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早产对恒牙牙胚成熟度的影响。

The impact of premature birth on dental maturation in the permanent dentition.

机构信息

Department of Orthodontics, Malmö University, SE-20506, Malmö, Sweden.

Faculty of Odontology, Malmö University, SE-20506, Malmö, Sweden.

出版信息

Clin Oral Investig. 2019 Feb;23(2):855-861. doi: 10.1007/s00784-018-2501-3. Epub 2018 Jun 8.

Abstract

OBJECTIVES

To evaluate tooth development and calculate dental maturity score in prematurely born children and to compare the findings with full-term born children.

MATERIAL AND METHODS

Nine-year-old preterm children were selected from the Swedish Medical Birth Register. One group consisted of 36 extremely preterm children (born before week 29), and the other included 38 very preterm children (born during weeks 29 to 32). Panoramic radiography was performed on each child and the preterm children were compared with 42 full-term born children. Five observers independently assessed the tooth development stages for all teeth in the left mandible (31-37) on the panoramic radiographs according to the method described by Demirjian et al. (Hum Biol 45:211-227, 1973). Data from tooth development stages were compiled and converted into a dental maturity score for each group. Kappa values were calculated for intra- and inter-observer agreement.

RESULTS

When the different development stages for each individual tooth were compared, all observers presented a significant delay in the maturity of tooth 37 for the extremely preterm group (p ≤ 0.002). The extremely preterm group had a significantly lower dental maturity score than the full-term group, as assessed by each observer (p ≤ 0.006). Kappa values for inter-observer agreement varied between 0.31 and 0.71 depending on tooth and intra-observer agreement was between 0.16 and 1.0.

CONCLUSIONS

At age 9, the extremely preterm children had a general delay in tooth development.

CLINICAL RELEVANCE

The increased survival rate of extremely preterm babies adds a new group of children to society. Dental clinicians should be aware that the delay in tooth development could impact the timing of orthodontic diagnostics and potential treatment.

摘要

目的

评估早产儿的牙齿发育情况并计算其牙龄,与足月产儿进行比较。

材料和方法

从瑞典医学出生登记处选取 9 岁的早产儿。一组包括 36 名极早产儿(出生于 29 周前),另一组包括 38 名非常早产儿(出生于 29 周至 32 周)。对每位儿童进行全景放射摄影,将早产儿与 42 名足月产儿进行比较。5 位观察者根据 Demirjian 等人(Hum Biol 45:211-227, 1973)描述的方法,独立评估左下颌(31-37)所有牙齿的牙发育阶段。将来自不同发育阶段的数据进行编译,并转换为每个组的牙龄分数。计算了观察者内和观察者间的 Kappa 值以评估一致性。

结果

当比较每个个体牙齿的不同发育阶段时,所有观察者均发现极早产儿组的 37 号牙成熟度明显延迟(p≤0.002)。每位观察者评估,极早产儿组的牙龄明显低于足月产组(p≤0.006)。观察者间的 Kappa 值取决于牙齿,范围在 0.31 至 0.71 之间,观察者内的一致性在 0.16 至 1.0 之间。

结论

在 9 岁时,极早产儿的牙齿发育普遍延迟。

临床相关性

极早产儿存活率的提高使社会新增了一个儿童群体。牙科临床医生应该意识到牙齿发育的延迟可能会影响正畸诊断和潜在治疗的时机。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3222/7736023/39b65f55a439/784_2018_2501_Fig1_HTML.jpg

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