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Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie 2/2012

01.04.2012 | Original article

Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment

verfasst von: PD Dr. P. Meyer-Marcotty, H. Böhm, C. Linz, F. Kunz, N. Keil, A. Stellzig-Eisenhauer, T. Schweitzer

Erschienen in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie | Ausgabe 2/2012

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Abstract

Objective

Unilateral positional plagiocephaly is the most common deformity of the head in infants. As part of a prospective controlled clinical study, the pathomorphology of the positional plagiocephaly in early infancy was examined. The goal was to use noninvasive three-dimensional (3D) imaging to generate, for the first time ever, a standard database of infants without head deformities, to quantify the asymmetry of the positional plagiocephaly, and to evaluate the effectiveness of functional growth control using head orthesis.

Patients and methods

In the present study, 3D soft-tissue data of the entire head were collected from a total of 40 infants: 20 with positional plagiocephaly (6.0 ± 0.97 months) and 20 infants without a head deformity (6.4 ± 0.3 months). Functional growth was controlled using a custom-made head orthesis. To evaluate the therapy, pre- and posttherapeutic scans were evaluated in three dimensions.

Results

Compared with the control group, infants with positional plagiocephaly demonstrated a reduced maximum length of the head, an increased head height, a shift in the ear axis as well as asymmetric anterior and posterior volumes of the neurocranium in lateral comparisons. Therapy using head orthesis led to a significant improvement of the asymmetry, with a reduction of the diagonal difference and an adjustment of the posterior volumes.

