A Dental Study in Patients with Cerebral Infantile Paralysis

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Other Title
  • 脳性小児麻痺患者の歯科学的研究
  • ノウセイ ショウニ マヒ カンジャ ノ シカガクテキ ケンキュウ
Published
1969
Resource Type
journal article
DOI
  • 10.5834/jdh.19.87
Publisher
Japanese Society for Oral Health

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1) Past History<BR>A survey on 124 pupils of a school for the handicapped in Shizuoka, Japan and 30 patients with cerebral infantile paralysis revealed disturbances durin labor such as premature delivery, difficult labor due to narrow birth canal, abnormal presentation, and coiling of the umblical cord. Many patients had history of acute febrile illness such as measles, whooping cough, and jaundice. Inability of sucking milk resulted in disturbance of general growth leading to abnormalities in the development of the jaws and teeth.<BR>2) Measurement of the palate<BR>The width of the palate tended to be smaller in the cerebral form than in the spinal form, while no such difference was noted in the height, indicating an abnormally intense biting pressure against the teeth during jaw movement. This might influence the maxilla of the patient in the process of growth. In an adynamic state, on the other hand, normal masticatory pressure is not exerted against the maxilla in the absence of action of muscles around the oral cavity, resulting in the height of the oral cavity.<BR>3) Mode of development of carious teeth<BR>Development of carious teeth was studied in 117 pupils of the school for the handicapped. More than 10 carious teeth were found in 31.4% of patients with cerebral infantile paralysis and 10.4% of patients with spinal infantile paralysis, probably due to the difficulty in nutritional intake during the suckling and infant stage, leading to nutritional disturbance and providing an unfavorable condition in odontogenesis. Marked motory disturbance of various organs in the oral cavity makes the self-cleansing of the oral cavity difficult, so that food debris remains in the oral cavity.<BR>4) Relationship in occlusion and alinement of the teeth<BR>The shift of midline between the upper and lower jaws seen in 20 of 25, and in all of the 11 with involuntary movement type. Torsion of the teeth was noted in 25 patients with cerebral infantile paralysis. Transposition of the teeth or crowded growth was seen in 9 of 25 cases of cerebral form, in 6 of 11 cases of involuntary movement type, and in 9 of 30 cases of spinal type. The shift of midline between upper and lower jaws was seen in 100% of the type of involuntary movement, indicating the abnormal anterior movement of the jaw and tongue especially the intense lateral and anterior-posterior movement of the jaw.<BR>These are also probably related with the frequent occurrence of the transposition and torsion of the teeth in the alinement of the teeth.<BR>5) Hypoplasia of the teeth<BR>Among 79 cases of cerebral infantile paralysis and 49 cases of spinal infantile paralysis, dental hypoplasia was seen in 41.77% of patients with cerebral infantile paralysis and 24.48% of patients with spinal infantile paralysis. The frequency in the latter was much smaller than that in the former. From the past history, the frequency of appearance of a white spot appeared to be higher as the attack on the process of growth was more severe.

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