lygidakis NA, Wong F, Jälevik B, Vierrou AM, Alaluusua S, Espelid I. Best Clinical Practice Guidance for clinicians dealing with children presenting with Molar�Incisor-Hypomineralisation (MIH): An EAPD Policy Document. Eur Arch Paediatr Dent.2010;11(2):75–81.
3. Mühlemann, HR, Son S. Gingival sulcus bleeding: a leading symptom in initial gingivitis. Helv Odontol Acta. 1971;15(2):107-113.
4. O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol.1972;43(1):38.
5. Canut Brusola JA. Ortododoncia clínica y terapéutica. Barcelona: Salvat; 1988.
6. Pacheco MCT, Casagrande CF, Teixeira LP, Finck NS, de Araújo MTM.Guidelines proposal for clinical recognition of mouth breathing children. Dent Press J Orthod. 2015;20(4):39–44.
7. Milanesi J de M, Berwig LC, Marquezan M, Schuch LH, Moraes AB de, Silva AMT. Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment. CoDAS. 2018;30(4).
8. Ribeiro GCA, Dos Santos ID, Santos ACN, Paranhos LR, César CPHAR. Influence of the breathing pattern on the learning process: a systematic review of literature. Braz J Otorhinolaryngol. 2016;82(4):466–78.
9. Brescovici S, Roithmann R. Modified glatzel mirror test reproducibility in the evaluation of nasal patency. Braz J Otorhinolaryngol. 2008;74(2):215–22.
10. Farkas LG. Anthropometrics of the Head and Face in Medicine. Ed. New York:Elsevier; 1981.
11. Moyers R. Manual de ortodoncia. 4a ed. Buenos Aires: Panamericana;1998.240 p.
12. Major MP, Flores-Mir C, Major PW. Assessment of lateral cephalometric diagnosis of adenoid hypertrophy and posterior upper airway obstruction: A systematic
review. Am J Orthod Dentofacial Orthop. 2006;130(6):700–8.
13. Mourelle MR. Correlación entre la maduración dentaria e indicadores de crecimiento esquelético en pacientes odontopediátricos [Tesis]. Madrid: Universidad
Complutense de Madrid, Servicio de Publicaciones; 2004.
14.Lamparsky DG. Skeletal age assessment utilizing cervical vertebrae. Pittsbugh: Universidad de Pittsburgh;1972.
15. O’Reilly M, Yanniello GJ. Mandibular growth changes and maturation of cervical vertebrae–a longitudinal cephalometric study. Angle Orthod. 1988;58(2):179–
184.
16. Brent Hassel BA, Farman A. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod. 1995;107(1):58-66.
17. Baccetti T, Franchi L, Jr JAM. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod.
2002;72(4):316-23.
18. Baccetti T, Franchi L, McNamara JA. The cervical vertebral maturation (CVM)method for the Assessment of optimal treatment timing in dentofacial orthopedics. Semin
Orthod. 2005;11:119–29.
19. Baccetti T, Franchi L, Cameron CG, Jr JAM. Treatment timing for rapid maxillary expansion. Angle Orthod. 2001;71(5):343-50.
20. Steiner C. Cephalometrics in clinical practice. Angle Orthod. 1959;29(1):8-29.
21. Ricketts RM. Perspectives in the clinical application of cephalometrics. The first fifty years. Angle Orthod. 1981;51(2):115–50.
McNamara JA. A method of cephalometric evaluation. Am J Orthod. 1984;86(6):449–69.
23. Lygidakis NA, Dimou G, Marinou D. Molar-Incisor-Hypomineralisation (MIH).A retrospective clinical study in Greek children. II. Possible medical aetiological factors.
Eur Arch Paediatr Dent. 2008;9(4):207-17.
24. Govardhan C, Murdock J, Norouz-Knutsen L, Valcu-Pinkerton S, Zaghi S.Lingual and maxillary labial frenuloplasty with myofunctional therapy as a treatment for mouth breathing and snoring. Case Rep Otolaryngol. 2019;2019(65):1–5.
25. Löfstrand-Tideström B, Thilander B, Ahlqvist-Rastad J, Jakobsson O, Hultcrantz E. Breathing obstruction in relation to craniofacial and dental arch morphology in 4-year�old children. Eur J Orthod. 1999;21(4):323–32.
26. Malandris M, Mahoney EK. Aetiology, diagnosis and treatment of posterior cross�bites in the primary dentition. Int J Paediatr Dent. 2004;14(3):155–66.
27. Kashbour W, Gupta P, Worthington HV, Boyers D. Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and
adolescents. Cochrane Database of Syst Rev. 2020;11.
28.European Academy of Paediatric Dentistry. Guidelines on the use of fluoride in children: an EAPD policy document. Eur Arch Paediatr Dent. 2009;10(3):129–35.
29. Marinho VC, Higgins JP, Logan S, Sheiham A. Topical fluoride (toothpastes,mouthrinses, gels or varnishes) for preventing dental caries in children and adolescents.
Cochrane Database Syst Rev. 2003;2003(4):Art. No.CD002782.
30. Martín C, Alarcón JA, Palma JC. Kinesiographic study of the mandible in young patients with unilateral posterior crossbite. Am J Orthod Dentofacial Orthop.
2000;118(5):541–8.
31. Throckmorton GS, Buschang PH, Hayasaki H, Pinto AS. Changes in the masticatory cycle following treatment of posterior unilateral crossbite in children. Am. J
Orthod Dentofacial Orthop. 2001;120(5):521–9.
32. Neto GP, Puppin-Rontani RM, Garcia RCMR. Changes in the masticatory cycle after treatment of posterior crossbite in children aged 4 to 5 years. Am J Orthod
Dentofacial Orthop. 2007;131(4):464–72.
33. Fleming P. Timing orthodontic treatment: early or late? Aust Dent J 2017;62(1):11–9.
34. Agostino P, Ugolini A, Signori A, Silvestrini-Biavati A, Harrison JE, Riley P.Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev. 2014;8
35.Thilander B, Wahlund S, Lennartsson B. The effect of early interceptive treatment in children with posterior cross-bite. Eur J Orthod. 1984;6(1):25-34.
36. Petrén S, Bondemark L. Correction of unilateral posterior crossbite in the mixed dentition: A randomized controlled trial. Am J Orthod Dentofacial Orthop.
2008;133(6):7-13.
37. Wu Y, Cao L, Cong J. The periodontal status of removable appliances vs fixed appliances. Med. 2020;99(50).
38. Cerroni S, Pasquantonio G, Condò R, Cerroni L. Orthodontic fixed appliance and periodontal status: an updated systematic review. Open Dent. J. 2018;12:614–22.
39. Trulsson U, Linläv L, Mohlin B, Strandmark M. Age dependence of compliance with orthodontic treatment in children with large overjet. An interview study. Swed Dent
J. 2004;28(2):101–9.
40. Greco PM. Joint autonomy. Am J Orthod. 2014;145(6):716.