Department of Orthodontics, University of Florence, Florence, Italy.
Am J Orthod Dentofacial Orthop. 2011 Aug;140(2):202-9. doi: 10.1016/j.ajodo.2011.04.015.
This study was a cephalometric evaluation of the growth changes in untreated subjects with deepbite at 4 time points during their developmental ages (from the early mixed dentition to the permanent dentition, and from the prepubertal phase to young adulthood).
A sample of 29 subjects with deepbite (overbite >4.5 mm) was followed longitudinally from about 9 through about 18 years of age. Dentofacial changes at 4 times, defined by the cervical vertebral maturation method, were analyzed on lateral cephalograms. Nonparametric statistical analysis was used for comparisons.
Overbite improved on average by 1.3 mm between the first and last measurements; it worsened significantly during the prepubertal period, but it improved significantly at the pubertal growth spurt. From the prepubertal ages through young adulthood, overbite improved in 83% of the subjects and self-corrected in 62% of the subjects. Improvements in overbite were related to the initial amount of maxillary incisor proclination. The significant improvement in overbite during the adolescent growth spurt depended on the amount of vertical growth of the mandibular ramus and the eruption of the mandibular molars.
Subjects with deepbite showed worsened occlusal conditions during the prepubertal and mixed dentition phases, but had significant improvements thereafter. Improvements in overbite cannot be predicted on the basis of skeletal vertical relationships. These results provide useful indications for appropriate orthodontic treatment timing for an increased overbite.
本研究通过头影测量评估了未经治疗的深覆患者在发育阶段(从混合牙列早期到恒牙列,从青春前期到成年早期)的 4 个时间点的生长变化。
选择 29 名深覆(覆>4.5mm)患者作为研究对象,采用颈椎成熟度分析法对其进行了 4 次的纵向随访,在侧位头颅侧位片上分析了 4 次的牙颌面变化。采用非参数统计分析进行比较。
平均而言,从第一次测量到最后一次测量,覆改善了 1.3mm;在青春前期明显加重,但在青春期生长突增时明显改善。从青春前期到成年早期,83%的患者覆改善,62%的患者自行矫正。覆的改善与上颌切牙前倾初始量有关。在青春期生长突增期间,覆显著改善取决于下颌升支的垂直生长量和下颌磨牙的萌出量。
深覆患者在青春前期和混合牙列期的咬合状况恶化,但此后有显著改善。覆的改善不能根据骨骼垂直关系来预测。这些结果为增加覆的适当正畸治疗时机提供了有用的依据。