[Dental and skeletal age in children with growth hormone deficiency treated with growth hormone--preliminary report].
BACKGROUND
Somatotrophic hypofunction (growth hormone deficiency--GHD) is one of the basic indications for treatment with growth hormone. One of characteristics of this disease is a delay of bone age in comparison to calendar one.


OBJECTIVE
The authors refer to the difference between chronological age and dental and skeletal age in children with growth hormone deficiency depending on the duration of treatment with growth hormone.


METHODS
Twenty five patients with somatotrophic pituitary gland deficiency treated with growth hormone constituted research material. The patients were divided into two groups depending on substitution therapy period length. Group I consisted of 6 children with a treatment time shorter than 1 year, while group II--19 individuals--included children with a therapy duration of over 1 year. All children were subject to clinical orthodontic examination--the kind of dental-occlusion defect was evaluated--and radiological diagnostics was conducted--orthopantomogram and cephalogram. Matiegka and Lukasova clinical method was used for evaluation of dental age, while for radiological dental age evaluation the Demirjian's method. Radiological evaluation, conducted basing on X-rays of palm and wrist and radiological atlas of Greulich-Pyle, was used for determination of skeletal age. Schwarz and Steiner's analyses were used for cephalogram evaluation, considering the following angle parameters: SNA, SNB, ANB and G mandible angle.


RESULTS
In group I malocclusions represented 66,6%, where of most common were class II malocclusion--33.3%, then increased overbite and open bites 16.7% of cases. In this group in all subjects dental abnormalities were diagnosed. In the group of children treated with growth hormone longer than 1 year (group II) malocclusion represented 86.6%, class II malocclusion 46.7%, scissor-bite and increased overbite 13.3%, furthermore in 66.7% open bite and class III malocclusion were diagnosed. In 33.3% teeth discrepancies were found. In both examined groups dominated skeletal class II . Furthermore in both examined groups an increase of G angle on about 0.3% was stated.


CONCLUSIONS
A longer substitution therapy period, and thus generally longer hormone influence period, intensifies its influence on craniofacial complex. This influence is advantageous and leads to a decrease of the disproportion in jaw dimensions, thus preventing the occurrence of gnathic and malocclusion.
Kawala
Beata
B
Department of Dentofacial Orthopedics and Orthodontics, Wrocław Medical University, Poland.
Matthews-Brzozowska
Teresa
T
Bieniasz
Jolanta
J
Noczyńska
Anna
A
D000293:Adolescent; D000365:Age Determination by Skeleton; D000366:Age Determination by Teeth; D001842:Bone and Bones / Q000187:drug effects; D002648:Child; D004393:Dwarfism, Pituitary / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D013006:Growth Hormone / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000209:etiology; D011994:Recombinant Proteins / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome
D011994:Recombinant Proteins; D013006:Growth Hormone