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扁桃体肥大与儿童牙颌面发育的关联:来自中国上海幼儿横断面研究的证据

The Association of Tonsil Hypertrophy with Pediatric Dentofacial Development: Evidence from a Cross-Sectional Study of Young Children in Shanghai, China.

作者信息

Tong Xianqin, Li Yuanyuan, Yang Gang, Zhang Hao, Jiang Yiwei, Yu Jin, Da Dongxin, Zeng Xiaoli, Liu Yuehua

机构信息

Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, People's Republic of China.

Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, People's Republic of China.

出版信息

Nat Sci Sleep. 2022 Oct 19;14:1867-1875. doi: 10.2147/NSS.S381020. eCollection 2022.

Abstract

PURPOSE

The prevalence of dentofacial deformity was reportedly higher than decades ago, to which upper airway (UA) obstruction-induced sleep-disordered breathing (SDB) might contribute a lot. Tonsil hypertrophy appears relatively common in the population of young children. Given that the association between tonsil hypertrophy and pediatric dentofacial deformity remained controversial, this cross-sectional research was designed to explore the internal relationship of those among young children in Shanghai, China.

PATIENTS AND METHODS

A stratified cluster sampling procedure was adopted, and a representative sample of 715 young children (8-10 years old) was recruited. The OSA-18 quality-of-life questionnaires (OSA-18) were finished by their guardians, and well-trained orthodontists performed the oral examinations. After collecting the valuable information, the descriptions and analyses were run by statistical software (SPSS, version 26.0).

RESULTS

715 participants (334 boys and 381 girls) were involved in the analyses. As calculated, the current prevalence of malocclusion identified by Angle's classification was 45.6% in this sample. No evident relation between OSA-18 scores and dentofacial abnormalities (P > 0.05) was found. With the enlargement of tonsil size, the proportion of children with triangular dental arch form (P < 0.05) and high vault palate (P < 0.001) was increasingly higher. More children with protruding profiles and fewer upright profiles were observed as the tonsil size increased, although it did not show a statistical difference (P = 0.103).

CONCLUSION

Dental and craniofacial growth deficiency has become more prevalent among children, demanding more concerns from health authorities. Tonsil hypertrophy plays an essential role in the direction of dentofacial development. More efforts from local health authorities should be made to enhance public propaganda and education on the prevention and interruption of tonsil hypertrophy and related dentofacial abnormalities.

摘要

目的

据报道,牙颌面畸形的患病率高于几十年前,上气道(UA)阻塞引起的睡眠呼吸紊乱(SDB)可能对此有很大影响。扁桃体肥大在幼儿群体中似乎相对常见。鉴于扁桃体肥大与儿童牙颌面畸形之间的关联仍存在争议,本横断面研究旨在探讨中国上海幼儿中这些因素之间的内在关系。

患者与方法

采用分层整群抽样程序,招募了715名8至10岁幼儿的代表性样本。由其监护人完成阻塞性睡眠呼吸暂停-18生活质量问卷(OSA-18),并由训练有素的正畸医生进行口腔检查。收集到有价值的信息后,使用统计软件(SPSS,版本26.0)进行描述和分析。

结果

715名参与者(334名男孩和381名女孩)参与了分析。经计算,本样本中按安氏分类法确定的错牙合畸形患病率为45.6%。未发现OSA-18评分与牙颌面异常之间存在明显关联(P>0.05)。随着扁桃体大小的增大,牙弓呈三角形(P<0.05)和高拱腭(P<0.001)的儿童比例越来越高。随着扁桃体大小增加,观察到更多凸面型儿童和更少直面型儿童,尽管差异无统计学意义(P=0.103)。

结论

牙齿和颅面生长发育不足在儿童中变得更加普遍,需要卫生当局更多关注。扁桃体肥大在牙颌面发育方向中起着重要作用。地方卫生当局应做出更多努力,加强对扁桃体肥大及相关牙颌面异常的预防和干预的公众宣传和教育。

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