Tabellion Maike, Loef Ines Caroline, Linsenmann Constanze Charlotte, Lisson Jörg Alexander
Department of Orthodontics (G56), Saarland University, Kirrberger Strasse 100, 66424, Homburg/Saar, Germany.
Clin Oral Investig. 2024 Dec 13;29(1):12. doi: 10.1007/s00784-024-06104-4.
Early orthodontic treatment with cost reimbursement within the framework of the German statutory health insurance (GKV) is only possible for a strictly defined malocclusion group as defined by the orthodontic indication groups (KIG). It is not yet clear whether the application of the KIG criteria and corresponding successful early orthodontic interventions result in no or significantly less need for treatment in the late mixed dentition or in the permanent dentition. This study therefore investigated short-term intervention stability from a 10-year-period.
Between 2009 and 2019, n = 661 patients were diagnosed with indication groups D (increased overjet), M (reversed overjet), B (scissors bite), K (crossbite), or P (lack of space) including orthodontic treatment need. N = 70 patients (35 female, 35 male) met the inclusion criteria of the study and had received early orthodontic treatment with a mean duration of 15.44 ± 2.20 months. Orthodontic indication groups (KIG) were evaluated at the beginning (aged 7.99 ± 1.44 years) and the end of early orthodontic treatment (aged 9.63 ± 1.49 years) and at a voluntary control or the beginning of additional orthodontic treatment (aged 11.85 ± 1.72 years). The evaluation included established procedures for categorization of orthodontic indication groups and their respective classification. Statistics included Chi-square test and Kendall´s tau-b. The level of significance was set at p < 0.05.
The results showed reversed overjet in 44.3% and crossbites in 41.4% of the patients as most common indication for early orthodontic treatment. At the end of early orthodontic treatment, no orthodontic treatment need was present in 87.1%. At the late mixed dentition, the treatment result of early orthodontic treatment was stable in N = 61 out of N = 70 patients.
The results of our study confirm preventive benefits of early orthodontic treatment, especially in patients with transverse anomalies or reversed overjet.
A short-term orthodontic intervention with correct indication during primary or early mixed dentition can prevent or reduce further treatment need during late mixed or permanent dentition, and should therefore not be postponed.
在德国法定医疗保险(GKV)框架内,只有符合正畸适应症组(KIG)严格定义的错颌畸形组才能获得早期正畸治疗费用报销。目前尚不清楚应用KIG标准及相应成功的早期正畸干预是否会导致在混合牙列后期或恒牙列期无需治疗或治疗需求显著减少。因此,本研究调查了10年期间的短期干预稳定性。
2009年至2019年期间,n = 661例患者被诊断为适应症组D(覆盖过大)、M(反覆盖)、B(剪刀咬)、K(反牙合)或P(间隙不足),包括正畸治疗需求。N = 70例患者(35例女性,35例男性)符合研究纳入标准,接受了平均时长为15.44±2.20个月的早期正畸治疗。在早期正畸治疗开始时(年龄7.99±1.44岁)、结束时(年龄9.63±1.49岁)以及在自愿复诊或开始额外正畸治疗时(年龄11.85±1.72岁)对正畸适应症组(KIG)进行评估。评估包括用于正畸适应症组分类及其各自分级的既定程序。统计学分析包括卡方检验和肯德尔tau-b检验。显著性水平设定为p < 0.05。
结果显示,44.3%的患者存在反覆盖,41.4%的患者存在反牙合,这是早期正畸治疗最常见的适应症。在早期正畸治疗结束时,87.1%的患者不存在正畸治疗需求。在混合牙列后期,70例患者中有61例早期正畸治疗的结果稳定。
我们的研究结果证实了早期正畸治疗的预防益处,尤其是在患有横向异常或反覆盖的患者中。
在乳牙期或早期混合牙列期进行具有正确适应症的短期正畸干预可以预防或减少混合牙列后期或恒牙列期的进一步治疗需求,因此不应推迟。