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[体位性斜头畸形是否会影响正畸治疗的需求以及下颌和咬合对称性?]

[Does positional plagiocephaly affect the need for orthodontic treatment, and the mandibular and occlusal symmetry?].

作者信息

Verdier Clarisse, Marangelli Gianni, Gebeile-Chauty Sarah

出版信息

Orthod Fr. 2022 Jun 1;93(2):169-186. doi: 10.1684/orthodfr.2022.81.

Abstract

INTRODUCTION

Positional plagiocephaly (PP) is characterized by an asymmetrical flatness of the posterior part of the skull which may involve the frontal part of the skull and the face. The aim is to assess whether children and adolescents with PP have more occlusal and skeletal asymmetries and whether the need for orthodontic treatment is greater than in the healthy population.

MATERIAL AND METHOD

A comparative cross-sectional epidemiological study was carried out. One hundred children and adolescents were included: 50 in the PP group and 50 in the control group. The need for orthodontic treatment was assessed by the Index of Orthodontic Treatment Need (IOTN). The mandibular and dental asymmetries were measured on lateral cephalometry by two indexes: index of mandibular asymmetry (IMA) and index of dental asymmetry (IDA) respectively. Chi and Student independence tests were performed with a threshold of 5%.

RESULTS

The tests are significant for IMA (p = 0.02) and IOTN (p = 0.000012). IDA is insignificant.

DISCUSSION

Orthosurgical treatment of mandibular laterognathies by mandibular recentering sometimes creates mandibular asymmetry, while the shift is basal. We must be able to act early on the vault of the skull to hope to obtain a consecutive effect on the base and therefore on the position of the glenoid cavities. Management by manual therapy and early cranial orthosis could be estimated.

CONCLUSION

The need for orthodontic treatment is significantly greater in PP. Unlike mandibular asymmetry, dental asymmetry is not significantly greater than in the control group, testifying to the adaptive capacities of the organism.

摘要

引言

体位性斜头畸形(PP)的特征是颅骨后部不对称扁平,可能累及颅骨前部和面部。目的是评估患有PP的儿童和青少年是否存在更多的咬合和骨骼不对称,以及正畸治疗的需求是否大于健康人群。

材料与方法

进行了一项比较性横断面流行病学研究。纳入了100名儿童和青少年:PP组50名,对照组50名。通过正畸治疗需求指数(IOTN)评估正畸治疗需求。通过两个指标在头颅侧位片上测量下颌和牙齿不对称:分别为下颌不对称指数(IMA)和牙齿不对称指数(IDA)。进行卡方检验和学生独立性检验,阈值为5%。

结果

IMA(p = 0.02)和IOTN(p = 0.000012)的检验具有显著性。IDA不具有显著性。

讨论

通过下颌重新定位对下颌偏颌进行正颌外科治疗有时会导致下颌不对称,而这种移位是基底性的。我们必须能够尽早对头盖骨进行干预,以期对基底进而对关节盂的位置产生连续的影响。可以评估手法治疗和早期颅骨矫形器的管理方法。

结论

PP患者的正畸治疗需求显著更高。与下颌不对称不同,牙齿不对称并不比对照组显著更大,这证明了机体的适应能力。

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