Anwar Nabila, Fida Mubassar
Department of Surgery, Section of Dentistry, The Aga Khan University Hospital, Karachi, Pakistan.
Eur J Orthod. 2009 Oct;31(5):516-22. doi: 10.1093/ejo/cjp010. Epub 2009 Aug 13.
The purpose of this study was to quantitatively evaluate skeletal and dental compensation in patients with vertical skeletal dysplasias and to determine which dentoalveolar parameters compensate for vertical jaw discrepancies. Cephalometric analyses were performed on pre-treatment lateral cephalographs of 186 orthodontic patients (120 females and 66 males; mean age 15 years 11 months) who met the selection criteria. SN-MP angle was used to classify the facial patterns as: hyperdivergent > 36 degrees, normo = 28-36 degrees, and hypo < 28 degrees. Analysis of variance (ANOVA) was used to determine statistical differences between the means in the three vertical facial types. To evaluate dental compensation quantitatively, correlation analyses were performed to find associations between skeletal and dental parameters. To further elucidate the compensatory nature of the lower incisors, regression analyses and scattergrams were obtained, with SN-MP as a measure of the vertical skeletal discrepancy. ANOVA showed statistically significant differences for most of the skeletal variables, but only for lower incisor height and inclination among the dentoalveolar parameters. Correlation analyses demonstrated significant relationships between various skeletal variables. LI-MP showed a negative relationship with SN-MP, whereas LAMdH demonstrated a positive linear relationship with SN-MP. Among all dentoalveolar heights, UAMxH showed the weakest, and LAMdH the strongest, associations with skeletal parameters. The variability in dentoalveolar compensation therefore demands individualized diagnosis and treatment planning. LAMdH and LI-MP parameters were the most likely, whereas UAMxH was the least likely parameter to compensate for vertical dysplasia.
本研究的目的是定量评估垂直骨骼发育异常患者的骨骼和牙齿代偿情况,并确定哪些牙槽参数可代偿垂直颌骨差异。对186例符合入选标准的正畸患者(120例女性,66例男性;平均年龄15岁11个月)治疗前的头颅侧位片进行头影测量分析。采用SN-MP角将面部类型分为:高度分散型>36度,正常型=28-36度,低度分散型<28度。采用方差分析(ANOVA)确定三种垂直面部类型均值之间的统计学差异。为了定量评估牙齿代偿情况,进行相关性分析以发现骨骼和牙齿参数之间的关联。为了进一步阐明下切牙的代偿性质,以SN-MP作为垂直骨骼差异的指标,获得了回归分析和散点图。方差分析显示,大多数骨骼变量存在统计学显著差异,但在牙槽参数中,仅下切牙高度和倾斜度存在差异。相关性分析表明,各种骨骼变量之间存在显著关系。LI-MP与SN-MP呈负相关,而LAMdH与SN-MP呈正线性相关。在所有牙槽高度中,UAMxH与骨骼参数的相关性最弱,而LAMdH与骨骼参数的相关性最强。因此,牙槽代偿的变异性需要个体化的诊断和治疗计划。LAMdH和LI-MP参数最有可能,而UAMxH参数最不可能代偿垂直发育异常。