Department of Orthodontics, University of Washington, Seattle, Wash.
Western Region, National Dental Practice-Based Research Network, Portland, Ore.
Am J Orthod Dentofacial Orthop. 2019 Sep;156(3):312-325. doi: 10.1016/j.ajodo.2019.05.005.
This aim of this paper is to describe and identify the practitioner and patient characteristics that are associated with treatment recommendations for adult anterior open bite patients across the United States.
Practitioners and patients were recruited within the framework of the National Dental Practice-Based Research Network. Practitioners were asked about their demographic characteristics and their treatment recommendations for these patients. The practitioners also reported on their patients' dentofacial characteristics and provided initial cephalometric scans and intraoral photographs. Patients were asked about their demographic characteristics, previous orthodontic treatment, and goals for treatment. Four main treatment groups were evaluated: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also investigated. Predictive multivariable models were created comparing various categories of treatment as well as extraction/nonextraction decisions.
Ninety-one practitioners (mostly orthodontists) and 347 patients were recruited from October 2015 to December 2016. Increased aligner recommendations were associated with white and Asian patients, the presence of tongue habits, and female practitioners. TADs were recommended more often in academic settings. Recommendations for orthognathic surgery were associated with demographic factors, such as availability of insurance coverage and practitioner race/ethnicity, and dentofacial characteristics, such as anteroposterior discrepancies, more severe open bites, and steeper mandibular plane angles. Extraction recommendations were largely associated with severe crowding and incisor proclination.
Both doctor and patient demographic factors, as well as dentofacial characteristics, were significantly associated with treatment recommendations for adult anterior open bite patients.
本文旨在描述和确定与美国成人前牙开𬌗患者治疗建议相关的从业者和患者特征。
从业者和患者是在美国国家牙科实践为基础的研究网络框架内招募的。从业者被问及他们的人口统计学特征以及他们对这些患者的治疗建议。从业者还报告了患者的牙颌面特征，并提供了初步的头颅侧位扫描和口内照片。患者被问及他们的人口统计学特征、以前的正畸治疗和治疗目标。评估了四个主要的治疗组：矫正器、固定矫治器、临时锚固装置（TADs）和正颌手术。还研究了拔牙。创建了预测多变量模型，比较了各种治疗类别以及拔牙/不拔牙决策。
2015 年 10 月至 2016 年 12 月期间，从 91 名从业者（主要是正畸医生）和 347 名患者中招募了参与者。增加使用矫正器的建议与白人患者和亚洲患者、舌习惯的存在以及女性从业者有关。TADs 更多地被推荐在学术环境中使用。正颌手术的建议与人口统计学因素（如保险覆盖范围和从业者的种族/民族）和牙颌面特征（如前后差异、更严重的开𬌗和更陡的下颌平面角度）有关。拔牙建议主要与严重拥挤和切牙前倾有关。
医生和患者的人口统计学因素以及牙颌面特征与成人前牙开𬌗患者的治疗建议显著相关。
