Miyajima K, McNamara J A, Sana M, Murata S
Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
Am J Orthod Dentofacial Orthop. 1997 Oct;112(4):425-34. doi: 10.1016/s0889-5406(97)70051-9.
The literature has little to say regarding the normal growth and development of untreated individuals with Class III malocclusion or anterior crossbite. In part, this paucity of information is because of the relatively low prevalence of these characteristics in European-American populations and the need, recognized by the lay public and health professionals, for treatment of these conditions. Given the absence of true longitudinal data, this study attempts to estimate the growth of the untreated individual with Class III malocclusion and anterior crossbite by evaluating large samples of untreated subjects at distinct developmental stages. Initially the morphologic characteristics of 2074 Japanese female patients who had anterior crossbite were evaluated cephalometrically before treatment. On the basis of the cephalometric analysis, all subjects who did not have a Class III molar relationship were excluded from further analysis, leaving a sample of 1376. The subjects then were classified into seven groups (120-256 subjects per group) according to Hellman's stages of dental development. Descriptive statistics for 28 measurements were calculated. The results of this study imply that the maxilla in Japanese females maintains a retruded relationship to the cranial base and does not become less retrusive with time. In contrast, the mandible is protrusive even in the late deciduous dentition and becomes more protrusive with time, making the discrepancy between the upper and lower jaws progressively more severe. Dental compensations in both arches become increasingly evident as development progresses, and the underlying skeletal and dentoalveolar imbalances also are reflected in the soft tissue profile.
关于未经治疗的III类错牙合或前牙反牙合个体的正常生长发育,文献中几乎没有相关论述。部分原因在于这些特征在欧美人群中的患病率相对较低,而且普通大众和健康专业人士都认为这些情况需要治疗。鉴于缺乏真实的纵向数据,本研究试图通过评估处于不同发育阶段的大量未经治疗的受试者样本,来估计未经治疗的III类错牙合和前牙反牙合个体的生长情况。最初,对2074名患有前牙反牙合的日本女性患者在治疗前进行了头影测量评估其形态特征。根据头影测量分析,所有不具有III类磨牙关系的受试者被排除在进一步分析之外,最终留下1376个样本。然后,根据赫尔曼牙齿发育阶段将受试者分为七组(每组120 - 256名受试者)。计算了28项测量指标的描述性统计数据。本研究结果表明,日本女性的上颌骨与颅底保持后缩关系,且不会随着时间推移而减少后缩程度。相比之下,下颌骨即使在乳牙晚期也呈前突状态,并且随着时间推移变得更加前突,使得上下颌之间的差异逐渐加剧。随着发育进展,上下牙弓的牙齿代偿越来越明显,潜在的骨骼和牙槽骨不平衡也反映在软组织侧貌上。