Van Erum R, Mulier M, Carels C, de Zegher F
Department of Orthodontics, Catholic University of Leuven, Belgium.
Eur J Orthod. 1998 Aug;20(4):417-25. doi: 10.1093/ejo/20.4.417.
Recently, children born small for gestational age (SGA) with a catch-up growth failure, have been selected for high dose growth hormone (GH) treatment. In order to gain greater insight concerning dentofacial growth and maturation of these patients, and to evaluate the possible effects of high does GH administration on facial structures, craniofacial growth and dental maturation were evaluated in short SGA persons. Seventy-seven cephalograms and orthopantomograms were available from 48 subjects, aged between 2 and 32 years. Craniofacial growth was assessed by calculating age- and gender-specific standard deviation scores (SDS) for eight linear and five angular measurements. Tooth formation was evaluated by means of a dental delay score (i.e. dental age minus chronological age). The SDS for craniofacial growth measurements for the lateral aspect showed a short anterior cranial base (-1.8 SDS), a small retropositioned mandible (< or = -1.7 SDS) and a small maxilla (-1.5 SDS); a high mandibular plane angle (+1.9 SDS) and a wide cranial base angle (+1 SDS). These findings result in a small retrognathic face with a relatively increased lower anterior face height (+1.7 SDS). In contrast to skeletal maturation, dental age was not delayed. The general growth retardation is, apparently, reflected to a differential extent within the craniofacial complex, while dental maturation appears to be a distinct process tightly linked to chronological age, and independent of general growth and bone age.
最近，出生时小于胎龄（SGA）且存在追赶生长失败的儿童已被选入高剂量生长激素（GH）治疗组。为了更深入了解这些患者的牙颌面生长和成熟情况，并评估高剂量GH给药对面部结构的可能影响，我们对身材矮小的SGA个体的颅面生长和牙齿成熟情况进行了评估。我们从48名年龄在2至32岁之间的受试者中获取了77张头颅侧位片和曲面断层片。通过计算八个线性测量值和五个角度测量值的年龄和性别特异性标准差分数（SDS）来评估颅面生长。通过牙齿延迟分数（即牙龄减去实足年龄）来评估牙齿形成情况。侧面颅面生长测量的SDS显示前颅底短（-1.8 SDS）、下颌骨向后移位小（≤-1.7 SDS）和上颌骨小（-1.5 SDS）；下颌平面角高（+1.9 SDS）和颅底角宽（+1 SDS）。这些结果导致面部后缩小，前下脸高度相对增加（+1.7 SDS）。与骨骼成熟不同，牙龄并未延迟。显然，全身生长发育迟缓在颅面复合体中反映程度不同，而牙齿成熟似乎是一个与实足年龄紧密相关、独立于全身生长和骨龄的独特过程。
