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混合牙列期儿童错牙合畸形、舌位与语音障碍的相关性:一项流行病学研究。

Association between malocclusion, tongue position and speech distortion in mixed-dentition schoolchildren: an epidemiological study.

机构信息

Universidade Federal Santa Maria (UFSM), Departamento de Estomatologia, Santa Maria, Brasil.

Universidade Federal Santa Maria (UFSM), Departamento de Fonoaudiologia, Santa Maria, Brasil.

出版信息

J Appl Oral Sci. 2021 Aug 16;29:e20201005. doi: 10.1590/1678-7757-2020-1005. eCollection 2021.

Abstract

BACKGROUND

Malocclusions are highly prevalent in childhood and adolescence, being considered a public health problem worldwide, in addition to be considered an important predictor in the tongue position and speech disorders.

OBJECTIVE

Evaluate the association of malocclusions with tongue position and speech distortion in mixed-dentition schoolchildren from the south of Brazil.

METHODOLOGY

This cross-sectional study was performed using a database of an epidemiological survey realized in the southern of Brazil, in 2015, for evaluating the dental and myofunctional condition of the mixed-dentition from 7-13 years' schoolchildren. The outcome variables were tongue position and speech distortion, evaluated by a trained and calibrated examiner. Characteristics regarding sociodemographic and oral health measures (Angle's classification of the malocclusion, overjet, overbite, posterior crossbite and respiratory mode) were also assessed. Poisson regression models with adjusted robust variance were used to evaluate the association among predictors variables in the outcomes. Results are presented as prevalence ratio (PR) and 95% confidence interval (95% CI).

RESULTS

A total of 547 children were evaluated. Schoolchildren who presented anterior open bite (PR 2.36 95%CI 1.59-3.49) and having oral/oral-nasal breathing (RP 2.51 95%CI 1.70-3.71) are more likely to have altered position of the tongue. Both deep bite and being male represent protection factors for the abnormal tongue position. Regarding speech distortion, deep overbite presents a protective relationship to speech distortion (PR 0.41; 95%CI 0.24-0.71), whereas schoolchildren with posterior crossbite were more likely to present this problem (PR 1.77; 95%CI 1.09-2.88).

CONCLUSION

Anterior open bite and posterior crossbite were the malocclusions related to speech distortion and/or altered tongue position. Oral/oral-nasal breathing was also related to myofunctional changes. Deep bite malocclusion was a protective factor for both speech problems and altered tongue position when compared to a normal overbite.

摘要

背景

错颌畸形在儿童和青少年中高发,被认为是一个全球性的公共卫生问题,此外,它还是舌位和言语障碍的一个重要预测因素。

目的

评估南巴西南部混合牙列期儿童错颌畸形与舌位及言语障碍的相关性。

方法

本横断面研究使用了 2015 年在巴西南部进行的一项流行病学调查的数据库,以评估 7-13 岁混合牙列儿童的牙齿和口腔肌肉功能状况。结果变量为舌位和言语障碍,由经过培训和校准的检查者进行评估。还评估了与社会人口统计学和口腔健康状况相关的特征(错颌畸形的 Angle 分类、覆𬌗、覆盖、后牙反𬌗和呼吸模式)。使用调整后的稳健方差泊松回归模型来评估预测变量与结果之间的关联。结果以患病率比(PR)和 95%置信区间(95%CI)表示。

结果

共评估了 547 名儿童。患有前牙开𬌗(PR 2.36 95%CI 1.59-3.49)和口呼吸/口鼻呼吸(RP 2.51 95%CI 1.70-3.71)的儿童更有可能出现舌位异常。深覆𬌗和男性均为异常舌位的保护因素。至于言语障碍,深覆𬌗与言语障碍呈保护关系(PR 0.41;95%CI 0.24-0.71),而后牙反𬌗的儿童更有可能出现这种问题(PR 1.77;95%CI 1.09-2.88)。

结论

前牙开𬌗和后牙反𬌗是与言语障碍和/或舌位异常相关的错颌畸形。口呼吸/口鼻呼吸也与口腔肌肉功能变化有关。深覆𬌗错颌畸形是正常覆盖与言语问题和异常舌位之间的保护因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a651/8373205/b28bcd18408f/1678-7757-jaos-29-e20201005-gf01.jpg

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