Korean J Orthod.  2022 May;52(3):165-171. 10.4041/kjod21.259.

Occlusal deviations in adolescents with idiopathic and congenital scoliosis

• Zhang H
• Ma J
• Zhang Z
• Feng Y
• Cai C
• Wang C

• KMID: 2529940
• DOI: http://doi.org/10.4041/kjod21.259

Abstract

Objective
This cross-sectional study aimed to investigate the characteristics of malocclusions in scoliotic patients through clinical examinations.
Methods
Fifty-eight patients with idiopathic scoliosis (IS) and 48 patients with congenital scoliosis (CS) participated in the study. A randomly selected group of 152 orthopedically healthy children served as the control group. Standardized orthodontic and orthopedic examination protocols were used to record the occlusal patterns and type of scoliosis. Assessments were made by three experienced orthodontists and a spinal surgery team. The differences in the frequency distribution of occlusal patterns were evaluated by the chi-squared test.
Results
In comparison with patients showing IS, patients with CS showed a higher incidence of Cobb angle ≥ 45° (p = 0.020) and included a higher proportion of patients receiving surgical treatments (p < 0.001). The distribution of the Angle Class II subgroup was significantly higher in the IS (p < 0.001) and CS (p = 0.031) groups than in the control group. In comparison with the healthy controls, the CS and IS groups showed significantly higher (p < 0.05) frequencies of asymmetric molar and asymmetric canine relationships, upper and lower middle line deviations, anterior deep overbite, unilateral posterior crossbite, and canted occlusal plane, with the frequencies being especially higher in CS patients and to a lesser extent in IS patients.
Conclusions
Patients with scoliosis showed a high frequency of malocclusions, which were most obvious in patients with CS.

Keyword

Facial asymmetry; Dentofacial anomalies; Scoliosis; Malocclusion

Figure

• 

  Figure 1 X-ray and dental images of an 18-year-old female patient with congenital scoliosis and an Angle Class II subgroup classification. A, Full-length anteroposterior spine X-ray image showing a severely deformed and twisted spine. B, Dental image showing normal mandibular occlusion on the right side. C, Dental image showing an oblique occlusal plane. D, Dental image showing mandibular deviation on the left side.

Reference

1. Karimi MT, Rabczuk T. 2018; Scoliosis conservative treatment: a review of literature. J Craniovertebr Junction Spine. 9:3–8.

2. Shakil H, Iqbal ZA, Al-Ghadir AH. 2014; Scoliosis: review of types of curves, etiological theories and conservative treatment. J Back Musculoskelet Rehabil. 27:111–5. DOI: 10.3233/BMR-130438. PMID: 24284269.

3. Qiu GX. 2017; Scoliosis in China: history and present status. Chin Med J (Engl). 130:2521–3. DOI: 10.4103/0366-6999.217081. PMID: 29067948. PMCID: PMC5678247.

4. Korbmacher H, Koch L, Eggers-Stroeder G, Kahl-Nieke B. 2007; Associations between orthopaedic disturbances and unilateral crossbite in children with asymmetry of the upper cervical spine. Eur J Orthod. 29:100–4. DOI: 10.1093/ejo/cjl066. PMID: 17290022.

5. Shakeel A, Asim HM, Ahmad N, Aziz A. 2018; Idiopathic scoliosis in secondary school girls: a screening programme. J Coll Physicians Surg Pak. 28:726. DOI: 10.29271/jcpsp.2018.09.726. PMID: 30158047.

6. Hitchcock HP. 1969; Treatment of a malocclusion associated with scoliosis. Angle Orthod. 39:64–8. DOI: 10.1043/0003-3219(1969)039<0064:TOAMAW>2.0.CO;2. PMID: 5250527.

7. Motoyoshi M, Shimazaki T, Sugai T, Namura S. 2002; Biomechanical influences of head posture on occlusion: an experimental study using finite element analysis. Eur J Orthod. 24:319–26. DOI: 10.1093/ejo/24.4.319. PMID: 12198861.

8. Segatto E, Lippold C, Végh A. 2008; Craniofacial features of children with spinal deformities. BMC Musculoskelet Disord. 9:169. DOI: 10.1186/1471-2474-9-169. PMID: 19102760. PMCID: PMC2637865.

9. Lippold C, van den Bos L, Hohoff A, Danesh G, Ehmer U. 2003; Interdisciplinary study of orthopedic and orthodontic findings in pre-school infants. J Orofac Orthop. 64:330–40. DOI: 10.1007/s00056-003-0236-4. PMID: 14692047.

10. Saccucci M, Tettamanti L, Mummolo S, Polimeni A, Festa F, Tecco S. 2011; Scoliosis and dental occlusion: a review of the literature. Scoliosis. 6:15. DOI: 10.1186/1748-7161-6-15. PMID: 21801357. PMCID: PMC3162939.

11. Hong JY, Suh SW, Modi HN, Yang JH, Hwang YC, Lee DY, et al. 2011; Correlation between facial asymmetry, shoulder imbalance, and adolescent idiopathic scoliosis. Orthopedics. 34:187. DOI: 10.3928/01477447-20110427-14. PMID: 21667906.

12. He C, Wong MS. 2018; Spinal flexibility assessment on the patients with adolescent idiopathic scoliosis: a literature review. Spine (Phila Pa 1976). 43:E250–8. DOI: 10.1097/BRS.0000000000002276. PMID: 28604491.

