Kinzinger Gero Stefan Michael, Hourfar Jan, Maletic Andrijana, Lisson Jörg Alexander
Practice Essen, Essen, Germany.
International Medical College, University Duisburg-Essen, Duisburg-Essen, Germany.
J Orofac Orthop. 2024 Oct 2. doi: 10.1007/s00056-024-00550-1.
Patients with statutory health insurance (SHI) in Germany must undergo an assessment of orthodontic treatment need using the "Kieferorthopädische Indikationsgruppen" (KIG; orthodontic indication groups) classification system since 2002. A treatment need only exists if anomalies of a certain degree of severity are present. The aim of this study was to evaluate the age-dependent prevalence and percentage distribution of KIG grades requiring treatment in patients with SHI before the age of 18 over a 10-year period.
Between 2012 and 2021, treatment indication existed for 1951 (1025 female, 926 male) out of 2288 patients with SHI in the cohort of this study before the age of 18 according to current SHI guidelines. The KIG classification was based on the highest existing KIG grade. There were no multiple classifications. The patient cohort was divided into three patient groups (PG) according to chronological age for analysis: PG 1 < 10 years of age (early treatment), PG 2 10 to < 13 years of age (main treatment) and PG 3 13 to < 18 years of age (late treatment).
In PG 1 (454 patients), the KIG classifications D (26.5%), K (25.5%), M (19.4%), and P (18.0%) dominated. In PG 2 (998 patients), classifications D (33.2%), predominated, whereas K (7.5%) and M (5.9%) rarely occurred. The classifications E (12.6%) and P (13.3%) appeared quite frequently. Transverse deviations occurred only about half as often in PG 2 as in PG 1 and PG 3. In PG 3 (499 patients), the classification E (17.6%) was particularly common, while P (2.6%) was rare. The proportion of KIG grades 5 decreased depending on age: 19% in PG 1, 13.5% in PG 2, 10.4% in PG 3. The prevalence of sagittal classifications was highest in all age groups (45.9% in PG 1, 39.1% in PG 2, 31.5% in PG 3).
The distribution of KIG classifications requiring treatment was not homogeneous, but age dependent. The differences were particularly evident in the early treatment group and may be due to the limited applicability of the KIG classification system in patients before late mixed dentition. With increasing age at initial examination, the prevalence of sagittal classifications decreased, while that of vertical classifications increased. Still, the sagittal classifications D and M occurred most frequently in all age groups. The KIG classification D was always the most common in all patients until the age of 18.
自2002年起，德国法定医疗保险（SHI）患者必须使用“口腔正畸指征组”（KIG）分类系统进行正畸治疗需求评估。只有存在一定严重程度的异常情况时才存在治疗需求。本研究的目的是评估18岁以下SHI患者在10年期间需要治疗的KIG分级的年龄依赖性患病率和百分比分布。
在2012年至2021年期间，根据现行SHI指南，本研究队列中的2288名18岁以下SHI患者中有1951名（1025名女性，926名男性）存在治疗指征。KIG分类基于现有的最高KIG分级。不存在多重分类。根据实足年龄将患者队列分为三个患者组（PG）进行分析：PG 1年龄小于10岁（早期治疗），PG 2年龄在10至<13岁之间（主要治疗），PG 3年龄在13至<18岁之间（晚期治疗）。
在PG 1组（454例患者）中，KIG分级D（26.5%）、K（25.5%）、M（19.4%）和P（18.0%）占主导。在PG 2组（998例患者）中，分级D（33.2%）占主导，而K（7.5%）和M（5.9%）很少出现。分级E（12.6%）和P（13.3%）出现频率相当高。横向偏差在PG 2组中的发生频率仅约为PG 1组和PG 3组的一半。在PG 3组（499例患者）中，分级E（17.6%）尤为常见，而P（2.6%）很少见。KIG 5级的比例随年龄降低：PG 1组为19%，PG 2组为13.5%，PG 3组为10.4%。矢状面分类的患病率在所有年龄组中最高（PG 1组为45.9%，PG 2组为39.1%，PG 3组为31.5%）。
需要治疗的KIG分类分布不均匀，而是与年龄相关。差异在早期治疗组中尤为明显，可能是由于KIG分类系统在晚期混合牙列之前的患者中适用性有限。随着初次检查时年龄的增加，矢状面分类的患病率降低，而垂直面分类的患病率增加。不过，矢状面分类D和M在所有年龄组中出现频率最高。在18岁之前，KIG分类D在所有患者中始终是最常见的。
