Keski-Nisula Katri, Keski-Nisula Leo, Mäkelä Päivi, Mäki-Torkko Tapani, Varrela Juha
Vaasa Central Hospital, Vaasa, Finland.
Am J Orthod Dentofacial Orthop. 2006 Sep;130(3):292-9. doi: 10.1016/j.ajodo.2005.01.025.
The aim of this investigation was to analyze craniofacial morphology in children with distal bites, large overjets, and deepbites in the early mixed dentition.
The sample comprised 486 Finnish children who are participating in an ongoing clinical trial. Cephalograms were obtained at the deciduous-mixed dentition interphase for the baseline of the trial. The mean age of the children was 5.1 years (SD, 2.6; range, 4.0-7.8 years).
Subjects with bilateral distal steps of > or =1 mm compared with normal had long midfaces (P <.05), short and retrusive mandibles (P <.05), small maxillomandibular differentials (P <.001), convex profiles (P <.01), retrusive mandibular incisors (P <.01), and large interincisal angles (P <.001). Children with overjets of > or =4 mm had retrusive mandibles (P <.001), long maxillae and midfaces (P <.001), small maxillomandibular differentials (P <.001), convex profiles (P <.001), and protrusive maxillary and retrusive mandibular incisors (P <.001). Children with deepbites (overbites of > or =4 mm) had short and retrusive mandibles (P <.05), long midfaces (P <.001) and maxillae (P <.05), small maxillomandibular differentials (P <.001), convex profiles (P <.01), retrusive mandibular incisors (P <.001), and large interincisal angles (P <.001). No differences were found in the length of anterior cranial base, the position of maxilla relative to cranial base, lower facial height, and facial axis angle between any malocclusion group and normal children. All correlations between the occlusal and skeletal characteristics were low, suggesting only weak associations at this stage of development.
These results indicate that the early dentofacial features of children with distal occlusions, large overjets, and deepbites differ from normal values. However, the skeletal patterns of these 3 malocclusion types showed considerable similarities, with long but neutrally positioned maxillae, retrusive mandibles, small maxillomandibular differences, convex profiles, retrusive mandibular incisors, and large interincisal angles, but normal growth directions and lower facial heights as common features.
本研究的目的是分析处于乳牙混合牙列早期的远中咬合、深覆盖和深覆合儿童的颅面形态。
样本包括486名参与一项正在进行的临床试验的芬兰儿童。在乳牙混合牙列交替期获取头颅侧位片作为试验基线。儿童的平均年龄为5.1岁(标准差2.6;范围4.0 - 7.8岁)。
与正常情况相比,双侧远中台阶≥1mm的受试者有长面中部(P <.05)、短而后缩的下颌骨(P <.05)、小的上下颌差异(P <.001)、凸面型(P <.01)、下颌切牙后缩(P <.01)以及大的切牙间角(P <.001)。覆盖≥4mm的儿童有后缩的下颌骨(P <.001)、长的上颌骨和面中部(P <.001)、小的上下颌差异(P <.001)、凸面型(P <.001)以及上颌切牙前突和下颌切牙后缩(P <.001)。深覆合(覆合≥4mm)的儿童有短而后缩的下颌骨(P <.05)、长的面中部(P <.001)和上颌骨(P <.05)、小的上下颌差异(P <.001)、凸面型(P <.01)、下颌切牙后缩(P <.001)以及大的切牙间角(P <.001)。在任何错颌组与正常儿童之间,前颅底长度、上颌相对于颅底的位置、面下高和面部轴角均未发现差异。咬合与骨骼特征之间的所有相关性均较低,表明在这个发育阶段仅有微弱关联。
这些结果表明,远中咬合、深覆盖和深覆合儿童的早期牙颌面特征与正常值不同。然而,这三种错颌类型的骨骼模式显示出相当大的相似性,其共同特征为长但位置中性的上颌骨、后缩的下颌骨、小的上下颌差异、凸面型、下颌切牙后缩以及大的切牙间角,但生长方向正常和面下高正常。