Honorary specialist registrar in orthodontics, University College London Eastman Dental Institute for Oral Health Care Sciences, London, United Kingdom.
Clinical lecturer in paediatric dentistry, University College London Eastman Dental Institute for Oral Health Care Sciences, London, United Kingdom.
Am J Orthod Dentofacial Orthop. 2012 Mar;141(3):307-314. doi: 10.1016/j.ajodo.2011.08.026.
INTRODUCTION: The aims of this study were to compare the radiographic development of permanent teeth in a group of children affected by dental agenesis with an unaffected control group and to determine the effects of confounding factors including the severity of the dental agenesis, age, sex, ethnicity, and the number of stages used to estimate dental age. METHODS: A single-center retrospective cross-sectional study of dental panoramic tomographs was undertaken between July 2007 and April 2008 in a postgraduate teaching school. A total of 139 patients (aged 9-18 years) were recruited from the orthodontic clinic on the basis of predetermined inclusion and exclusion criteria to either a dental agenesis group or a control group. Dental panoramic tomograms were assessed, and the stages of development of the permanent teeth in the left maxillary and left mandibular regions were scored by using the 12 stages of Haavikko and the 8 stages of Demirjian and Goldstein. For each tooth scored, the mean dental age and standard error were determined by using the dental age assessment method, and an estimated dental age for each subject was derived by using the weighted average method. RESULTS: A statistically significant delay in dental age was found in the patients with dental agenesis compared with the control group. The dental age assessment method of Haavikko showed a delay of 1.20 years (SD, 1.74), and the method of Demirjian and Goldstein showed a delay of 1.64 years (SD, 1.75). It was also observed that older patients with dental agenesis had greater delays in tooth formation (P <0.001). With the Haavikko method, for every year of chronologic age, the delay in dental age increased by 0.53 year; with the Demirjian and Goldstein method, the delay increased by 0.48 year. A significant association was seen between the severity of dental agenesis and the delay in dental age (P <0.01). With both methods, for each additional developmentally absent tooth, the dental age was delayed by 0.13 year (lower confidence interval, -0.22; upper confidence interval, 0.35). There was no evidence that sex or ethnicity has an effect on the delay in dental age in patients with dental agenesis. CONCLUSIONS: The development of permanent teeth in children with dental agenesis is delayed when compared with a matched control group. The severity of dental agenesis affected the magnitude of the delay (P <0.01). This delay has implications in orthodontic treatment planning and in the estimation of age for legal, immigration, archaeological, and forensic purposes.
简介：本研究旨在比较一组患有牙缺失症的儿童与无牙缺失症的对照组之间的恒牙放射发育情况，并确定混杂因素的影响，包括牙缺失症的严重程度、年龄、性别、种族以及用于估计牙龄的阶段数。
方法：这是一项单中心回顾性病例对照研究，于 2007 年 7 月至 2008 年 4 月在一所研究生教学学校进行。根据预定的纳入和排除标准，从正畸诊所招募了 139 名年龄在 9-18 岁之间的患者，将其分为牙缺失症组或对照组。通过使用 Haavikko 的 12 个阶段和 Demirjian 和 Goldstein 的 8 个阶段，对左侧上颌和左侧下颌区域的恒牙发育阶段进行评估和评分。对于每个评分的牙齿，通过使用牙龄评估方法确定平均牙龄和标准误差，并通过加权平均法得出每个受试者的估计牙龄。
结果：与对照组相比，患有牙缺失症的患者牙龄明显延迟。Haavikko 的牙龄评估方法显示延迟 1.20 年（标准差，1.74），Demirjian 和 Goldstein 的方法显示延迟 1.64 年（标准差，1.75）。还观察到，牙缺失症患者年龄越大，牙齿形成的延迟越大（P<0.001）。使用 Haavikko 方法，每增加 1 岁的年龄，牙龄延迟增加 0.53 年；使用 Demirjian 和 Goldstein 方法，延迟增加 0.48 年。牙缺失症的严重程度与牙龄延迟之间存在显著关联（P<0.01）。使用两种方法，每增加一个发育性缺失的牙齿，牙龄延迟 0.13 年（置信区间下限，-0.22；置信区间上限，0.35）。没有证据表明性别或种族会影响牙缺失症患者牙龄的延迟。
结论：与匹配的对照组相比，患有牙缺失症的儿童恒牙发育延迟。牙缺失症的严重程度影响延迟的程度（P<0.01）。这一延迟对正畸治疗计划以及在法律、移民、考古和法医学方面估计年龄具有重要意义。
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