title: Retrospective clinical investigation of the impact of early treatment of children with Down's syndrome according to Castillo-Morales.
abstract: BACKGROUND
  Infants and toddlers with Down's syndrome are treated at the Department of Orthodontics, University of Frankfurt/Main only when the tongue protrudes over the lower lip, hindering mouth closure. No plate therapy is applied in patients with less tongue protrusion. This study aimed to assess objectively the treatment effects of stimulation plate therapy after Castillo-Morales at this early stage of development.
  
  
  METHODS
  The follow-up covered 33 children, 20 of whom showed no mouth closure with the tongue resting protrusively on the lower lip at first examination at the age of 8 months. These 20 children received orthodontic treatment based on a stimulation plate. The parents were advised to insert the plate four times a day for about half an hour respectively. The overall treatment time was ca. 2 years. The second group (13 children) received no early treatment, as the functional parameters were only slightly altered at the age of 7 months. At follow-up, the children of the treatment group were between 8.8 +/- 2.3, and those of the control group 8.9 +/- 3.0 years old. The children underwent clinical examination; the parents answered a questionnaire. Additionally, study casts and intraoral photographs were taken along with frontal and profile photographs. The factors assessed were various functions, dentition, facial development, and subjective rating of the parents.
  
  
  RESULTS
  In contrast to the initial findings, no difference between the two groups was found at follow-up.
  
  
  CONCLUSIONS
  Early treatment using a stimulation plate thus appears to mitigate or even normalize the initially more severe dysfunctions recorded in the study group as compared to the controls.
authors.affiliation: Department of Orthodontics, Stiftung Carolinum, University of Frankfurt/Main, Germany. g.schuster@em.uni-frankfurt.de
authors.forename: G
authors.initials: G
authors.lastname: Schuster
authors.forename: R
authors.initials: R
authors.lastname: Giese
mesh_terms: D000367:Age Factors; D004314:Down Syndrome / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D009968:Orthodontic Appliances, Removable; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D014059:Tongue