Craniofacial morphology in Turner syndrome karyotypes

ABSTRACT Introduction: A complete or partial absence of an X chromosome in the karyotype of phenotypic females has an impact on craniofacial morphology. The aim of this study was to determine the characteristics of the craniofacial complex in patients with Turner syndrome (TS), and to evaluate the influence of various karyotypes on craniofacial morphology. Material and methods: The study population was comprised of 40 TS female patients, aged 9.2 to 18 years, and 40 healthy females, aged 9.3 to 18 years, as the control group. The TS patients were subdivided according to karyotype. All study participants were evaluated cephalometrically. An analysis of variance (ANOVA) and Tukey’s multiple comparison test were used for analysis of the differences between the means in Turner subgroups and the control group. Results: In general, the girls with TS were characterized by smaller dimensions and an altered morphology of the craniofacial complex compared with the unaffected girls. The curvature of the frontal bone was significantly increased, while the diameter of the head was reduced. Both the maxilla and mandible were retrognathic, posteriorly rotated, and reduced in antero-posterior length. The cranial base was shorter and flattened. Among the different karoytypes, no significant differences were determined in the dimensions of the craniofacial complex in girls with TS. Conclusions: Our findings indicate that the karyotype has no effect on craniofacial morphology and we confirmed that a specific model of craniofacial morphology in individuals with TS is present in early childhood

Laser analgesic during orthodontic therapy

Introduction: Most of the patients feel pain 4 hours after the arch applying, gaining the highest level after 24 hours and its lowering in the next few days. Literature reports show that the fear of pain is a very important reason for discouraging the patient to agree for this kind of orthodontic treatment The aim of this study was to evaluate the effectiveness of the biostimulative laser treatment in pain reduction in patients with fixed orthodontic appliances. Materials and methods. Fifteen patients were treated with low energy level biostimulative diode laser, used 2 minutes per quadrant immediately after placement of fixed orthodontic appliances and in the following four days. The control group of 15 patients received analgesic therapy for period of five days. The pain was assessed subjectively as strong, medium or no pain. The pain disappeared in 20% of the subjects in the examined group after the first day, while in 60% and 26.6% of the subjects medium and isolated pain was still present at day 2 and 3, respectively. Results. The pain disappeared in all the patients treated with laser at day 5. In the control group, strong pain was present in all the subjects the first day, decreasing to 60% of strong pain and 20% medium pain the second day. After day three, the control group demonstrated medium localized pain in 40% of the cases, which dropped to 26.6% after the fourth day, suggesting delayed pain reduction, compared to the laser treated group. Conclusion. Our results suggest that the low energy laser treatment can successfully be used for pain reduction during the initial discomfort period after placing fixed orthodontic appliances

Dental arch dimensions and palatal height in children with Turner syndrome

ABSTRACT Introduction: A complete or partial absence of an X chromosome in girls with Turner Syndrome (TS) has an impact on dental arch morphology. The aim of this study was to analyze the sizes of dental arches as well as the height of the palatal vault in patients with TS, and to determine the influence of various karyotypes on the study variables. Materials and methods: The study population sample consisted of 40 TS female patients, aged 9.2 to 18 years, and 40 healthy females aged 9.3 to 18 years, as the control group. The TS patients were subdivided according to karyotype (monosomy X, mosaic, and isochromosome). Dental arch width and length, and palatal height were measured directly on plaster dental casts. Results: The results showed differences in the dental arch dimensions between TS and control groups. The maxillary dental arch was narrower and shorter, but the mandibular arch was shorter and of normal width in the TS group. The palate in TS patients were normal in height and did not differ from those of the control subjects. Although the dental arch dimensions and palatal height were slightly reduced in mosaic and isochromosome karyotypes compared with those in 45,X females, the investigation revealed no significant differences between the karyotypes. Conclusions: Our findings indicate that the reduction of X chromosomal genetic material in Turner syndrome females results in the reduction of dental arch dimensions, which is further reflected in the increased frequency of malocclusion in these individuals. Importantly, this study demonstrates that palatal height is normal, contrary to some reports in the literature. It is further significant that the TS karyotype does not affect dentoalveolar morphology and palatal height