Conclusion

Conservative growth control of extrinsically deformed infant skulls represents an interdisciplinary medical expansion of the orthodontic therapeutic spectrum. To prevent potential effects of positional plagiocephaly on the viscerocranium, head orthesis therapy is advisable in infancy.
Literatur
1.
Zurück zum Zitat Argenta L, David L, Thompson J (2004) Clinical classification of positional plagiocephaly. J Craniofac Surg 15:368–372PubMedCrossRef Argenta L, David L, Thompson J (2004) Clinical classification of positional plagiocephaly. J Craniofac Surg 15:368–372PubMedCrossRef
2.
Zurück zum Zitat Atmosukarto I, Shapiro LG, Starr JR et al (2010) Three-dimensional head shape quantification for infants with and without deformational plagiocephaly. Cleft Palate Craniofac J 47:368–377PubMedCrossRef Atmosukarto I, Shapiro LG, Starr JR et al (2010) Three-dimensional head shape quantification for infants with and without deformational plagiocephaly. Cleft Palate Craniofac J 47:368–377PubMedCrossRef
3.
Zurück zum Zitat Bjoerk A, Bjoerk L (1964) Artificial deformation and cranio-facial asymmetry in ancient Peruvians. J Dent Res 43:353–362PubMedCrossRef Bjoerk A, Bjoerk L (1964) Artificial deformation and cranio-facial asymmetry in ancient Peruvians. J Dent Res 43:353–362PubMedCrossRef
4.
Zurück zum Zitat Boere-Boonekamp MM, Linden-Kuiper LL van der (2001) Positional preference: prevalence in infants and follow-up after two years. Pediatrics 107:339–343PubMedCrossRef Boere-Boonekamp MM, Linden-Kuiper LL van der (2001) Positional preference: prevalence in infants and follow-up after two years. Pediatrics 107:339–343PubMedCrossRef
5.
Zurück zum Zitat Brenner DJ, Hall EJ (2007) Current concepts – computed tomography – an increasing source of radiation exposure. New Engl J Med 357:2277–2284PubMedCrossRef Brenner DJ, Hall EJ (2007) Current concepts – computed tomography – an increasing source of radiation exposure. New Engl J Med 357:2277–2284PubMedCrossRef
6.
Zurück zum Zitat Bruneteau RJ, Mulliken JB (1992) Frontal plagiocephaly: synostotic, compensational, or deformational. Plast Reconstr Surg 89:21–31, discussion 32–23PubMedCrossRef Bruneteau RJ, Mulliken JB (1992) Frontal plagiocephaly: synostotic, compensational, or deformational. Plast Reconstr Surg 89:21–31, discussion 32–23PubMedCrossRef
7.
Zurück zum Zitat Clarren SK (1981) Plagiocephaly and torticollis: etiology, natural history, and helmet treatment. J Pediatr 98:92–95PubMedCrossRef Clarren SK (1981) Plagiocephaly and torticollis: etiology, natural history, and helmet treatment. J Pediatr 98:92–95PubMedCrossRef
8.
Zurück zum Zitat Cohen MJ (2000) Epidemiology of craniosynostosis. In: Cohen MJ, MacLean RE (eds) Craniosynostosis: diagnosis, evaluation, and management. Oxford University Press, New York, pp 112–118 Cohen MJ (2000) Epidemiology of craniosynostosis. In: Cohen MJ, MacLean RE (eds) Craniosynostosis: diagnosis, evaluation, and management. Oxford University Press, New York, pp 112–118
9.
10.
Zurück zum Zitat Graham JM Jr, Gomez M, Halberg A et al (2005) Management of deformational plagiocephaly: repositioning versus orthotic therapy. J Pediatr 146:258–262PubMedCrossRef Graham JM Jr, Gomez M, Halberg A et al (2005) Management of deformational plagiocephaly: repositioning versus orthotic therapy. J Pediatr 146:258–262PubMedCrossRef
11.
Zurück zum Zitat Hartmann J, Meyer-Marcotty P, Benz M et al (2007) Reliability of a method for computing facial symmetry plane and degree of asymmetry based on 3D-data. J Orofac Orthop 68:477–490PubMedCrossRef Hartmann J, Meyer-Marcotty P, Benz M et al (2007) Reliability of a method for computing facial symmetry plane and degree of asymmetry based on 3D-data. J Orofac Orthop 68:477–490PubMedCrossRef
12.
Zurück zum Zitat Hutchison BL, Hutchison LA, Thompson JM, Mitchell EA (2004) Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics 114:970–980PubMedCrossRef Hutchison BL, Hutchison LA, Thompson JM, Mitchell EA (2004) Plagiocephaly and brachycephaly in the first two years of life: a prospective cohort study. Pediatrics 114:970–980PubMedCrossRef
13.
Zurück zum Zitat Hutchison BL, Thompson JM, Mitchell EA (2003) Determinants of nonsynostotic plagiocephaly: a case-control study. Pediatrics 112:e316PubMedCrossRef Hutchison BL, Thompson JM, Mitchell EA (2003) Determinants of nonsynostotic plagiocephaly: a case-control study. Pediatrics 112:e316PubMedCrossRef
14.
Zurück zum Zitat Kane AA, Lo LJ, Vannier MW, Marsh JL (1996) Mandibular dysmorphology in unicoronal synostosis and plagiocephaly without synostosis. Cleft Palate Craniofac J 33:418–423PubMedCrossRef Kane AA, Lo LJ, Vannier MW, Marsh JL (1996) Mandibular dysmorphology in unicoronal synostosis and plagiocephaly without synostosis. Cleft Palate Craniofac J 33:418–423PubMedCrossRef
