Cephalometric comparison between children with and without Down's syndrome

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Abstract
Craniofacial development is analysed in 1,896 patients with Down's syndrome (age 0–14 years) in comparison to a matching control group consisting of 1,154 healthy children. The midface area and cranial base are under-developed in the youngest age group (0 to 3 months, n = 130). The length deficit increases up to the 14th year of life. The NSBa angle is obtuse, indicating a flat cranial base. The maxilla is under-developed but on average exhibits normal forward-downward growth pattern without an anterior or posterior rotation. Mandibular size starting from normal values is mildly hypoplastic at the age of 14. The gonion angle develops normally. The upper and lower incisors show increasing protrusion, the latter to a minor degree. These findings indicate that craniofacial dysplasia is already present at birth, becoming more severe with increasing age. An anterior open bite and class III malocclusion, which are frequently described in patients with Down's syndrome, may be due mainly to proclination of the incisors, under-development of the maxilla and a more anterior position of the hypoplastic but normally shaped mandible.

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