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Epidemiology of dento-skeletal dysmorphoses in children treated for craniosynostosis in infancy
Edouard Lange1, Julie Chauvel-Picard1, Aqeel Lari A2
1Service de Chirurgie Maxillo-Faciale et Chirurgie Orale, Hôpital de la Croix Rousse, 103 grande rue de la Croix Rousse, 69004 Lyon, France; Service de Chirurgie Maxillo-Faciale et Plastique Pédiatrique, Hôpital Femme-Mère-Enfant, 59 Boulevard Pinel, 69500 Bron, France; Université Claude Bernard Lyon 1, 43 boulevard du 11 novembre 1918, 69100, Villeurbanne, France.
Background And Objective:
Craniosynostosis, defined as the premature fusion of one or more cranial sutures, leads to craniofacial deformities and may impair facial growth. Despite early surgical correction, the long-term impact on dento-skeletal development remains insufficiently characterized. This study evaluated the prevalence and determinants of dento-skeletal dysmorphoses (DSDs) in children who underwent craniosynostosis surgery during infancy and were followed until completion of growth.
Materials And Methods:
This ambispective study included 95 patients treated surgically for syndromic or nonsyndromic craniosynostosis at Lyon University Hospital between 2004 and 2006. Data were collected on craniosynostosis type, age at surgery, diagnosis and type of DSDs, treatment, and cranial base angle. Descriptive statistics and logistic regression analyses were used to assess prevalence, distribution and risk factors.
Results:
Among the 95 children, 48 (50.5 %) developed a DSD. This patient had undergone craniosynostosis surgery at significantly older age (8.3 ± 2.9 vs 5.9 ± 2.4 months; Mann-Whitney test, p < 0.001). Trigonocephaly was strongly associated with maxillary transverse deficiency (OR = 4.84; 95 % CI [1.19-19.7]; p = 0.028), while scaphocephaly also showed a higher prevalence (21.1 %) without statistical significance. Scaphocephaly had the highest rate of Class II malocclusion (34.2 %), whereas brachycephaly and anterior plagiocephaly were mainly associated with Class III (100 % and 50 %, respectively). All syndromic cases developed Class III malocclusions.
Conclusion:
Despite early cranial surgery, craniosynostosis remains associated with altered craniofacial growth and a high prevalence of malocclusions. Older age at surgy was an independent risk factor for DSDs. These findings underscore the importance of systematic, long-term orthodontic follow-up in both syndromic and nonsyndromic patients and suggest that an earlier surgical management may help reduce the risk of subsequent DSD.
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