15.
Zurück zum Zitat Kane AA, Mitchell LE, Craven KP, Marsh JL (1996) Observations on a recent increase in plagiocephaly without synostosis. Pediatrics 97:877–885PubMed Kane AA, Mitchell LE, Craven KP, Marsh JL (1996) Observations on a recent increase in plagiocephaly without synostosis. Pediatrics 97:877–885PubMed
16.
Zurück zum Zitat Kawamoto HK, Kim SS, Jarrahy R, Bradley JP (2009) Differential diagnosis of the idiopathic laterally deviated mandible. Plast Reconstr Surg 124:1599–1609PubMedCrossRef Kawamoto HK, Kim SS, Jarrahy R, Bradley JP (2009) Differential diagnosis of the idiopathic laterally deviated mandible. Plast Reconstr Surg 124:1599–1609PubMedCrossRef
17.
Zurück zum Zitat Kwon TG, Park HS, Ryoo HM, Lee SH (2006) A comparison of craniofacial morphology in patients with and without facial asymmetry- a three-dimensional analysis with computed tomography. Int J Oral Maxillofac Surg 35:43–48PubMedCrossRef Kwon TG, Park HS, Ryoo HM, Lee SH (2006) A comparison of craniofacial morphology in patients with and without facial asymmetry- a three-dimensional analysis with computed tomography. Int J Oral Maxillofac Surg 35:43–48PubMedCrossRef
18.
Zurück zum Zitat Lee RP, Teichgraeber JF, Baumgartner JE et al (2008) Long-term treatment effectiveness of molding helmet therapy in the correction of posterior deformational plagiocephaly: a five-year follow-up. Cleft Palate Craniofac J 45:240–245PubMedCrossRef Lee RP, Teichgraeber JF, Baumgartner JE et al (2008) Long-term treatment effectiveness of molding helmet therapy in the correction of posterior deformational plagiocephaly: a five-year follow-up. Cleft Palate Craniofac J 45:240–245PubMedCrossRef
19.
Zurück zum Zitat Lipira AB, Gordon S, Darvann TA et al (2010) Helmet versus active repositioning for plagiocephaly: a three-dimensional analysis. Pediatrics 126:e936–e945PubMedCrossRef Lipira AB, Gordon S, Darvann TA et al (2010) Helmet versus active repositioning for plagiocephaly: a three-dimensional analysis. Pediatrics 126:e936–e945PubMedCrossRef
20.
Zurück zum Zitat Lo LJ, Marsh JL, Pilgram TK, Vannier MW (1996) Plagiocephaly: differential diagnosis based on endocranial morphology. Plast Reconstr Surg 97:282–291PubMedCrossRef Lo LJ, Marsh JL, Pilgram TK, Vannier MW (1996) Plagiocephaly: differential diagnosis based on endocranial morphology. Plast Reconstr Surg 97:282–291PubMedCrossRef
21.
Zurück zum Zitat Loveday BP, Chalain TB de (2001) Active counterpositioning or orthotic device to treat positional plagiocephaly? J Craniofac Surg 12:308–313PubMedCrossRef Loveday BP, Chalain TB de (2001) Active counterpositioning or orthotic device to treat positional plagiocephaly? J Craniofac Surg 12:308–313PubMedCrossRef
22.
Zurück zum Zitat McKay DR, Davidge KM, Williams SK et al (2010) Measuring cranial vault volume with three-dimensional photography: a method of measurement comparable to the gold standard. J Craniofac Surg 21:1419–1422PubMedCrossRef McKay DR, Davidge KM, Williams SK et al (2010) Measuring cranial vault volume with three-dimensional photography: a method of measurement comparable to the gold standard. J Craniofac Surg 21:1419–1422PubMedCrossRef
23.
Zurück zum Zitat Meyer-Marcotty P, Alpers GW, Gerdes ABM, Stellzig-Eisenhauer A (2010) Impact of facial asymmetry in visual perception: A 3-dimensional data analysis. Am J Orthod Dentofac Orthop 137:168e1–e8 Meyer-Marcotty P, Alpers GW, Gerdes ABM, Stellzig-Eisenhauer A (2010) Impact of facial asymmetry in visual perception: A 3-dimensional data analysis. Am J Orthod Dentofac Orthop 137:168e1–e8
24.
Zurück zum Zitat Meyer-Marcotty P, Stellzig-Eisenhauer A (2009) Dentofacial self-perception and social perception of adults with unilateral Cleft Lip and Palate. J Orofac Orthop 70:224–236PubMedCrossRef Meyer-Marcotty P, Stellzig-Eisenhauer A (2009) Dentofacial self-perception and social perception of adults with unilateral Cleft Lip and Palate. J Orofac Orthop 70:224–236PubMedCrossRef
25.
Zurück zum Zitat Mortenson PA, Steinbok P (2006) Quantifying positional plagiocephaly: reliability and validity of anthropometric measurements. J Craniofac Surg 17:413–419PubMedCrossRef Mortenson PA, Steinbok P (2006) Quantifying positional plagiocephaly: reliability and validity of anthropometric measurements. J Craniofac Surg 17:413–419PubMedCrossRef
26.
Zurück zum Zitat Moss SD (1997) Nonsurgical, nonorthotic treatment of occipital plagiocephaly: what is the natural history of the misshapen neonatal head? J Neurosurg 87:667–670PubMedCrossRef Moss SD (1997) Nonsurgical, nonorthotic treatment of occipital plagiocephaly: what is the natural history of the misshapen neonatal head? J Neurosurg 87:667–670PubMedCrossRef
