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Does long term parenteral nutrition in children have an impact on malocclusion? Preliminary report
Dorota Olczak-Kowalczyk1, Ewa Krasuska-Sławińska, Mikołaj Danko
1Department of Pediatric Dentistry, Medical University of Warsaw, do-k@o2.pl.
Insights
Long-term parenteral nutrition is linked to increased malocclusion in children. Reduced oral intake and low body mass in children receiving parenteral nutrition correlate with dental issues.
Area of Science:
- Pediatric Nutrition
- Orthodontics
- Growth and Development
Background:
- Parenteral nutrition (PN) is a life-sustaining intervention for children with gastrointestinal issues.
- The long-term effects of PN on oral development, specifically malocclusion, are not well-established.
- Understanding these impacts is crucial for comprehensive pediatric care.
Purpose of the Study:
- To investigate the association between long-term partial parenteral nutrition (PN) and malocclusion in pediatric patients.
- To identify potential contributing factors to malocclusion in children receiving PN.
Main Methods:
- A cohort study comparing 31 children receiving long-term PN (mean 5.71 years) with 30 healthy controls.
- Data collected included birth history, growth parameters, and oral occlusion assessments.
- Statistical analyses included chi-square and Spearman correlation tests (p<0.05).
Main Results:
- Children on PN had significantly higher rates of malocclusion (38.71%) compared to controls (13.3%).
- Common malocclusions in the PN group included crossbite, open bite, and tooth crowding.
- A positive correlation was found between malocclusion and PN duration, feeding frequency, and low body mass.
Conclusions:
- Long-term PN, reduced oral feeding, and low body mass are associated with increased risk of malocclusion in children.
- These findings highlight the need for monitoring oral health in pediatric patients receiving long-term PN.
- Further research into interventions to mitigate these orthodontic complications is warranted.
Aim:
To evaluate the impact of long-term partial parenteral nutrition and its complications on malocclusion in children and adolescents.
Material And Methods:
The assessment involved 61 patients (2.25 to16 years of age) without a masticatory parafunction - i.e. 31 subjects receiving parenteral nutrition for a mean period of 5.71±2.87 years, and 30 healthy control subjects. The medical records provided information on the delivery (full-term, preterm), birth body mass, Apgar score, weight deficiency at the age of 1 year; the patient assessment included the current body mass, the number of enteral meals per day and parenteral meals per week, occlusion (acc.to Orlik-Grzybowska's parameters). The statistical analysis was performed by using the chi-square test, Spearman's correlation analysis; the statistical significance was p<0.05.
Results:
Premature infants with low birth body mass (38.7%), Apgar score below 7 (25.8%), underweight in the first year of life (74.2%) and on examination day (58.1%) were only part of the test group. Mean number of eaten meals: 4.63±1.88 in parenteral nutrition patients, 6.26±1.39 in healthy individuals in the control group. Malocclusions were significantly more frequent in the children receiving parenteral nutrition (38.71%: the most frequent defects included crossbite (19.31%), open bite malocclusion (12.9%), crowding of teeth (9.67%), than in the control group (13.3%: crossbite (3.3%), open bite malocclusion (3.3), crowding of teeth (3.3%). A correlation was statistically proved between the malocclusion and parenteral nutrition, the number of parenteral feeding sessions per week, the current low body mass.
Conclusion:
Long-term parenteral nutrition, a decreased number of oral meals and a coexistent low body mass at the developmental age may contribute to the development of malocclusion.
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