Bäckman B, Grevér-Sjölander A-C, Holm A-K, Johansson I
Department of Odontology/Paediatric Dentistry, Umeå University, Umeå, Sweden.
Int J Paediatr Dent. 2003 Sep;13(5):327-35. doi: 10.1046/j.1365-263x.2003.00485.x.
The aim of this study was to describe oral development and morphology in 18-month-old children with Down syndrome (DS) treated with palatal plates in combination with structured communication and speech training. The aim is further to describe the design of the palatal plates, compliance in their use and to give a brief report of their effect on oral motor function and speech.
Forty-two children with DS were followed from < or = 6 months of age until 18+/-3 months old. In addition to language intervention, and oral motor and sensory stimulation provided by speech therapists for all children with DS in Sweden, palatal plates provided by dentists are included in the training programme. In the evaluation, the children in the project were compared with two control groups of children matched for age; one group of children with DS who had not been treated with palatal plates, and one group of children with normal development.
Compared to the children with normal development, both groups of children with DS had fewer teeth erupted and a lower prevalence of sucking habits. Deviant morphology of the tongue in the form of diastase, lingua plicata or a sulcus in the anterior third of the tongue was only seen in children with DS. All children with normal development had positive values for overjet compared to 53% of the children with DS. The palatal plates were used 2-3 times daily for a total mean time of 15 min. Compliance in use of the plates decreased with age, mainly due to eruption of teeth and subsequent loss of retention. Evaluation of oral motor function and speech show that the children with DS in the project had better motor prerequisites for articulation than the control children with DS.
Palatal plate therapy did not affect oral parameters, i.e., eruption of teeth, types and prevalence of sucking habits, tongue morphology and symptoms of hypotonia. In combination with oral motor and sensory stimulation, palatal plate therapy had a positive effect on oral motor performance and prerequisites for articulation.
本研究旨在描述18个月大的唐氏综合征（DS）患儿在接受腭板治疗并结合结构化沟通与言语训练后的口腔发育及形态。进一步目的是描述腭板的设计、使用依从性，并简要报告其对口腔运动功能和言语的影响。
42名DS患儿从≤6个月龄开始随访至18±3个月龄。除了瑞典所有DS患儿都接受的语言干预以及言语治疗师提供的口腔运动和感觉刺激外，训练计划还包括牙医提供的腭板。在评估中，将项目中的患儿与两个年龄匹配的对照组儿童进行比较；一组未接受腭板治疗的DS患儿，以及一组发育正常的儿童。
与发育正常的儿童相比，两组DS患儿萌出的牙齿更少，吮吸习惯的发生率更低。仅在DS患儿中观察到以舌裂、舌褶或舌前三分之一处沟纹形式出现的异常舌形态。所有发育正常的儿童覆盖均为正值，而DS患儿中这一比例为53%。腭板每天使用2 - 3次，总平均使用时间为15分钟。随着年龄增长，腭板使用的依从性下降，主要原因是牙齿萌出及随后固位力丧失。口腔运动功能和言语评估表明，项目中的DS患儿比对照组DS患儿具有更好的发音运动基础。
腭板治疗未影响口腔参数，即牙齿萌出、吮吸习惯的类型和发生率、舌形态及肌张力减退症状。与口腔运动和感觉刺激相结合，腭板治疗对口腔运动表现和发音基础有积极影响。
