Cranial Base Dimensions in Children with Down Syndrome: A Comparative Cephalometric Study

Abstract

Background: To ascertain if there are differences between the anterior cranial base length (ACBL), posterior cranial base
length (PCBL), total cranial base length (TCBL), and cranial base angle (CBA) in children with Down syndrome, compared
to a control population of children without Down syndrome
Methods: This was a cohort study consisting of twenty (20) individuals with Down syndrome (DS) recruited from special
needs schools and 20 control individuals recruited from pre-orthodontic patients who presented for orthodontic treatment at
the University of Benin Teaching Hospital. The study population was made up of children between ages 10-15 years (mean
12.6 ± 2.1) consisting of 10 males and 10 females for both study groups. Comparative evaluation of findings from the linear
measurements (ACBL, PCBL, TBL) and angular measurement (CBA) between individuals with Down syndrome and
controls were made using the independent t-test.Asignificant level of p<0.05 was set for this study.
Results: Significant deviations in the parameters evaluated were observed among the Down syndrome individuals. Down
syndrome individuals were observed to have a statistically significant reduction (p<0.0001) in their anterior cranial base
length (ACBL), posterior cranial base length (PCBL), and total cranial base length (TCBL) when compared to the control
individuals. However, the cranial base angle (CBA) among Down syndrome individuals was observed to be significantly
larger (p< 0.004) than in the control group. This observation was the same for both genders.
Conclusion: This study shows that the cranial base dimensions of individuals with Down syndrome are significantly
different from those of control individuals with the former having shorter linear dimensions and larger cranial base angles.
Further flattening of the cranial base has been reported with the use of function/orthopaedic appliances in patients with Down
syndrome. Orthodontists should therefore exercise caution when using this appliance for this group of patients.