Análise da morfologia da coluna cervical superior, maturação vertebral e estágios de mineralização dentária em indivíduos com síndrome de Prader-Willi e apneia obstrutiva do sono

Abstract

Introduction: Prader–Willi syndrome (PWS) is a rare genetic disorder characterized by growth retardation, endocrine disorders, hypotonia, and an increased risk of Obstructive Sleep Apnea (OSA). Patients with OSA also present alterations in the morphology of the upper cervical spine. These conditions can impact skeletal and dental development in these individuals. Objectives: To evaluate vertebral maturation, upper cervical spine morphology, and stages of dental mineralization associated with age estimation in individuals with PWS and OSA. Materials and Methods: The sample consisted of 24 individuals (12 with PWS and 12 age- and sex-matched controls). Panoramic and cephalometric radiographs were analyzed, applying the Nolla, Demirjian, and Nicodemo methods for dental mineralization stages and age estimation, the Sandham method for upper cervical spine morphology, and the Hassel and Farman vertebral maturation analysis. The results were statistically compared between groups, considering a significance level of 5%. Results: No statistically significant differences were observed between groups regarding the stages of dental mineralization, cervical changes (p = 1.00), or vertebral maturation (p = 0.577). Only tooth 33, when analyzed by the Nolla method, showed statistically significant differences (p = 0.028). The Nolla method showed a greater correlation with chronological age (r = 0.935, r = 9.37), while the Demirjian method tended to overestimate age. The overall accuracy of the dental methods was limited but consistent between groups (p = 1.00). Conclusion: Patients with PWS appear to have relatively preserved dental mineralization and skeletal maturation. Despite the presence of OSA, these individuals appear to have no changes in the morphology of the upper cervical spine. Radiographic evaluation can aid in the management and clinical monitoring of this population