1Phd fellow, DDS, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy.
Associate Professor, DDS, PhD, Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospital Leuven, Belgium.
Eur J Paediatr Dent. 2020 Mar;21(1):46-52. doi: 10.23804/ejpd.2020.21.01.09.
It has been suggested that atypical swallowing (AS) may negatively influence the skeletal and alveolar development, but its specific effects are still unclear. The aim of this work is to compare the cephalometric characteristics of children and adolescents with and without AS.
Study design: Case-control retrospective cross-sectional study. One hundred patients with (AS group) and 100 patients without AS (control group, C) were retrospectively selected. Their cephalometric data before orthodontic treatment were compared using a 3-way ANOVA variance test to detect any differences between groups considering: the type of swallowing (AS vs C); whether or not the second dentition was completed (SDC vs SDNC); and the gender (males-M and females-F). In addition, a Student-t test for unpaired data was carried out to detect differences between M and F within the AS and C groups.
When compared to the controls, AS patients showed a significantly decreased SNB angle (p<.01), increased ANB and SN^Go. Me angles (p<.0001), increased overjet and lower facial height (p<.01), decreased overbite (p<.0001), and increased proclination of the upper incisors. AS-SDC patients also showed significantly increased alveolar length. Within the AS and C groups, skeletal and alveolar measurements were larger in males, with higher significance in the C group, suggesting a different trend of growth in AS patients.
AS seems to affect the skeletal growth causing mandibular clockwise rotation, skeletal Class II, open bite and incisor proclination. To compensate for these effects, an increase in alveolar growth together with molar eruption seems to be induced.
有人认为非典型吞咽（AS）可能会对骨骼和牙槽骨的发育产生负面影响，但具体影响尚不清楚。本研究旨在比较有和无 AS 的儿童和青少年的头影测量特征。
研究设计：病例对照回顾性横断面研究。回顾性选择 100 例有（AS 组）和 100 例无 AS（对照组，C）的患者。使用三向方差分析检验比较他们在正畸治疗前的头影测量数据，以检测组间差异，考虑：吞咽类型（AS 与 C）；第二恒牙是否萌出（SDC 与 SDNC）；性别（男性-M 和女性-F）。此外，还进行了非配对数据的 Student-t 检验，以检测 AS 和 C 组内 M 和 F 之间的差异。
与对照组相比，AS 患者的 SNB 角明显减小（p<.01），ANB 和 SN^Go. Me 角增大（p<.0001），覆盖增加，面下高度减小（p<.01），覆减小（p<.0001），上颌切牙前突增加。AS-SDC 患者的牙槽长度也显著增加。在 AS 和 C 组内，男性的骨骼和牙槽测量值较大，在 C 组中具有更高的显著性，表明 AS 患者的生长趋势不同。
AS 似乎会影响骨骼生长，导致下颌顺时针旋转、骨骼 II 类、开颌和切牙前突。为了补偿这些影响，似乎会诱导牙槽生长增加和磨牙萌出。
