DDS Rome private practitioner.
Associate Professor, President of the Dental Hygiene Course B, Sapienza University of Rome, Department of Oral and Maxillofacial Sciences, Rome, Italy.
Eur J Paediatr Dent. 2018 Dec;19(4):317-323. doi: 10.23804/ejpd.2018.19.04.13.
To analyse the presence and prevalence of gnathologic problems in a sample of children, candidate for orthodontic treatment, and evaluate the relationship between psychological factors and gnathological problems. The purpose of this study was also to evaluate a simple protocol with specific psychological test and a questionnaire for the rapid diagnosis of gnathologic problems, useful for possible screening studies on a wider population.
Study Design: Observational, cross-sectional study. Among the patients coming for a first orthodontic evaluation 106 children, aged between 8 and 16 years, were examined. A complete orthodontic evaluation was performed in all patients; the RCMAS (Revised Children's Manifest Anxiety Scale) was used in the study to test the psychological condition, while the selected test for the diagnosis of gnathologic problems was the Fonseca Test. The prevalence of temporomandibular disorders (TMD) was evaluated with descriptive statistical analysis, and the eventually present correlation with a positive psycological test for anxiety has been evaluated with correlation parameters: c2 test of Pearson, and Cramer's V index.
The mean age of the children was 10.74 years. Females accounted for 55.66% of the total compared to 44.34% males. Signs and symptoms of TMD were present on average in 82% and 32% respectively. A remarkable amount of children also showed signs of psychological problems, mostly represented by anxiety. Positive correlation resulted between TMD (Fonseca scores) and increased overbite. Cross-correlations have been obtained, tested with Pearson c2 test and Cramer's V index, between level of anxiety, muscle pain on palpation, bad habits, and headache. The Class II subdivision molar class and altered canine relationship have been related to the presence of articular noise.
The protocol largely respected the need for speed of administration, comprehensiveness and reliability that we set out to achieve. Limited correlations have been assessed between occlusal conditions and positivity to the administrated tests. Further studies are desirable to increase the sample population.
分析一组接受正畸治疗的儿童患者的颌骨问题的存在和流行情况，并评估心理因素与颌骨问题之间的关系。本研究还旨在评估一种简单的方案，该方案使用特定的心理测试和问卷来快速诊断颌骨问题，以便在更广泛的人群中进行可能的筛查研究。
研究设计：观察性、横断面研究。在前来进行首次正畸评估的患者中，检查了 106 名 8 至 16 岁的儿童。对所有患者进行了全面的正畸评估；在研究中使用 RCMAS（修订后的儿童 manifest 焦虑量表）测试心理状况，而用于诊断颌骨问题的选择测试是 Fonseca 测试。使用描述性统计分析评估颞下颌关节紊乱（TMD）的患病率，并使用相关参数评估与焦虑阳性心理测试之间的相关性：Pearson 的 c2 检验和 Cramer's V 指数。
儿童的平均年龄为 10.74 岁。女性占总数的 55.66%，男性占 44.34%。TMD 的体征和症状平均分别存在于 82%和 32%的患者中。相当多的儿童也表现出心理问题的迹象，主要表现为焦虑。TMD（Fonseca 评分）与深覆颌增加呈正相关。通过 Pearson c2 检验和 Cramer's V 指数测试，获得了交叉相关性，包括焦虑程度、触诊时肌肉疼痛、不良习惯和头痛。Ⅱ类亚类磨牙类和改变的尖牙关系与关节噪音的存在有关。
该方案在很大程度上满足了我们设定的快速管理、全面性和可靠性的需求。评估了咬合状况与所进行测试的阳性结果之间的相关性。需要进一步的研究来增加样本量。
