Department of Orthodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
Angle Orthod. 2010 May;80(3):440-5. doi: 10.2319/062609-358.1.
OBJECTIVE: To test the null hypothesis that there is no relationship between infraocclusion and the occurrence of other dental anomalies in subjects selected for clear-cut infraocclusion of one or more deciduous molars. MATERIALS AND METHODS: The experimental sample consisted of 99 orthodontic patients (43 from Boston, Mass, United States; 56 from Jerusalem, Israel) with at least one deciduous molar in infraocclusion greater than 1 mm vertical discrepancy, measured from the mesial marginal ridge of the first permanent molar. Panoramic radiographs and dental casts were used to determine the presence of other dental anomalies, including agenesis of permanent teeth, microdontia of maxillary lateral incisors, palatally displaced canines (PDC), and distal angulation of the mandibular second premolars (MnP2-DA). Comparative prevalence reference values were utilized and statistical testing was performed using the chi-square test (P < .05) and odds ratio. RESULTS: The studied dental anomalies showed two to seven times greater prevalence in the infraocclusion samples, compared with reported prevalence in reference samples. In most cases, the infraoccluded deciduous molar exfoliated eventually and the underlying premolar erupted spontaneously. In some severe phenotypes (10%), the infraoccluded deciduous molar was extracted and space was regained to allow uncomplicated eruption of the associated premolar. CONCLUSION: Statistically significant associations were observed between the presence of infraocclusion and the occurrence of tooth agenesis, microdontia of maxillary lateral incisors, PDC, and MnP2-DA. These associations support a hypothesis favoring shared causal genetic factors. Clinically, infraocclusion may be considered an early marker for the development of later appearing dental anomalies, such as tooth agenesis and PDC.
目的:检验零假设,即选择单个或多个乳磨牙存在明显近中移位的患者,其远中萌出间隙不足与其他牙齿异常的发生无关。
材料和方法:实验样本由 99 名正畸患者组成(43 名来自美国马萨诸塞州波士顿,56 名来自以色列耶路撒冷),至少有一颗萌出间隙超过 1mm 垂直不调的乳磨牙,从第一恒磨牙近中颊尖嵴测量。全景片和牙模用于确定其他牙齿异常的存在,包括恒牙缺失、上颌侧切牙过小、尖牙腭向错位(PDC)和下颌第二前磨牙远中倾斜(MnP2-DA)。使用了比较流行率参考值,并使用卡方检验(P<0.05)和优势比进行了统计检验。
结果:与参考样本中的报告流行率相比,研究中的牙齿异常在近中移位样本中出现的流行率高出两到七倍。在大多数情况下,萌出间隙不足的乳磨牙最终脱落,下方的前磨牙自然萌出。在一些严重的表型(10%)中,萌出间隙不足的乳磨牙被拔除,以恢复空间,使相关前磨牙能够顺利萌出。
结论:观察到萌出间隙不足与牙齿缺失、上颌侧切牙过小、PDC 和 MnP2-DA 存在之间存在统计学显著关联。这些关联支持了共享因果遗传因素的假说。临床上,萌出间隙不足可被视为发生迟发性牙齿异常(如牙齿缺失和 PDC)的早期标志物。
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