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III类错牙合畸形患者颅底的形态测量学研究

Morphometry of the cranial base in subjects with Class III malocclusion.

作者信息

Singh G D, McNamara J A, Lozanoff S

机构信息

Department of Dental Surgery & Periodontology, Dundee Dental Hospital & School, University of Dundee, Scotland, UK.

出版信息

J Dent Res. 1997 Feb;76(2):694-703. doi: 10.1177/00220345970760021101.

Abstract

The significance of the cranial base in the development of Class III malocclusion remains uncertain. The purpose of this study was to determine whether the form of the cranial base differs between prepubertal Class I and Class III subjects. Lateral cephalographs of 73 children of European-American descent aged between 5 and 11 years with Class III malocclusion were compared with those of their counterparts with a normal, Class I molar occlusion. The cephalographs were traced, checked, and subdivided into seven age- and sex-matched groups. Average geometries, scaled to an equivalent size, were generated based on 13 craniofacial landmarks by means of Procrustes analysis, and these configurations were statistically tested for equivalence. Bivariate and multivariate analyses utilizing 5 linear and angular measurements were undertaken to corroborate the Procrustes analysis. Graphical analysis, utilizing thin-plate spline and finite element methods, was performed for localization of differences in cranial base morphology. Results indicated that cranial base morphology differed statistically for all age-wise comparisons. Graphical analysis revealed that the greatest differences in morphology occurred in the posterior cranial base region, which generally consisted of horizontal compression, vertical expansion, and size contraction. The sphenoidal region displayed expansion, while the anterior regions showed shearing and local increases in size. It is concluded that the shape of the cranial base differs in subjects with Class III malocclusion compared with the normal Class I configuration, due in part to deficient orthocephalization, or failure of the cranial base to flatten during development.

摘要

颅底在Ⅲ类错牙合畸形发展中的意义仍不明确。本研究的目的是确定青春期前Ⅰ类和Ⅲ类受试者的颅底形态是否存在差异。将73名年龄在5至11岁之间的欧美裔Ⅲ类错牙合畸形儿童的头颅侧位片与其具有正常Ⅰ类磨牙咬合的同龄人进行比较。对头颅侧位片进行描图、检查,并细分为7个年龄和性别匹配的组。通过普氏分析,基于13个颅面标志点生成平均几何形状,并将其缩放到等效大小,然后对这些构型进行等效性统计检验。利用5项线性和角度测量进行双变量和多变量分析,以证实普氏分析。采用薄板样条法和有限元法进行图形分析,以定位颅底形态的差异。结果表明,在所有年龄组的比较中,颅底形态在统计学上存在差异。图形分析显示,形态差异最大的部位出现在颅底后部区域,该区域通常表现为水平压缩、垂直扩展和尺寸缩小。蝶骨区域表现为扩展,而前部区域则出现剪切和局部尺寸增加。研究得出结论,Ⅲ类错牙合畸形受试者的颅底形状与正常Ⅰ类构型不同,部分原因是正颅化不足,即颅底在发育过程中未能变平。

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