Warren John J, Bishara Samir E
College of Dentistry, The University of Iowa, Iowa City 52242-1010, USA.
Am J Orthod Dentofacial Orthop. 2002 Apr;121(4):347-56. doi: 10.1067/mod.2002.121445.
The purpose of this study was to determine the association between the duration of nutritive and nonnutritive sucking behaviors and various occlusal characteristics in the primary dentition. Sucking behavior data were collected on 372 children followed longitudinally from birth by using periodic questionnaires completed by parents. Study models were obtained from the children at 4 to 5 years of age and assessed for posterior crossbite, anterior open bite, and overjet. Dental arch parameters including arch widths, arch lengths, and arch depths were measured directly from the models. The subjects were grouped according to type of habit (pacifier or digit) and duration of nonnutritive sucking behaviors (less than 12, 12 to 24, 24 to 36, 36 to 48, and more than 48 months). Children with nonnutritive sucking of less than 12 months were further grouped according to the duration of breast-feeding. The dental arch and the occlusal characteristics were then compared among these groups. The results indicated no relationship between duration of breast-feeding during the first year of life and any dental arch or occlusal parameters. The study found that prolonged pacifier habits resulted in changes to the dental arches and the occlusal parameters that were different from the effects of digit sucking. In addition, some changes in the dental arch parameters and occlusal characteristics (eg, prevalence of posterior crossbite and increased amount of overjet) persisted well beyond the cessation of the pacifier or digit habit. Although further study is needed to determine the effects of nonnutritive sucking behavior in the mixed dentition, the results suggest that current recommendations for discontinuing these habits may not be optimal in preventing habit-related malocclusions.
本研究的目的是确定乳牙列期营养性和非营养性吮吸行为的持续时间与各种咬合特征之间的关联。通过使用家长定期填写的问卷，收集了372名从出生起就进行纵向跟踪的儿童的吮吸行为数据。在儿童4至5岁时获取研究模型，并评估后牙反合、前牙开合和覆盖情况。直接从模型上测量包括牙弓宽度、牙弓长度和牙弓深度在内的牙弓参数。根据习惯类型（安抚奶嘴或手指）和非营养性吮吸行为的持续时间（少于12个月、12至24个月、24至36个月、36至48个月以及超过48个月）对受试者进行分组。非营养性吮吸少于12个月的儿童再根据母乳喂养的持续时间进一步分组。然后比较这些组之间的牙弓和咬合特征。结果表明，出生后第一年的母乳喂养持续时间与任何牙弓或咬合参数之间均无关联。研究发现，长期使用安抚奶嘴的习惯会导致牙弓和咬合参数发生变化，这些变化与吮指的影响不同。此外，牙弓参数和咬合特征的一些变化（例如后牙反合的患病率和覆盖量增加）在停止使用安抚奶嘴或手指习惯后仍持续很长时间。尽管需要进一步研究来确定非营养性吮吸行为在混合牙列期的影响，但结果表明，目前关于戒除这些习惯的建议在预防与习惯相关的错牙合方面可能并非最佳。
