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Ben Salem M, Perrin JP, Loin J, Corre P, Boeffard C, Ghedira H, Bertin H. Dental anomalies in craniofacial microsomia and condylo-mandibular dysplasia: A retrospective study of 103 patients. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101903. [PMID: 38710448 DOI: 10.1016/j.jormas.2024.101903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/15/2024] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Craniofacial microsomia (CFM) and camel-hump condylo-mandibular dysplasia (CMD) are developmental disorders affecting the mandible that share common clinical features. This study aimed to investigate and compare the dental anomalies (DA) between the two entities for differential diagnosis and to propose appropriate treatment. METHODS This retrospective cross-sectional study was based on panoramic radiographs of patients diagnosed with CFM or CMD. DA were evaluated using the classification reported by Bilge. Delayed tooth eruption on the affected side was noted based on a comparison with the contralateral side. Nolla's stages of tooth calcification were used to assess dental development. RESULTS A total of 103 patients were included, 80 subjects (77.7 %) in CFM group and 23 patients (22.3 %) in CMD group. The prevalence of DA among CFM and CMD-affected patients were 80.0 % and 95.7 %, respectively. Tooth ectopia, tooth impaction, dental development delay, and delayed tooth eruption on the affected side exhibited a significant association with the two craniofacial malformations. The overall affected teeth (molars, premolars, canines) differed between the two craniofacial malformations. Dental abnormalities such as oligodontia, hyperdontia, dentin dysplasia, and anomalies of shape were seen only in subjects affected by CFM. CONCLUSION DA were widely observed in patients with CFM and CMD. The global distribution of affected teeth differed between the two conditions and some DA were detected only in CFM patients. When clinical diagnosis remains uncertain, some specific radiological characteristics of DA can be used to differentiate CFM from CMD.
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Affiliation(s)
- Mouna Ben Salem
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia; Laboratory of Biological, Clinical and Dento-Facial Approach, University of Monastir, Monastir, Tunisia
| | - Jean-Philippe Perrin
- Stomatology and Maxillo-facial Surgery Unit, Nantes University Hospital, F-44000 Nantes, France.
| | - Justine Loin
- Stomatology and Maxillo-facial Surgery Unit, Nantes University Hospital, F-44000 Nantes, France.
| | - Pierre Corre
- Stomatology and Maxillo-facial Surgery Unit, Nantes University Hospital, F-44000 Nantes, France; Nantes University, Oniris, Angers University, Nantes University Hospital, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France.
| | - Camille Boeffard
- Nantes University, Oniris, Angers University, Nantes University Hospital, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, F-44000 Nantes, France; Nantes University, Nantes Hospital, Department of Restorative Dentistry and Endodontics, F-44000 Nantes, France.
| | - Hichem Ghedira
- Pediatric and Preventive Dentistry Department, Faculty of Dental Medicine of Monastir, Monastir, Tunisia; Laboratory of Biological, Clinical, and Dento-Facial Approach, University of Monastir, Monastir, Tunisia.
| | - Hélios Bertin
- Stomatology and Maxillo-facial Surgery Unit, Nantes University Hospital, F-44000 Nantes, France; Nantes University, Angers University, Nantes University Hospital, INSERM, CNRS, CRCI2NA, F-44000 Nantes, France.
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Abstract
Animal bodies in general and faces in particular show mirror symmetry with respect to the median-sagittal plane, with exceptions rarely occurring. Bilateral symmetry to the median sagittal plane of the body also evolved very early. From an evolutionary point of view, it should therefore have fundamental advantages, e.g., more effective locomotion and chewing abilities. On the other hand, the recognition of bilaterally symmetric patterns is an important module in our visual perception. In particular, the recognition of faces with different spatial orientations and their identification is strongly related to the recognition of bilateral symmetry. Maxillofacial surgery and Dentistry affect effective masticatory function and perceived symmetry of the lower third of the face. Both disciplines have the ability to eliminate or mitigate asymmetries with respect to form and function. In our review, we will demonstrate symmetric structures from single teeth to the whole face. We will further describe different approaches to quantify cranial, facial and dental asymmetries by using either landmarks or 3D surface models. Severe facial asymmetries are usually caused by malformations such as hemifacial hyperplasia, injury or other diseases such as Noma or head and neck cancer. This could be an important sociobiological reason for a correlation between asymmetry and perceived disfigurement. The aim of our review is to show how facial symmetry and attractiveness are related and in what way dental and facial structures and the symmetry of their shape and color influence aesthetic perception. We will further demonstrate how modern technology can be used to improve symmetry in facial prostheses and maxillofacial surgery.
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