Seemann Jana, Kundt Günther, Stahl de Castrillon Franka
Poliklinik für Kieferorthopädie der Klinik und Polikliniken für Zahn-, Universität Rostock, Rostock, Deutschland.
J Orofac Orthop. 2011 Mar;72(1):21-32. doi: 10.1007/s00056-010-0004-1. Epub 2011 Mar 11.
The aim of this study was to provide basic representative data on the prevalence of malocclusions involving space deficiency in both primary and early mixed dentition and to examine the relationship between these malocclusions and orofacial dysfunctions. The results should be viewed from an orthodontic prevention and early treatment perspective.
Orthodontic findings in the maxilla and mandible as well as the myofunctional status of 766 children in primary dentition and 2,209 children in mixed dentition were examined clinically in a cross-sectional study. The following parameters from each jaw were subjected to orthodontic analysis: crowding in the anterior and posterior regions of the maxilla and mandible in primary and mixed dentitions, deviations from normal maxillary arch forms in the primary dentition, deviations from normal anterior maxillary arch width in mixed dentition and maxillary apical base morphology in mixed dentition. Static and dynamic orofacial dysfunctions were documented with reference to specific parameters and clinical tests.
Crowding was observed in every tenth child in primary dentition (10.8%) and in every second child in mixed dentition (49.7%). Habitual open mouth posture, visceral swallowing, articulation disorders and oral habits were statistically significantly more frequent in children in primary dentition presenting a narrow maxillary arch. Reduced anterior maxillary arch width (compression) was statistically more frequent in children in early mixed dentitions with habitual open mouth posture. A narrow maxillary apical base correlated positively with all the orofacial dysfunctions analyzed.
Deviations from a regular arch form become apparent very early during dentition development and coexist with specific orofacial dysfunctions. They are thus important indicators for the early detection of functional abnormalities, causing deviations from normal dentition development. In children with orofacial dysfunctions the development of a narrow maxillary dental arch should be prevented by myofunctional therapy and by educating the parents. Interceptive orthodontic measures to treat a narrow maxillary arch in primary and early mixed dentition should also focus on eliminating functional disturbing factors, such as orofacial dysfunctions. Interdisciplinary cooperation with specialists in other fields of medicine, e.g. otorhinolaryngology and speech therapy, is essential to achieve this goal.
本研究旨在提供有关乳牙列和早期混合牙列中伴有牙列间隙不足的错牙合畸形患病率的基本代表性数据,并研究这些错牙合畸形与口面功能障碍之间的关系。应从正畸预防和早期治疗的角度看待这些结果。
在一项横断面研究中,对766名乳牙列儿童和2209名混合牙列儿童的上颌和下颌正畸检查结果以及肌功能状态进行了临床检查。对每个颌骨的以下参数进行正畸分析:乳牙列和混合牙列中上颌和下颌前后段的拥挤情况、乳牙列中上颌牙弓形态偏离正常的情况、混合牙列中上颌牙弓前部宽度偏离正常的情况以及混合牙列中上颌根尖基底形态。根据特定参数和临床检查记录静态和动态口面功能障碍。
乳牙列中每十名儿童中有一名出现拥挤(10.8%),混合牙列中每两名儿童中有一名出现拥挤(49.7%)。在上颌牙弓狭窄的乳牙列儿童中,习惯性张口姿势、咽式吞咽、发音障碍和口腔习惯在统计学上明显更为常见。在有习惯性张口姿势的早期混合牙列儿童中,上颌牙弓前部宽度减小(压缩)在统计学上更为常见。上颌根尖基底狭窄与所有分析的口面功能障碍呈正相关。
在牙列发育过程中,牙弓形态偏离正常的情况很早就会出现,并与特定的口面功能障碍共存。因此,它们是早期发现导致牙列发育偏离正常的功能异常的重要指标。对于有口面功能障碍的儿童,应通过肌功能治疗和对家长进行教育来预防上颌牙弓狭窄的发展。在乳牙列和早期混合牙列中治疗上颌牙弓狭窄的阻断性正畸措施也应侧重于消除功能干扰因素,如口面功能障碍。与其他医学领域的专家,如耳鼻喉科和言语治疗专家进行跨学科合作对于实现这一目标至关重要。