Moscow State University of Medicine and

Dentistry
Department of Orthodontics

Child Neurology Department, Russian State Medical

University, Moscow, Russia

ASSESSMENT OF NEUROBEHAVIOURAL
STATUS AND MOTOR DISORDERS WITH
MALOCCLUSION IN CHILDREN

I.A. Rubleva, A.B. Slabkovskaya, L.S. Persin, N.N. Zavadenko

Non-nutritive sucking behaviors such as finger-
thumb- and tongue-sucking, tongue thrust, lips- or
cheek-sucking, nail-, lip- or tongue-biting and other
pressure habits represent causative factors for
malocclusion. Many authors noted association
between sucking habits and different types of
malocclusion.
Many authors point out the
association between psycho-
neurological disorders and
different types of malocclusion in
children with sucking habits
 Jacobson A. 1963.
 Sheldon G.H. 1969.
 Brenner J.E. 1974.
 Lester, G., Bierbrauer В., Selfridge B.,
Gomeringer D. 1976.
 Geis A., Piarulle H. 1988.
 Green S. 2003.
 During neurological examination many children
with sucking habits are diagnosed as having
Minimal Cerebral Dysfunction or Attention
Deficit Hyperactivity Disorder (ADHD).
 Dysfunction of muscular and central nervous
systems lead to the postural balance
disturbance. The method of stabilometric
analysis is the modern approach to evaluate
motor system functioning.

N.N.Zavadenko, A.S.Petroukhin.
Diagnosis and Treatment of Cognitive and Behavioural
Disorders in Children.
Inergy Limited, London, 2007, 120 p.
 AIM…

to assess the psycho-

neurological status and
motor disorders in children
with malocclusion and
sucking habits.
 MATERIAL and METHODS:
Two groups of children, aged 8-12 years, were
examined.

 1st group –  2nd (control) group

40 children with of 15 children did not
malocclusion and have signs of
sucking habits. malocclusion and
sucking habits.
 Methods

 Parent’s Questionnaire (Zavadenko,

2005) to detect the symptoms of neuro-
behavioural disorders
 Physical and Neurological Exam for
Subtle Signs (PANESS) (Denckla, 1985)
 Stabilometric tests with the BioPostural
System
Physical and Neurological
Examination for Subtle Signs
(PANESS) by Denckla (1985)
PANESS is very informative
for the assessment of gross
and fine motor functions in
children. Most ADHD children
demonstrate poor
performance in both types of
this battery tasks, including:

1. walking line tasks and rest

postures/stations tasks or
2. tasks for hands and feet
repetitive and successive
movements of limbs (fine
motor proficiency).
Motor functions
assessment by
stabilometric tests with
the BioPostural System
RESULTS and
DISCUSSION
 The rate of malocclusions in children
with sucking habits

100

80

60

40

20

0
I)
sI rj e
t 1st group
la s e b i te e
n ( C o v
en p b it sI
II)
s io o p e s
i or de la
c cl u e r n (C
o t io
stal an l us
di c c
ia lo
s
me
Scores for Parents
Questionnaire in two groups of
patients
100

80

60

40

20

0
1st group
2nd (control) group
Totally 15.3% of children
with sucking habits had a
history of previously
diagnosed Attention Deficit
Hyperactivity Disorder
(ADHD)
PANESS (Physical and Neurological Exam for Subtle
Signs) Assessment

Cluster Definition Normal 2nd 1st group

score (control)
group
Errors, 1. walking line tasks 3-8 9 15
Precision, and rest
Rhythm
2. repetitive and 4-15 11 20
successive 0 is
movements of limbs best
(fine motor
score
proficiency).

Time of tasks for hands and 5 – 12 10 14

perfoming feet repetitive and
tests, sec. successive
movements (fine
motor proficiency).
 Stabilometric
assessment
confirmed motor
disorders in
children with
sucking habits.
Performing test of upright stance with Eyes
Opened in the 1st group revealed Ellipses surface
increased 2 times and during examination with
Eyes Closed increased 2.7 times compared with
2nd (control) group.
OPENED CLOSED


1st
group


2nd
(control)
group
More prominent changes were revealed in children with distal
occlusion. Sway area and Surface of stabilometric ellipses in
children with distal occlusion (Eyes Opened) increased 2.3 times
and during examination with Eyes Closed increased 2.7 times
compared with 2nd (control) group.

group of children
with distal occlusion
(Class II)

2nd (control)
group
CONCLUSIONS:
 Many children with sucking habits
and malocclusion have comorbid
psychoneurological and postural
disturbances
 Patients with malocclusion and a
sucking habit need detailed
neurobehavioral examination and
should be studied in collaboration with
other specialists, such as child
neurologists and posturologist.
irubleva@mail.ru