Palate morphology of bruxist children with mixed dentition. A pilot study C. C. RESTREPO* , C. SFORZA † , A. COLOMBO † , A. PELA ´ EZ-VARGAS* & V. F. FERRARIO † *CES-LPH Research Group, Medellı ´n, CES University, Colombia and † Laboratory of Functional Anatomy of the Stomatognathic Apparatus, Department of Human Morphology, University of Milan, Milan, Italy SUMMARY The objective of the study was to analyse quantitatively palatal morphology in bruxist and non-bruxist children with mixed dentition. Twenty- three children with mixed dentition were classified as bruxist according to their anxiety level, audible occlusal sounds related by the parents and signs of temporomandibular disorders; 23 children were control subjects matched for gender, age, and dental formula. The maxillary dental arches of all subjects were reproduced from alginate impressions cast in dental stone with a standardized technique. The casts were digitalized and mathematical equations were used to obtain the form of the palate in the sagittal, frontal and horizontal planes. Bruxist chil- dren had a statistically significant longer palate in the sagittal plane than control children; palatal shape differed especially in correspondence of the third, fourth and fifth teeth, bruxist children show- ing a relatively higher palate than control children. In this pilot study, sagittal plane differences in the palate between bruxist and non-bruxist children matched for age and gender were found. Further investigations are needed to understand better the clinical implications of the findings. Results should be taken into account in the diagnosis of the occlusal development in children with parafunctions to prevent future abnormalities: a bruxist child may have bigger dental arches than a normal child. KEYWORDS: palate, bruxism, growth and develop- ment, morphometry Accepted for publication December 9 2007 Introduction The aetiology of bruxism has been defined as multi- factorial (1). It is mainly regulated centrally, but influenced peripherally (2). Oral habits (3), temporo- mandibular disorders (TMD) (4–7), malocclusions (8, 9), hypopnoea (10), high anxiety levels (11) and stress (12) among others (13) could influence the peripheral occurrence of bruxism. These factors act as a motion stimulus to the central nervous system, which reacts with an alteration in the neurotransmission of dopa- mine (14, 15) and the answer is the clenching or grinding of the teeth. The effects of bruxism on teeth (16, 17) as well as on facial morphology (18–20) have been widely studied, but its relationship with the function and / or the shape of the upper maxilla or jaw has not been reported in children, although alterations in the hard palate of adult bruxists, such as torus palatinus have been reported (21). In particular, the analysis of palatal normal mor- phology in bruxist children appears to have been neglected so far. Quantitative investigations of normal palatal size and shape are infrequent. As reviewed elsewhere (22, 23), the main shortcoming seems to be technical: direct techniques in which several standard- ized landmarks are used as endpoints for caliper measurements are time-consuming and prone to error and cannot be used with the current computerized methods of treatment planning. Indirect analyses with the use of two-dimensional projections (radiographs, photographs or photocopies) are insufficient for the ª 2008 The Authors. Journal compilation ª 2008 Blackwell Publishing Ltd doi: 10.1111/j.1365-2842.2008.01848.x Journal of Oral Rehabilitation 2008 35; 353–360