Bäckman Birgitta, Grevér-Sjölander Ann-Christin, Bengtsson Karin, Persson Jenny, Johansson Iréne
Department of Odontology/Paediatric Dentistry, Umeå University, Umeå, Sweden.
Int J Paediatr Dent. 2007 Jan;17(1):19-28. doi: 10.1111/j.1365-263X.2006.00781.x.
The aim of this study was to describe the number of erupted teeth, sucking habits, tongue morphology, facial expression and speech in children with Down syndrome (DS) aged 48 +/- 6 months and treated from 6 months of age with palatal plates in combination with speech and language therapy.
The research took the form of a multicentre, multidisciplinary, longitudinal study of children with DS followed from the age of 6 months. A total of 37 children with DS were included. One child could not cooperate at all and was excluded from the evaluations. In combination with speech and language intervention provided by speech and language therapists, the children used palatal plates provided by dentists from 6 months of age. In the evaluation, the children in the sample (n = 36) were compared with two similarly aged control groups: one group of children with DS who never had used palatal plates (n = 31) and one group of children with normal development (n = 36). The evaluation of oral parameters was performed by dentists after calibration. Registration of facial expression and speech was done by a speech and language therapist, and the evaluation was done by two speech and language therapists and one phonetician who were calibrated in joint discussions.
In contrast to the children with DS in the control group, the subjects in the study were found to have as many erupted teeth as the children with normal development. The prevalence of sucking habits did not differ between the three groups. Only children with DS sucked their tongue, a toy or other things in addition to a thumb or dummy. The prevalence of tongue diastase in the study group with DS was of the same magnitude as in the evaluation at the age of 18 +/- 3 months. The palatal plates were used by 57-65% of the children without any larger problems. In the study sample, the possible beneficial effects of palatal plate therapy were a lower prevalence of posterior cross-bite, a higher prevalence of frontal cusp-to-cusp relation and a lower prevalence of frontal open bite. Evaluation of facial expression and speech showed a higher score for facial expression and a better communicative capacity in the children in the study group than in the control children with DS.
In children with DS, palatal plate therapy between 6 and 48 months of age in connection with speech and language intervention had a positive effect on occlusion, oral motor function, facial expression and speech. No harmful effects were observed. Although this is a valuable method, however, it must be emphasized that palatal plate therapy puts additional demands on already burdened children and their caretakers.
本研究旨在描述年龄在48±6个月、自6个月起接受腭板治疗并结合言语和语言治疗的唐氏综合征（DS）患儿的萌出牙齿数量、吮吸习惯、舌形态、面部表情和言语情况。
本研究采用多中心、多学科的纵向研究形式，对6个月起的DS患儿进行随访。共纳入37名DS患儿。有1名患儿完全无法配合，被排除在评估之外。在言语和语言治疗师提供言语和语言干预的同时，患儿从6个月起使用牙医提供的腭板。在评估中，将样本中的患儿（n = 36）与两个年龄相仿的对照组进行比较：一组是从未使用过腭板的DS患儿（n = 31），另一组是发育正常的儿童（n = 36）。口腔参数由经过校准的牙医进行评估。面部表情和言语的记录由言语和语言治疗师完成，评估由两名言语和语言治疗师以及一名经过联合讨论校准的语音学家进行。
与对照组的DS患儿相比，研究中的受试者萌出牙齿数量与发育正常的儿童一样多。三组之间吮吸习惯的患病率没有差异。只有DS患儿除了吮吸拇指或安抚奶嘴外，还会吮吸舌头、玩具或其他物品。研究组DS患儿的舌间隙患病率与18±3个月龄时评估的患病率处于同一水平。57% - 65%的患儿使用腭板时没有出现较大问题。在研究样本中，腭板治疗可能的有益效果是后牙反合患病率较低、前牙尖对尖关系患病率较高以及前牙开合患病率较低。面部表情和言语评估显示，研究组患儿的面部表情得分更高，沟通能力比对照组DS患儿更好。
对于DS患儿，6至48个月龄期间进行腭板治疗并结合言语和语言干预，对咬合、口腔运动功能、面部表情和言语有积极影响。未观察到有害影响。尽管这是一种有价值的方法，但必须强调的是，腭板治疗对本就负担沉重的患儿及其照料者提出了额外要求。
