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乳牙列和早期混合牙列的正畸学研究结果——对预防策略的推断

Orthodontic findings in the deciduous and early mixed dentition--inferences for a preventive strategy.

作者信息

Stahl Franka, Grabowski Rosemarie

机构信息

Department of Orthodontics, University of Rostock, Germany.

出版信息

J Orofac Orthop. 2003 Nov;64(6):401-16. doi: 10.1007/s00056-003-0313-8.

Abstract

AIM AND METHOD

The aim of the present epidemiologic study was to obtain representative basic data on the frequency, extent and age-dependence of malocclusions in the deciduous and early mixed dentition. The developmental tendencies of specific malocclusions were investigated from the aspect of orthodontic prevention. The collective comprised 8,864 preschool and school-aged children, of whom 1,225 were in the deciduous dentition (mean age 4.5 years) and 7,639 in the mixed dentition (mean age 8.9 years). The orthodontic data were clinically assessed as sagittal, transversal, or vertical single-arch and occlusal findings. In addition, the malocclusions were classified according to their primary symptoms. Early infantile habits, tongue dysfunctions, speech defects and incompetent lip closure were registered separately.

RESULTS

57% of the children were found to have malocclusions, with the frequency rising statistically significantly in dependence on age from the deciduous to the mixed dentition (p < or = 0.001). The mean extent of excessive overjet increased significantly from the deciduous to the mixed dentition. Crossbite with mandibular midline discrepancies were observed significantly more frequently in the deciduous dentition. Although the frequency of anterior open bite underwent a significant decline from the deciduous to the mixed dentition, open bite was the malocclusion most frequently associated with dysfunction in both groups. The significant increase in traumatic deep bite in the mixed dentition indicates an unfavorable developmental tendency in this anomaly until after the eruption of the permanent incisors.

CONCLUSION

The need for preventive orthodontic therapy and for the intensified application of interceptive and early treatment measures is stressed in view of the high number of malalignments and malocclusions in the deciduous and mixed dentition and the tendency for some forms of malocclusion to deteriorate as the dentition develops.

摘要

目的与方法

本流行病学研究的目的是获取乳牙列和早期混合牙列错牙合畸形的频率、程度及年龄依赖性的代表性基础数据。从正畸预防的角度研究特定错牙合畸形的发展趋势。研究对象包括8864名学龄前和学龄儿童,其中1225名处于乳牙列(平均年龄4.5岁),7639名处于混合牙列(平均年龄8.9岁)。正畸数据通过矢状向、横向或垂直单牙弓及咬合情况进行临床评估。此外,错牙合畸形根据其主要症状进行分类。早期婴儿习惯、舌功能障碍、言语缺陷和唇闭合不全分别进行记录。

结果

发现57%的儿童有错牙合畸形,从乳牙列到混合牙列,其频率随年龄增长有统计学显著升高(p≤0.001)。从乳牙列到混合牙列,平均覆盖过大程度显著增加。乳牙列中观察到下颌中线偏差的反牙合更为常见。尽管从乳牙列到混合牙列前牙开牙合的频率显著下降,但开牙合是两组中最常与功能障碍相关的错牙合畸形。混合牙列中创伤性深覆牙合的显著增加表明,在恒牙切牙萌出后,这种异常仍有不利的发展趋势。

结论

鉴于乳牙列和混合牙列中错牙合不齐和错牙合畸形的数量众多,以及某些形式的错牙合畸形随着牙列发育有恶化的趋势,强调了正畸预防治疗以及加强阻断性和早期治疗措施应用的必要性。

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