Marshall Steven D, Caspersen Matthew, Hardinger Rachel R, Franciscus Robert G, Aquilino Steven A, Southard Thomas E
Visiting associate professor, Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, IA 52242, USA.
Am J Orthod Dentofacial Orthop. 2008 Sep;134(3):344-52. doi: 10.1016/j.ajodo.2006.10.037.
Ferdinand Graf von Spee is credited with characterizing human occlusal curvature viewed in the sagittal plane. This naturally occurring phenomenon has clinical importance in orthodontics and restorative dentistry, yet we have little understanding of when, how, or why it develops. The purpose of this study was to expand our understanding by examining the development of the curve of Spee longitudinally in a sample of untreated subjects with normal occlusion from the deciduous dentition to adulthood.
Records of 16 male and 17 female subjects from the Iowa Facial Growth Study were selected and examined. The depth of the curve of Spee was measured on their study models at 7 time points from ages 4 (deciduous dentition) to 26 (adult dentition) years. The Wilcoxon signed rank test was used to compare changes in the curve of Spee depth between time points. For each subject, the relative eruption of the mandibular teeth was measured from corresponding cephalometric radiographs, and its contribution to the developing curve of Spee was ascertained.
In the deciduous dentition, the curve of Spee is minimal. At mean ages of 4.05 and 5.27 years, the average curve of Spee depths are 0.24 and 0.25 mm, respectively. With change to the transitional dentition, corresponding to the eruption of the mandibular permanent first molars and central incisors (mean age, 6.91 years), the curve of Spee depth increases significantly (P < 0.0001) to a mean maximum depth of 1.32 mm. The curve of Spee then remains essentially unchanged until eruption of the second molars (mean age, 12.38 years), when the depth increases (P < 0.0001) to a mean maximum depth of 2.17 mm. In the adolescent dentition (mean age, 16.21 years), the depth decreases slightly (P = 0.0009) to a mean maximum depth of 1.98 mm, and, in the adult dentition (mean age 26.98 years), the curve remains unchanged (P = 0.66), with a mean maximum depth of 2.02 mm. No significant differences in curve of Spee development were found between either the right and left sides of the mandibular arch or the sexes. Radiographic measurements of tooth eruption confirm that the greatest increases in the curve of Spee occur as the mandibular permanent incisors, first molars, or second molars erupt above the pre-existing occlusal plane.
On average, the curve of Spee initially develops as a result of mandibular permanent first molar and incisor eruption. The curve of Spee maintains this depth until the mandibular permanent second molars erupt above the occlusal plane, when it again deepens. During the adolescent dentition stage, the curve depth decreases slightly and then remains relatively stable into early adulthood.
费迪南德·格拉夫·冯·施佩被认为描绘了矢状面观察到的人类咬合曲线。这种自然发生的现象在正畸学和修复牙科学中具有临床重要性,但我们对其何时、如何或为何形成知之甚少。本研究的目的是通过纵向观察一组未经治疗、咬合正常的受试者从乳牙列到成年期斯皮曲线的发育情况,来扩展我们的认识。
选取并检查了爱荷华面部生长研究中16名男性和17名女性受试者的记录。在他们从4岁(乳牙列)到26岁(恒牙列)的7个时间点的研究模型上测量斯皮曲线的深度。使用威尔科克森符号秩检验比较各时间点之间斯皮曲线深度的变化。对于每个受试者,从相应的头颅侧位片中测量下颌牙齿的相对萌出情况,并确定其对斯皮曲线发育的影响。
在乳牙列中,斯皮曲线最小。在平均年龄4.05岁和5.27岁时,斯皮曲线深度的平均值分别为0.24毫米和0.25毫米。随着向混合牙列转变,对应于下颌第一恒磨牙和中切牙萌出(平均年龄6.91岁),斯皮曲线深度显著增加(P < 0.0001),平均最大深度达到1.32毫米。然后斯皮曲线基本保持不变,直到第二磨牙萌出(平均年龄12.38岁),此时深度增加(P < 0.0001),平均最大深度达到2.17毫米。在青少年牙列(平均年龄16.21岁)中,深度略有下降(P = 0.0009),平均最大深度为1.98毫米,而在恒牙列(平均年龄26.98岁)中,曲线保持不变(P = 0.66),平均最大深度为2.02毫米。在下颌牙弓的左右两侧或不同性别之间,斯皮曲线发育没有显著差异。牙齿萌出的影像学测量证实,斯皮曲线最大的增加发生在下颌恒切牙、第一磨牙或第二磨牙萌出到先前咬合平面之上时。
平均而言,斯皮曲线最初是由于下颌第一恒磨牙和切牙萌出而形成的。斯皮曲线保持这一深度,直到下颌第二恒磨牙萌出到咬合平面之上,此时曲线再次加深。在青少年牙列阶段,曲线深度略有下降,然后在成年早期保持相对稳定。