Vig K W
Department of Orthodontics, College of Dentistry, The Ohio State University, Columbus, USA.
Am J Orthod Dentofacial Orthop. 1998 Jun;113(6):603-11. doi: 10.1016/s0889-5406(98)70219-7.
The orthodontic relevance of nasorespiratory obstruction and its effect on facial growth continues to be debated after almost a century of controversy. The continuing interest in nasal obstruction is fueled by strong convictions, weak evidence, and the prevailing uncertainty of cause and effect relationships that exist. The essence of any debate is to provide opposing evidence from which a majority vote is obtained. Political issues may be appropriately resolved by such means as a majority vote. Scientific issues, however, can only be resolved by data and appropriately structured hypotheses put to the test. One of the problems in debating nasorespiratory obstruction and facial growth is the inability to provide unequivocal answers to such issues as: How much nasal obstruction is clinically significant? At what age is the onset critical and for how long does it have to exist before an effect on facial growth can be expected? To provide unequivocal answers, clinical studies need to be designed to identify and quantify the degree of nasorespiratory obstruction and compare individuals for any clinically relevant differences. The purpose of this article is to review the available evidence. If both data and untested popular beliefs are subjected to the same rigorous criteria, indications for the orthodontic management of patients with nasorespiratory obstruction may gain a more rational approach to treatment recommendations.
在历经近一个世纪的争论后，鼻呼吸阻塞与面部生长的正畸相关性及其对面部生长的影响仍备受争议。强烈的信念、薄弱的证据以及因果关系的普遍不确定性，使得人们对鼻阻塞的关注度持续居高不下。任何争论的核心在于提供相互对立的证据，进而通过多数表决得出结果。政治问题或许可通过多数表决等方式得以妥善解决。然而，科学问题唯有通过数据以及经过合理构建并加以检验的假设才能解决。在探讨鼻呼吸阻塞与面部生长的过程中，存在的一个问题是无法就以下问题给出明确答案：临床上具有显著意义的鼻阻塞程度究竟是多少？发病的关键年龄是多少，在对面部生长产生影响之前需要持续存在多长时间？为给出明确答案，临床研究需进行设计，以识别并量化鼻呼吸阻塞的程度，并比较个体之间的任何临床相关差异。本文旨在回顾现有证据。倘若数据与未经检验的流行观点都遵循相同的严格标准，那么对于鼻呼吸阻塞患者的正畸治疗指征，或许能在治疗建议方面获得更为合理的方法。
