Chen X X, Xia B, Ge L H, Yuan J W
Department of Pediatric Dentistry, First Clinical Division, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China.
Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Dec 18;48(6):1060-1066.
To assess the effects of breast-feeding duration, bottle-feeding duration and oral habits on the occlusal characteristics of primary dentition in 3-6-year-old children in Beijing.
This cross sectional study was conducted via an examination of the occlusal characteristics of 734 children combined with a questionnaire completed by their parents/guardians. The examination was performed by a single, previously calibrated examiner and the following variables were evaluated: presence or absence of deep overbite, open bite, anterior cross bite, posterior cross bite, deep overjet, terminal plane relationship of the second primary molar, primary canine relationship, crowding and spacing. Univariate analysis and multiple Logistic regressions were applied to analyze the associations.
It was found that a short duration of breast-feeding (never or ≤6 months) was directly associated with posterior cross bite (OR=3.13, 95%CI=1.11-8.82, P=0.031) and no maxillary space (OR=1.63, 95%CI=1.23-2.98, P=0.038). In children breast-fed for ≤6 months, the probability of developing pacifier-sucking habits was 4 times that for those breast-fed for >6 months (OR=4.21, 95%CI=1.85-9.60, P=0.000 2). The children who were bottle-fed for over 18 months had a 1.45-fold higher risk of nonmesial step occlusion and a 1.43-fold higher risk of class II canine relationship compared with those who were bottle-fed for 6-18 months. Non-nutritive sucking habits were also found to affect occlusion: a prolonged digit-sucking habit increased the probability of an anterior open bite, while a pacifier-sucking habit was associated with excessive overjet and absence of lower arch developmental space. Tongue-thrust habit was associated with anterior open bite (OR=4.21, 95%CI=1.85-9.60, P=0.000 2) and posterior cross bite (OR=7.24, 95%CI=1.30-40.13, P=0.024). Lower lip sucking habit was associated with deep overjet and had a negative association with class III canine relationship. Unilateral chewing was associated with spacing in mandibular (OR=1.57, 95%CI=1.03-2.41, P=0.037). Mouth breathing was associated with chronic rhinitis and adenoidal hypertrophy and had an association with spacing in maxillary. The chi-square test did not indicate a statistically significant association between upper lip sucking habit and any occlusal characteristics.
Breast-feeding duration was shown to be associated with the prevalence of posterior crossbite, or no maxillary space in the deciduous dentition and development of a pacifier-sucking habit. Children who had a longer duration of bottle-feeding were more likely to develop class II canine relationship. Children who had an oral habit were more likely to develop abnormal occlusal characteristics.
评估母乳喂养时长、奶瓶喂养时长及口腔习惯对北京3至6岁儿童乳牙列咬合特征的影响。
本横断面研究通过检查734名儿童的咬合特征,并结合其父母/监护人填写的问卷进行。检查由一名经过预先校准的单一检查者进行,并评估以下变量:深覆合、开颌、前牙反颌、后牙反颌、深覆盖、第二乳磨牙终末平面关系、乳尖牙关系、拥挤和间隙。采用单因素分析和多元逻辑回归分析相关性。
发现母乳喂养时间短(从未或≤6个月)与后牙反颌(比值比[OR]=3.13,95%置信区间[CI]=1.11 - 8.82,P=0.031)和上颌无间隙(OR=1.63,95%CI=1.23 - 2.98,P=0.038)直接相关。在母乳喂养≤6个月的儿童中,养成安抚奶嘴吸吮习惯的概率是母乳喂养>6个月儿童的4倍(OR=4.21,95%CI=1.85 - 9.60,P=0.0002)。与奶瓶喂养6至18个月的儿童相比,奶瓶喂养超过18个月的儿童出现非近中阶梯式咬合的风险高1.45倍,出现Ⅱ类尖牙关系的风险高1.43倍。还发现非营养性吸吮习惯会影响咬合:长期吮指习惯增加前牙开颌的概率,而安抚奶嘴吸吮习惯与覆盖过大和下牙弓发育间隙缺失有关。吐舌习惯与前牙开颌(OR=4.21,95%CI=1.85 - 9.60,P=0.0002)和后牙反颌(OR=7.24,95%CI=1.30 - 40.13,P=0.024)有关。下唇吸吮习惯与深覆盖有关,与Ⅲ类尖牙关系呈负相关。单侧咀嚼与下颌间隙有关(OR=1.57,95%CI=1.03 - 2.41,P=0.037)。口呼吸与慢性鼻炎和腺样体肥大有关,与上颌间隙有关。卡方检验未表明上唇吸吮习惯与任何咬合特征之间存在统计学上的显著关联。
母乳喂养时长与乳牙列后牙反颌、上颌无间隙的患病率及安抚奶嘴吸吮习惯的形成有关。奶瓶喂养时间较长的儿童更易出现Ⅱ类尖牙关系。有口腔习惯的儿童更易出现异常咬合特征。