27.
Zurück zum Zitat Netherway DJ, Abbott AH, Gulamhuseinwala N et al (2006) Three-dimensional computed tomography cephalometry of plagiocephaly: asymmetry and shape analysis. Cleft Palate Craniofac J 43:201–210PubMedCrossRef Netherway DJ, Abbott AH, Gulamhuseinwala N et al (2006) Three-dimensional computed tomography cephalometry of plagiocephaly: asymmetry and shape analysis. Cleft Palate Craniofac J 43:201–210PubMedCrossRef
28.
Zurück zum Zitat Plank LH, Giavedoni B, Lombardo JR et al (2006) Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 17:1084–1091PubMedCrossRef Plank LH, Giavedoni B, Lombardo JR et al (2006) Comparison of infant head shape changes in deformational plagiocephaly following treatment with a cranial remolding orthosis using a noninvasive laser shape digitizer. J Craniofac Surg 17:1084–1091PubMedCrossRef
29.
Zurück zum Zitat Pogliani L, Mameli C, Fabiano V, Zuccotti GV (2011) Positional plagiocephaly: what the pediatrician needs to know. A review. Childs Nerv Syst 27:1867–1876PubMedCrossRef Pogliani L, Mameli C, Fabiano V, Zuccotti GV (2011) Positional plagiocephaly: what the pediatrician needs to know. A review. Childs Nerv Syst 27:1867–1876PubMedCrossRef
30.
Zurück zum Zitat Pollack IF, Losken HW, Fasick P (1997) Diagnosis and management of posterior plagiocephaly. Pediatrics 99:180–185PubMedCrossRef Pollack IF, Losken HW, Fasick P (1997) Diagnosis and management of posterior plagiocephaly. Pediatrics 99:180–185PubMedCrossRef
31.
Zurück zum Zitat Robinson S, Proctor M (2009) Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr 3:284–295PubMedCrossRef Robinson S, Proctor M (2009) Diagnosis and management of deformational plagiocephaly. J Neurosurg Pediatr 3:284–295PubMedCrossRef
32.
Zurück zum Zitat Rogers GF, Miller J, Mulliken JB (2008) Comparison of a modifiable cranial cup versus repositioning and cervical stretching for the early correction of deformational posterior plagiocephaly. Plast Reconstr Surg 121:941–947PubMedCrossRef Rogers GF, Miller J, Mulliken JB (2008) Comparison of a modifiable cranial cup versus repositioning and cervical stretching for the early correction of deformational posterior plagiocephaly. Plast Reconstr Surg 121:941–947PubMedCrossRef
33.
Zurück zum Zitat Schaaf H, Malik CY, Streckbein P et al (2010) Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity. J Craniofac Surg 21:1677–1682PubMedCrossRef Schaaf H, Malik CY, Streckbein P et al (2010) Three-dimensional photographic analysis of outcome after helmet treatment of a nonsynostotic cranial deformity. J Craniofac Surg 21:1677–1682PubMedCrossRef
34.
Zurück zum Zitat St John D, Mulliken JB, Kaban LB, Padwa BL (2002) Anthropometric analysis of mandibular asymmetry in infants with deformational posterior plagiocephaly. J Oral Maxillofac Surg 60:873–877CrossRef St John D, Mulliken JB, Kaban LB, Padwa BL (2002) Anthropometric analysis of mandibular asymmetry in infants with deformational posterior plagiocephaly. J Oral Maxillofac Surg 60:873–877CrossRef
35.
Zurück zum Zitat Weinberg SM, Naidoo S, Govier DP et al (2006) Anthropometric precision and accuracy of digital three-dimensional photogrammetry: comparing the Genex and 3dMD imaging systems with one another and with direct anthropometry. J Craniofac Surg 17:477–483PubMedCrossRef Weinberg SM, Naidoo S, Govier DP et al (2006) Anthropometric precision and accuracy of digital three-dimensional photogrammetry: comparing the Genex and 3dMD imaging systems with one another and with direct anthropometry. J Craniofac Surg 17:477–483PubMedCrossRef
36.
Zurück zum Zitat Xia JJ, Kennedy KA, Teichgraeber JF et al (2008) Nonsurgical treatment of deformational plagiocephaly: a systematic review. Arch Pediatr Adolesc Med 162:719–727PubMedCrossRef Xia JJ, Kennedy KA, Teichgraeber JF et al (2008) Nonsurgical treatment of deformational plagiocephaly: a systematic review. Arch Pediatr Adolesc Med 162:719–727PubMedCrossRef
Metadaten
Titel
Head orthesis therapy in infants with unilateral positional plagiocephaly: an interdisciplinary approach to broadening the range of orthodontic treatment
verfasst von
PD Dr. P. Meyer-Marcotty
H. Böhm
C. Linz
F. Kunz
N. Keil
A. Stellzig-Eisenhauer
T. Schweitzer
Publikationsdatum
01.04.2012
Verlag
Springer-Verlag
Erschienen in
Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie / Ausgabe 2/2012
Print ISSN: 1434-5293
Elektronische ISSN: 1615-6714
DOI
https://doi.org/10.1007/s00056-011-0070-z

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