Projects / Programmes
Evaluation of morphological characteristics of the back and face among subjects with unilateral functional crossbite in the prepubertal phase with a non-invasive three-dimensional method
| Code |
Science |
Field |
Subfield |
| 3.02.00 |
Medical sciences |
Stomatology |
|
| Code |
Science |
Field |
| B007 |
Biomedical sciences |
Medicine (human and vertebrates) |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
unilateral functional crossbite, back asymmetry, early treatment, screening method, preventive care
Researchers (10)
Organisations (2)
Abstract
Background. For UFCB in the prepubertal period, facial asymmetry, functional in origin is characteristic. During growth and development this asymmetry has a tendency to worsen and becomes skeletal in origin therefore requires surgical treatment. Growth of the craniofacial region is closely correlated with the cervicovertebral anatomy. It has been reported that the neck morphology, in particular the cervical spine is correlated with the morphology of the dentofacial complex. Occlusion asymmetries have been reported to be highly correlated with orthopaedic asymmetries in the transverse plane. In fact, children with UFCB show more frequently asymmetric shoulders and pelvis and scoliosis. Among children with scoliosis or torticollis a higher prevalence of UFCB, 26 to 55 percent, has been reported. To our knowledge in the reported literature there is no study that evaluated the degree of back asymmetry among children with UFCB in the primary and early mixed dentition phase. Aim. The aim of the present study is to develop a non-invasive, objective and reliable screening method for the assessment of morphological characteristics and asymmetries of the back among children with and without malocclusion. The objectives are to assess the morphological characteristics of the back and to evaluate the degree of back and face asymmetry and to assess if there is any correlation between the degree of back and facial asymmetry among subjects with and without unilateral functional crossbite (UFCB) in the primary and early mixed dentition phase using a non-invasive three-dimensional (3D) method. Hypothesis. H1: Subjects with unilateral functional crossbite have a greater degree of back asymmetry than subjects without this malocclusion. H2: The degree of back asymmetry in subjects with unilateral functional crossbite is higher at the cervical part and smaller at the lumbal part. H3: There is a significant positive correlation between back and face asymmetry. Subjects and Methods. A group of subjects in the primary and early mixed dentition phase aged 5-7 years, referred to the orthodontist because of UFCB and a group of children without malocclusion will be included in the present study. Non-invasive stereophotogrammetric cameras (ArtecTM MHT, Artec 3D Scanners, Luxemburg) that enable capturing of larger surfaces will be used for scanning of the back region from the neck to the hips. Similar 3D stereophotogrammetric cameras (3dMD Face System, GB) will be used for facial scanning.
The back and face surfaces will be analyzed using the software package Rapidform 2006 (Inus Technology Inc, Korea), and both qualitative and quantitative assessment of their asymmetry will be performed. Furthermore, clinical assessment of the back will be performed with the subject standing in a relaxed position, sitting on an adjustable stool and by the forward-bending test according to Adams. Statistical differences between the two groups will be tested using either parametric or nonparametric test, according to data distribution. The correlation between back and face asymmetry will be evaluated with the correlation coefficient. Expected results. We expect that subjects with unilateral functional crossbite have, beside a greater degree of facial asymmetry, also a greater degree of back asymmetry than subjects without this malocclusion. We expect to find a significant positive correlation between back and face asymmetry, though subjects with higher percentages of facial asymmetry exhibit also a higher percentage of back asymmetry. Three-dimensional surface assessment of back asymmetry could be a good non-invasive screening method for early detection of functional or skeletal spine discrepancies at a very young age in order to prevent adverse skeletal growth.
Significance for science
The functional facial asymmetry seen among children with unilateral functional crossbite due to a lateral mandibular shift, during growth and development has a tendency to worsen and results in a skeletal mandibular and facial asymmetry. Similarly, a functional back asymmetry, if not treated, may result in spine asymmetry at a later developmental stage. Of note, it has been demonstrated that craniofacial growth is associated with cervicovertebral anatomy in subjects without evident orthopaedic disorders. Although some attempts have been made to assess the correlation between asymmetric occlusion and body posture, mainly all the studies were performed on subjects in the pubertal or post-pubertal phase using either two-dimensional and invasive methods. The evaluation of the differences in the degree of back asymmetry between subjects with unilateral functional crossbite and subjects without malocclusion will give us new insight on the possibility of diagnosing back asymmetry in subjects with unilateral functional crossbite at an early (pre-pubertal) developmental stage. These findings will represent an original scientific contribution as in the reported literature no study was performed using a three-dimensional noninvasive optical system for the assessment of back anomalies among children with unilateral functional crossbite during the pre-pubertal growth phase.
We expect also to find a significant positive correlation between back and face asymmetry, though subjects with higher percentages of facial asymmetry exhibit also a higher percentage of back asymmetry. In case of a significant correlation, detection of facial asymmetry could represent an indication for an early orthopaedic examination.
Therefore, the results of the present research proposal could be useful for the development of a new and reliable non-invasive method for the assessment of back asymmetry at a very young age. Three-dimensional surface assessment of back asymmetry could be a good non-invasive screening tool for any early detection (and treatment) of functional or skeletal spine discrepancies at a very young age in order to prevent adverse skeletal growth and would represent an original and important contribution to the professional approach in the diagnosis and treatment of these anomalies.
We expect to present the original results of the proposed research project at national and itnernational conferences and publish them in important scientific and professional journals.
Significance for the country
A growing number of patients are seeking concomitant treatment for dental malocclusion and postural disorders having a huge burden on the health system. As both, malocclusions and back anomalies have a tendency to worsen during growth and development and functional anomalies usually result in skeletal anomalies at the end of growth, early detection and treatment would be profitable. In fact, for both malocclusions and back anomalies treatment at an early developmental stage is usually easier, less invasive (more conservative) and cheaper. On the other hand, treatment at a later developmental stage usually includes a surgical approach with possible concomitant complications and though higher costs and burden for the national health system. Nonetheless, more complicated treatment approaches at later developmental stages prolong the waiting lists and the accessibility of treatment for the population.
According to the national program of preventive screening of children and young adults of the National Institute of Public Health early diagnosis (and treatment) would be beneficial, mainly in terms of preventing adverse skeletal growth. The results of the present research proposal could be useful for the development of a new and reliable non-invasive screening method for the assessment of back asymmetry at a very young age. Three-dimensional surface assessment of back asymmetry could be a good non-invasive screening tool for any early detection (and treatment) of functional or skeletal spine discrepancies at a very young age in order to prevent adverse skeletal growth. Based on the results of the proposed research project we will be able to issue the guidelines for general practitioners and dentist for early diagnosis of face and back asymmetries, including the indications for referral to the specialist for treatment.
Most important scientific results
Interim report,
final report
Most important socioeconomically and culturally relevant results
Interim report,
final report
