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成骨不全症(OI)患儿口颌问题的评估——初步研究

Evaluation of stomatognathic problems in children with osteogenesis imperfecta (osteogenesis imperfecta - oi) - preliminary study.

作者信息

Smoląg Danuta, Kulesa-Mrowiecka Małgorzata, Sułko Jerzy

机构信息

Medical Department, Jagiellonian University Collegium Medicum, Kraków, Poland, PhD studies.

Institute of Physiotherapy, Health Science Department, Jagiellonian University, Kraków, Poland.

出版信息

Dev Period Med. 2017;21(2):144-153. doi: 10.34763/devperiodmed.20172102.144153.

Abstract

UNLABELLED

According to epidemiological data, muscular dysfunctions of the masticatory system occur in 15-23% of the population. Preventive examinations of functional disorders of the stomatognathic system are, therefore, of particular importance. A distinct group of patients exposed to dysfunctions in the area of the masticatory organ locomotor apparatus comprises those with genetic diseases characterised by disorders in collagen formation. One of such diseases is osteogenesis imperfecta (OI) and dentinogenesis imperfecta that usually goes together with the former.

AIM

The objective of this work was to evaluate the frequency with which particular disorders of the masticatory organ locomotor apparatus occur within the group of patients with osteogenesis imperfecta.

MATERIAL AND METHODS

The study was performed on patients of the Orthopaedic Clinic of the Polish-American Paediatric Institute in Kraków. The mean age of the children was 7.9 years. In all the cases, a genetic diagnosis of OI has been confirmed. The research methods were based on an in-depth interview on family diseases, pregnancy, postnatal period, feeding, subjective assessment of dysfunctions in the stomatognathic system. An examination of the deformations in the stomatognathic system and the skeleton was conducted, as well as an examination of the trauma and tone of the jaw. The relationship between breastfeeding and swallowing and speech disorders was also evaluated. The impact of intubation on mandibular ranges was investigated.

RESULTS

The results obtained were subjected to statistical analysis on the basis of which conclusions were drawn concerning disorders in the stomatognathic system which tend to occur in children with OI. The renunciation of breastfeeding significantly contributes to sucking and swallowing disorders, rumen disorders, as well as biomechanical disorders in the temporomandibular joint. A significant dependence between breastfeeding and swallowing problems was found, whereas there was no such dependence with respect to speech impediments.

CONCLUSIONS

The results of the research conducted led to the following conclusions: 1. Among pediatric patients with OI there are disorders in the stomatognathic system. The most common dysfunctions are: abdominal, swallowing and sucking disorders, abnormal muscle structure of the rumen and biomechanical disorders in the temporomandibular joints. Breastfeeding significantly contributes to swallowing disorders. 2. The therapeutic process involving children with OI requires the cooperation of specialists in orthopedics, pediatrics, physiotherapy, orthodontics and neurologopedics to carry out comprehensive diagnostics and treatment tailored to the individual needs of the patient. 3. In order to draw final conclusions, there is a need for more research by means of objective tools, such as EMG and a condensate recorder.

摘要

未标注

根据流行病学数据,咀嚼系统的肌肉功能障碍在15% - 23%的人群中出现。因此,对口颌系统功能障碍进行预防性检查尤为重要。咀嚼器官运动装置区域功能障碍的一个特殊患者群体包括那些患有以胶原蛋白形成紊乱为特征的遗传疾病的患者。其中一种疾病是成骨不全症(OI),牙本质发育不全通常与前者同时出现。

目的

本研究的目的是评估成骨不全症患者群体中咀嚼器官运动装置特定障碍的发生频率。

材料与方法

该研究在克拉科夫波兰 - 美国儿科学研究所骨科诊所的患者中进行。儿童的平均年龄为7.9岁。所有病例均已确诊为OI的基因诊断。研究方法基于对家族疾病、妊娠、产后时期、喂养、口颌系统功能障碍主观评估的深入访谈。对口颌系统和骨骼的变形进行了检查,以及对下颌的创伤和张力进行了检查。还评估了母乳喂养与吞咽及言语障碍之间的关系。研究了插管对下颌活动范围的影响。

结果

对所得结果进行了统计分析,并据此得出关于成骨不全症儿童中倾向于出现的口颌系统障碍的结论。放弃母乳喂养显著导致吸吮和吞咽障碍、瘤胃障碍以及颞下颌关节的生物力学障碍。发现母乳喂养与吞咽问题之间存在显著相关性,而在言语障碍方面不存在这种相关性。

结论

所进行的研究结果得出以下结论:1. 在患有成骨不全症的儿科患者中存在口颌系统障碍。最常见的功能障碍是:腹部问题、吞咽和吸吮障碍、瘤胃肌肉结构异常以及颞下颌关节的生物力学障碍。母乳喂养显著导致吞咽障碍。2. 涉及成骨不全症儿童的治疗过程需要骨科、儿科、物理治疗、正畸和神经骨科专家的合作,以针对患者的个体需求进行全面的诊断和治疗。3. 为了得出最终结论,需要借助肌电图(EMG)和冷凝记录器等客观工具进行更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8e3/8522973/b53f62724811/jmotherandchild-21-144-g001.jpg

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