FREQUENCY OF UPPER CERVICAL VERTEBRAL DEFORMITIES AMONG ORTHODONTIC PATIENTS WITH CONGENITALLY MISSING PERMANENT TEETH.

Abstract

ABSTRACT:

INTRODUCTION: Congenitally missing teeth (CMT), tooth agenesis and/or hypodontia are commonly encountered dental anomalies, found to have varying prevalence in different regions. Cervical vertebral deformities include a variety of morphological variations which in many cases go unnoticed specially if not associated with a syndrome. Patients with these deformities can have varying responses to orthodontic treatment particularly with functional appliances.

METHODS: Pre-treatment lateral cephalograms of 91 patients presenting to the Orthodontics’ department of Islamabad Dental Hospital, with congenitally missing permanent teeth as identified by their Orthopantomograms, were included in the study. The lateral cephalograms were studied for cervical vertebral morphologies and any gross deformities were noted. Linear measurements were taken after eliminating magnification errors on Viewbox software. Intra-rater reliability was tested by recording the measurements at a 2-week interval, under identical conditions. Frequency of observed cervical vertebral deformities was calculated among patients with congenitally missing permanent teeth. Male and female subjects were evaluated to rule out any gender differences. Furthermore, patients were categorized on the basis of their FMA values. P value <0.05 was considered significant.

RESULTS: The frequency of cervical vertebral deformities among patients with congenitally missing permanent teeth was found to be 96.7%. There were no significant differences between male and female subjects (p > 0.05). Majority of these patients (65%) were categorized as having a hyperdivergent facial pattern.  

CONCLUSIONS: Patients with congenitally missing permanent teeth have a greater frequency of cervical vertebral deformities which can impact decision-making during orthodontic treatment planning, particularly in growing patients, as functional appliances do not respond as expected in these patients, owing to the associated craniofacial features.