Fixed multibracket dental therapy has challenges but can be successfully performed in young persons with Down syndrome.

Purpose The objective of this study was to analyze the feasibility of orthodontic treatment with fixed multibracket dental appliances (FMAs) in patients with Down syndrome (DS). Methods The study sample was formed of 25 patients with DS who underwent orthodontic treatment with FMAs. Dental and skeletal characteristics, aspects of FMA treatment, retainer use and recurrences were analyzed. Results were compared with a control group of healthy, age-, sex- and PAR index-matched individuals. Results All the controls underwent a single desensitization session, whereas 2-3 sessions were necessary in 11 patients with DS (p < 0.001). All the controls underwent bimaxillary treatment, compared with 11 patients with DS (p < 0.001). Only 8 patients with DS wore intermaxillary elastics, compared with 19 controls (p = 0.004). Complications were more common in patients with DS than in controls (p = 0.003), due particularly to traumatic ulcers development. There were more failures during the maintenance phase in patients with DS than in controls (p = 0.001). The mean duration of treatment was 37 months in patients with DS and 23 months in controls. More cemented retainers were used in the controls than in patients with DS (p = 0.050). Conclusions It is possible to perform orthodontic treatment with FMAs in patients with DS, although treatment may take longer than usual and the frequency of complications is higher than in controls. Implications for Rehabilitation Certain dental characteristics of Down syndrome (DS) make these children firm candidates for orthodontic intervention. There is little literature available on orthodontic treatment in patients with DS, particularly with regard to the use of fixed appliances. This case-control study shows that it is possible to perform orthodontic treatment with fixed appliances in adequately selected patients with DS. However, in patients with DS orthodontic treatment may take longer than usual and the frequency of complications is higher than in the general population.