13. Shen J, Parent S, Wu J, Aubin CÉ, Mac-Thiong JM, Kadoury S, et al. 2020; Towards a new 3D classification for adolescent idiopathic scoliosis. Spine Deform. 8:387–96. DOI: 10.1007/s43390-020-00051-2. PMID: 32026444.

14. Alsiddiky AM. 2015; An insight into early onset of scoliosis: new update information- a review. Eur Rev Med Pharmacol Sci. 19:2750–65. PMID: 26241527.

15. Mackel CE, Jada A, Samdani AF, Stephen JH, Bennett JT, Baaj AA, et al. 2018; A comprehensive review of the diagnosis and management of congenital scoliosis. Childs Nerv Syst. 34:2155–71. DOI: 10.1007/s00381-018-3915-6. PMID: 30078055.

16. Lewandowska J, Opydo-Szymaczek J, Mehr K, Głowacki J. 2019; Bilateral dentoalveolar asymmetries in female patients with adolescent idiopathic scoliosis. Acta Bioeng Biomech. 21:53–62. DOI: 10.37190/ABB-01457-2019-01. PMID: 32022798.

17. Laskowska M, Olczak-Kowalczyk D, Zadurska M, Czubak J, Czubak-Wrzosek M, Walerzak M, et al. 2019; Evaluation of a relationship between malocclusion and idiopathic scoliosis in children and adolescents. J Child Orthop. 13:600–6. DOI: 10.1302/1863-2548.13.190100. PMID: 31908677. PMCID: PMC6924124.

18. Dubousset J. 2020; Past, present, and future in pediatric spinal surgery. Ann Transl Med. 8:36. DOI: 10.21037/atm.2019.08.13. PMID: 32055627. PMCID: PMC6995910.

19. Kuznia AL, Hernandez AK, Lee LU. 2020; Adolescent idiopathic scoliosis: common questions and answers. Am Fam Physician. 101:19–23.

20. Yaman O, Dalbayrak S. 2014; Idiopathic scoliosis. Turk Neurosurg. 24:646–57. DOI: 10.5137/1019-5149.JTN.8838-13.0. PMID: 25269032.

21. Ben-Bassat Y, Yitschaky M, Kaplan L, Brin I. 2006; Occlusal patterns in patients with idiopathic scoliosis. Am J Orthod Dentofacial Orthop. 130:629–33. DOI: 10.1016/j.ajodo.2005.01.032. PMID: 17110260.

22. Zhou S, Yan J, Da H, Yang Y, Wang N, Wang W, et al. 2013; A correlational study of scoliosis and trunk balance in adult patients with mandibular deviation. PLoS One. 8:e59929. DOI: 10.1371/journal.pone.0059929. PMID: 23555836. PMCID: PMC3612109. PMID: 1d06faeef8544b1abde7d6ea3a84a043.

23. Michelotti A, Manzo P, Farella M, Martina R. 1999; [Occlusion and posture: is there evidence of correlation?]. Minerva Stomatol. 48:525–34. Italian. PMID: 10768011.

24. Kim TH, Kim JH, Kim YJ, Cho IS, Lim YK, Lee DY. 2014; The relation between idiopathic scoliosis and the frontal and lateral facial form. Korean J Orthod. 44:254–62. DOI: 10.4041/kjod.2014.44.5.254. PMID: 25309865. PMCID: PMC4192527.

25. Jeong KY, Min KJ, Woo J, Yim SY. 2015; Craniofacial asymmetry in adults with neglected congenital muscular torticollis. Ann Rehabil Med. 39:440–50. DOI: 10.5535/arm.2015.39.3.440. PMID: 26161351. PMCID: PMC4496516.

26. Végh A, Fábian G, Jianu R, Segatto E. 2012; Orofacial characteristics of adolescents with diagnosed spinal disorders. Biomed Tech (Berl). 57:65–9. DOI: 10.1515/bmt-2011-0036. PMID: 22718594.

27. Tecco S, Mummolo S, Marchetti E, Tetè S, Campanella V, Gatto R, et al. 2011; sEMG activity of masticatory, neck, and trunk muscles during the treatment of scoliosis with functional braces. A longitudinal controlled study. J Electromyogr Kinesiol. 21:885–92. DOI: 10.1016/j.jelekin.2011.08.004. PMID: 21889363.

28. Saifuddin M, Miyamoto K, Ueda HM, Shikata N, Tanne K. 2003; An electromyographic evaluation of the bilateral symmetry and nature of masticatory muscle activity in jaw deformity patients during normal daily activities. J Oral Rehabil. 30:578–86. DOI: 10.1046/j.1365-2842.2003.00991.x. PMID: 12787454.

29. Kondo E. 2004; Features and treatment of skeletal class III malocclusion with severe lateral mandibular shift and asymmetric vertical dimension. World J Orthod. 5:9–24. PMID: 15615138.

30. Seo SJ, Yim SY, Lee IJ, Han DH, Kim CS, Lim H, et al. 2013; Is craniofacial asymmetry progressive in untreated congenital muscular torticollis? Plast Reconstr Surg. 132:407–13. DOI: 10.1097/PRS.0b013e3182959e30. PMID: 23584628.