[The value of studying the cervical spine in craniofacial asymmetries].

INTRODUCTION

The relationship between facial asymmetry and cervical anomaly is rarely mentioned in the diagnosis of dento-maxillo-facial orthopaedics. It is regrettable that the study of the cervical spine is often ignored in the etio-pathogenesis of these dysmorphoses, particularly in cases of facial asymmetry.

OBJECTIVE

The aim is twofold: to encourage orthodontists and maxillofacial surgeons to make a systematic study of the cervical spine in craniofacial dysmorphoses and in particular craniofacial asymmetries, without claiming that they are becoming specialists in cervical spine pathology, and to introduce the necessary training in malformations of this anatomical region as part of the orthodontist specialisation curriculum.

MATERIAL AND

METHODS

Conventional radiographic examinations can detect abnormalities of the cervical spine and cervico-occipital hinge. These anomalies can be clarified by additional radiographic exploration, conebeam, CT scan or others views.

RESULTS

Some craniofacial, facial and dentoalveolar asymmetries are caused by abnormalities of the cervico-occipital hinge. Conventional radiological examinations prescribed in dento-maxillo-facial orthopaedics can be used to detect unrecognized spinal anomalies and inform patients or parents, thereby ensuring the practitioner's responsibility.

DISCUSSION: The three components-atlas, axis and occipital-are confused in a complex embryological process that explains the polymorphism of malformations in this region.

CONCLUSION

Any vertical and/or transverse facial and dento-alveolar asymmetry requires systematic investigation of the cervical spine as a whole and of the cranio-spinal joint in particular in search of any abnormalities.