Mew M
Lecturer and Clinical Director, London School of Facial Orthotropics, 16-18 Pampisford Road, Purley, Surrey, CR8 2NE.
Br Dent J. 2014 May;216(10):555-8. doi: 10.1038/sj.bdj.2014.401.
This article proposes a possible syndrome, craniofacial dystrophy (CFD), as one of the underlying causes of malocclusion and a range of other symptoms. These symptoms have seen a dramatic rise in the twentieth century, lack a clear aetiology and are currently treated symptomatically. Over the last 10,000 years there has been a progressive downswing in the anterior craniofacial structure (ACS), possibly due to a combination of changes in the masticatory effort and the posture of the tongue and the mandible. If the mouth is postured open and the muscles are weaker the face lengthens, a downswing, reducing the cross sectional area at the level of the oropharynx. This leads to less space for the tongue, the airway and the teeth, and is exacerbated by an increasingly evident 'suckling like' swallowing pattern. Changes in the shape of the ACS affect the functions for which this structure is responsible, leading to a range of symptoms, including malocclusion. Certain compensatory responses are possible to maintain these functions, primarily the airway. These vary between individuals, may be under genetic influence and may also influence the ACS and dentition, at times creating vicious cycles.
本文提出一种可能的综合征——颅面发育不良(CFD),作为错牙合畸形及一系列其他症状的潜在病因之一。这些症状在20世纪显著增加,病因不明,目前只能对症治疗。在过去一万年中,前颅面结构(ACS)逐渐下降,这可能是由于咀嚼力、舌头和下颌姿势的变化共同作用的结果。如果嘴巴处于张开姿势且肌肉较弱,面部就会变长,即出现下降,从而减少口咽水平的横截面积。这会导致舌头、气道和牙齿的空间变小,并且越来越明显的“类似吮吸”的吞咽模式会加剧这种情况。ACS形状的变化会影响该结构所负责的功能,从而导致一系列症状,包括错牙合畸形。为维持这些功能,主要是气道功能,可能会出现某些代偿反应。这些反应因人而异,可能受遗传影响,也可能反过来影响ACS和牙列,有时会形成恶性循环。