Postgraduate Program in Dentistry, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
Division of Endocrinology, Health Sciences Graduate Program, Federal University of Sergipe, Aracaju, Sergipe, Brazil.
Growth Horm IGF Res. 2022 Feb;62:101444. doi: 10.1016/j.ghir.2022.101444. Epub 2022 Jan 18.
The growth of the dental arches depends on GH and insulin-like growth factor type 1 (IGF1), but the consequences of GH deficiency (GHD) on their growth are still unclear, probably due to the acquired etiology of GHD in most described series, often associated with additional pituitary deficits (thyrotrophic, corticotrophic and gonadotrophic hormones), and imperfections of related replacement therapies, which may affect the dental arch growth. To avoid these limitations, we took advantage of a unique cohort of subjects with isolated GH deficiency (IGHD) due the same mutation in the GH releasing hormone receptor gene, living with very low serum GH and low to undetectable circulating IGF1 levels. Our purpose was to analyze the dimensions of maxillary and mandibular dental arches.
22 adult IGHD (15 untreated and 7 previously partially treated with GH) and 33 controls were enrolled in a cross-sectional study using the Ortho Insight 3D and MeshMixer software, RESULTS: In untreated IGHD subjects all maxillary arch measures were smaller than controls, while among mandibular arches, only the mandibular canine width and the mandibular arch length were reduced. In partially GH treated subjects only the palate depth, the maxillary canine width, the maxillary and mandibular arch lengths remained smaller than controls.
IGHD reduces the growth of maxillary arch to a greater degree than the mandibular arch, suggesting different control of superior and inferior dental arches. GH treatment increases some of these measures.
牙弓的生长依赖于生长激素（GH）和胰岛素样生长因子 1（IGF1），但生长激素缺乏症（GHD）对牙弓生长的影响仍不清楚，这可能是由于大多数描述的系列中 GHD 的获得性病因，常伴有其他垂体缺陷（促甲状腺素、促皮质素和促性腺激素），以及相关替代治疗的不完善，这可能会影响牙弓的生长。为了避免这些局限性，我们利用了一组因生长激素释放激素受体基因突变而导致的孤立性生长激素缺乏症（IGHD）的独特患者队列，他们的血清 GH 和循环 IGF1 水平非常低，处于低水平或无法检测到。我们的目的是分析上颌和下颌牙弓的尺寸。
我们进行了一项横断面研究，共纳入 22 名成年 IGHD 患者（15 名未治疗和 7 名之前部分接受 GH 治疗）和 33 名对照者，使用 Ortho Insight 3D 和 MeshMixer 软件。
在未接受治疗的 IGHD 患者中，所有上颌弓测量值均小于对照组，而下颌弓中只有下颌尖牙宽度和下颌弓长度减小。在部分接受 GH 治疗的患者中，只有腭深、上颌尖牙宽度、上颌和下颌弓长度仍小于对照组。
IGHD 对上颌弓的生长抑制程度大于下颌弓，表明上颌和下颌牙弓的生长受不同的控制。GH 治疗可增加其中一些指标。
