RESUMO
El síndrome de Down en niños se asocia con múltiples alteraciones orofaciales, dentro de ellas se ha mencionado el retraso en la erupción dental, cuya comprensión no es aún del todo conocida. Se realizó una revisión para analizar los conceptos de erupción dental y acerca de la evidencia disponible respecto al retraso en la erupción dental de los niños con síndrome de Down y su relación con la maduración de los dientes o con otros factores sistémicos y locales. Se observó escasez de estudios sobre el tema, sin embargo, con la literatura encontrada se pudo concluir que el retraso de erupción de las piezas dentales parece no tener relación con la maduración de la pieza dental, sino a otros procesos que tienen lugar durante la erupción dental o que puede ser parte del retraso general del crecimiento y del desarrollo que caracteriza al síndrome de Down.
Down syndrome in children is associated with multiple orofacial alterations, among them delayed tooth eruption has been mentioned, the understanding of which is not yet fully known. A review was carried out to analyze the concepts of tooth eruption and the available evidence regarding delayed tooth eruption in children with Down syndrome, and its relationship with tooth maturation or with other systemic and local factors. Few studies were observed on the subject, however, with the found literature it was possible to conclude that the delay in tooth eruption seems not to be related to the maturation of the tooth, but it is related to other processes that take place during tooth eruption or it may be part of the general delay in growth and development that characterizes Down syndrome.
RESUMO
Severe skeletal open bites may be ideally treated with a combined surgical-orthodontic approach. Alternatively, compensations may be planned to camouflage the malocclusion with orthodontics alone. This case report describes the treatment of an 18-year-old man who presented with a severe open bite involving the anterior and posterior teeth up to the first molars, increased vertical dimension, bilateral Class III molar relationship, bilateral posterior crossbite, dental midline deviation, and absence of the maxillary right canine and the mandibular left first premolar. A treatment plan including the extraction of the mandibular right first premolar and based on uprighting and vertical control of the posterior teeth, combined with extrusion of the anterior teeth using multiloop edgewise archwire mechanics and elastics was chosen. After 6 months of alignment and 2 months of multiloop edgewise archwire mechanics, the open bite was significantly reduced. After 24 months of treatment, anterior teeth extrusion, posterior teeth intrusion, and counterclockwise mandibular rotation were accomplished. Satisfactory improvement of the overbite, overjet, sagittal malocclusion, and facial appearance were achieved. The mechanics used in this clinical case demonstrated good and stable results for open-bite correction at the 2-year posttreatment follow-up.
