Warren John J, Slayton Rebecca L, Bishara Samir E, Levy Steven M, Yonezu Takuro, Kanellis Michael J
Department of Preventive and Community Dentistry, University of Iowa, Iowa City, Iowa, USA.
Pediatr Dent. 2005 Nov-Dec;27(6):445-50.
Little is known about the extent to which nonnutritive sucking habits contribute to malocclusion in the mixed dentition. The purpose of this study was to report on the relationship between certain occlusal traits in the mixed dentition and longitudinal sucking behaviors.
Dental examinations were conducted on 630 children in the mixed dentition who participated in a large, ongoing longitudinal study. Five hundred eighty consented to impressions, and 524 adequate study models were obtained. Of these, 444 also had adequate longitudinal nonnutritive sucking data obtained via mailed questionnaires to parents at 3- to 6-month intervals from birth to 8 years. Sucking behaviors were grouped by predominant type and duration. Study models were hand articulated using wax bites to evaluate the occlusion for the presence of open bite, crossbite, molar relationship, and excessive overjet. Bivariate statistical analyses related presence of these malocclusions to sucking duration and type.
Fifty-five percent of the children had malocclusions (anterior open bite, posterior crossbite, bilateral Class II molar relationship, or overjet >4 mm). Class II molar relationship was most common (30%). Overall, anterior open bite and posterior crossbite was associated with habits of 36 months or more. Sustained pacifier habits, including those of 24 to 47 months, were associated with anterior open bite and Class II molar relationships, while digit habits were associated with anterior open bite when sustained for 60 months or longer.
Malocclusions are quite prevalent in the mixed dentition, and anterior open bite and posterior crossbite may be preventable by modifying nonnutritive sucking behaviors.
关于非营养性吮吸习惯在混合牙列中导致错牙合畸形的程度，人们了解甚少。本研究的目的是报告混合牙列中某些咬合特征与纵向吮吸行为之间的关系。
对参与一项大型持续纵向研究的630名混合牙列儿童进行了牙科检查。580名儿童同意取印模，获得了524个合适的研究模型。其中，444名儿童还通过从出生到8岁每隔3至6个月向家长邮寄问卷的方式获得了足够的纵向非营养性吮吸数据。吮吸行为按主要类型和持续时间进行分组。研究模型用蜡咬合进行手工咬合，以评估咬合情况，检查是否存在开牙合、反牙合、磨牙关系和过度覆盖。对这些错牙合畸形的存在与吮吸持续时间和类型进行双变量统计分析。
55%的儿童有错牙合畸形（前牙开牙合、后牙反牙合、双侧II类磨牙关系或覆盖>4mm）。II类磨牙关系最为常见（30%）。总体而言，前牙开牙合和后牙反牙合与持续36个月或更长时间的习惯有关。持续使用安抚奶嘴的习惯，包括持续24至47个月的习惯，与前牙开牙合和II类磨牙关系有关，而持续60个月或更长时间的手指吮吸习惯与前牙开牙合有关。
错牙合畸形在混合牙列中相当普遍，通过改变非营养性吮吸行为，前牙开牙合和后牙反牙合可能是可以预防的。
