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安氏 I 类、安氏 II 类 1 分类或安氏 II 类 2 分类错(牙合)伴上前牙过度覆(牙合)的成人的牙颌面形态。

Dentoskeletal morphology in adults with Class I, Class II Division 1, or Class II Division 2 malocclusion with increased overbite.

机构信息

Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkey.

Department of Orthodontics, Gazi University Faculty of Dentistry, Ankara, Turkey.

出版信息

Am J Orthod Dentofacial Orthop. 2019 Aug;156(2):248-256.e2. doi: 10.1016/j.ajodo.2019.03.006.

Abstract

INTRODUCTION

The treatment options for adults with increased overbite are limited to dentoalveolar changes that camouflage the condition. Because of high relapse tendency, defining the problem area is important when creating a treatment plan. This study aimed to evaluate dentoskeletal morphology in skeletal Class I and II anomalies associated with Angle Class I, Class II Division 1 (Class II/1), and Class II Division 2 (Class II/2) malocclusions with increased overbite compared with normal occlusion.

METHODS

Pretreatment cephalograms of 306 patients (131 men, 175 women; overall ages 18-45 years) were evaluated. Four groups were constructed. Three groups had increased overbite (>4.5 mm): group 1 (n = 96) skeletal Class I (ANB = 0.5°-4°), group 2 (n = 85) skeletal Class II (ANB >4.5°) with Class II/1; and group 3 (n = 79) skeletal Class II with Class II/2 malocclusion. Group 4 as a control (n = 46) skeletal Class I normal overbite. Dental and skeletal characteristics of the groups were compared by sex. For statistical evaluations, analysis of variance followed by Tukey post hoc, Mann-Whitney U, and Kruskall-Wallis tests were used. Additionally correlation coefficients between overbite and skeletal/dental parameters were calculated.

RESULTS

Between sexes, with regard to skeletal parameters, the men had greater values in millimetric measurements, and the women had higher SN/GoGn values. Maxillary/mandibular molar heights and the mandibular incisor heights were higher in men. In group 1, decreased lower anterior facial height (LAFH), retrusive mandibular incisors, and increased interincisal degree were determined. The maxillary molars were intrusive, whereas the vertical position of the mandibular molars and incisors in both jaws were normal. In group 2, retrognathic mandible, increased LAFH and mandibular plane angle, extrusive maxillary/mandibular incisors, protrusive mandibular incisors, and decreased interincisal degree were found. In group 3, decreased LAFH, increased interincisal degree, and retrusive incisors in both jaws were determined. There were significant negative correlations between SN/GoGN, palatal plane, and overbite in group 2 and between ANS-SN and overbite in group 3, and positive correlation between interinsical angle and overbite in all increased overbite groups.

CONCLUSIONS

Dental morphology seems to be the main factor of increased overbite. Differences between groups were related primarily to inclinations and vertical positions of the incisors, rather than molar positions.

摘要

简介

对于深覆合的成年人,治疗选择仅限于掩饰这种情况的牙牙槽变化。由于高复发倾向,在制定治疗计划时确定问题区域很重要。本研究旨在比较正常咬合与骨性 I 类和 II 类错(Angle 分类 I、I 类 2 分类(Class II/1)和 II 类 2 分类(Class II/2)深覆合的骨骼畸形,评估牙颌面形态。

方法

评估了 306 名患者(男 131 名,女 175 名;总体年龄 18-45 岁)的治疗前头颅侧位片。构建了四个组。三组深覆合(>4.5mm):组 1(n=96)为骨性 I 类(ANB=0.5°-4°),组 2(n=85)为骨性 II 类(ANB>4.5°)伴 II/1 分类;和组 3(n=79)为骨性 II 类伴 II/2 错(Angle 分类)。组 4 作为对照组(n=46)为骨性 I 类正常覆合。通过性别比较各组的牙齿和骨骼特征。为了进行统计评估,使用方差分析、Tukey 事后检验、Mann-Whitney U 检验和 Kruskal-Wallis 检验。此外,还计算了深覆合与骨骼/牙齿参数之间的相关系数。

结果

在性别方面,在骨骼参数方面,男性的毫米测量值更大,而女性的 SN/GoGn 值更高。上颌/下颌磨牙高度和下颌切牙高度在男性中更高。在组 1 中,确定了下前颜面高度(LAFH)降低、下颌切牙后缩和切牙间角度增加。上颌磨牙内倾,而上下颌磨牙和切牙的垂直位置正常。在组 2 中,发现下颌后缩、LAFH 增加、下颌平面角增加、上颌/下颌切牙外倾、下颌切牙前突和切牙间角度减小。在组 3 中,确定了上下颌 LAFH 降低、切牙间角度增加和切牙后缩。在组 2 中,SN/GoGN、腭平面和深覆合之间存在显著负相关,在组 3 中,ANS-SN 和深覆合之间存在显著正相关,所有深覆合组中切牙间角度与深覆合之间存在正相关。

结论

牙齿形态似乎是深覆合的主要因素。各组之间的差异主要与切牙的倾斜度和垂直位置有关,而与磨牙位置无关。

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