噛みしめ型FKO適用状況と効果の検討 Examination in Regard to the Applied Status and Effects on the Biting Type FKO

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本研究は,上顎前突の治療に用いている噛みしめ型FKO(B-FKO)の適用・撤去の判断,および臨床的効果を明らかにすることを目的とする。対象は,B-FKOを適用した男児8名,女児13名である。検討資料は,カルテ,咬合模型,側貌頭部エックス線規格写真の角度・距離計測値である。装置適用者のうち下顎の前方劣成長が認められる症例が61.9%,下顎の劣成長が認められない症例が38.1%であり,それぞれ下顎の成長促進と咬合の挙上を目的としていた。<BR>装置装着年齢は平均9歳10か月,撤去年齢は平均11歳5か月であり,適切に装置を使用した者は61.9%であった。撤去の理由は,期待した効果が得られたためとしていたものが61.9%,使用状況が悪く,効果が期待できないことを理由としていたものが38.1%であった。装置適用者を適用目的で下顎の成長促進群と咬合の挙上群に分類し,顎顔面の骨格形態を正常者と比較すると,促進群では上下顎骨の前後関係により,挙上群では歯軸傾斜によって上顎前突が示されており,撤去時にそれらの項目の改善傾向が認められた。<BR>しかし,上顎前突の傾向は示されたままで,正常咬合者群の標準値まで達していなかった。また,撤去時の判断は単純に不正要因の解消だけなく,軟組織形態の変化に対する視覚的な判断の影響が示唆された。撤去時から撤去1年後までの変化に対する定性的評価では両群とも上下顎の前後的関係において後戻り傾向が見られた。

The aims of this study were to examine the applied status of a biting type FKO (B-FKO) which is a modified Andersen type FKO and to re-examine its effects. The B-FKO was applied with the object of promoting the mandibular growth toward the mesial direction by clenching at the molar segment. The subjects consisted of 21 patients, aged 8-12.3 years,9.8 years on average, all of whom possessed an large over jet (deep bite and protrusion) and to whom the B-FKO had been applied. Numerous parameters such as cephalometric analysis, study casts and treatment record were assessed at the onset of the treatment using the B-FKO, at the removal and 1 year after the removal to determine treatment-related changes due to therapy with the B-FKO.<BR>According to the treatment record, the two objects for employing this appliance were to promote the mandibular growth (PG) and to reduce the over jet or bite. The former has a frequency of 61.9%and with skeletal factors taken from roentgenographic cephalometry while the later has a frequency of 38.1% with the dento-alveolar factor. The appliance has been used during the beginning of a mixed dentition. Attitude on the part of the patients when using the appliance was demonstrated as an important factor which have the benefits on the therapy. Among the changes in the skeletal profile from the onset of the B-FKO to its removal, as for the deference between the onset and the removal ∠ANB, over jet, and ∠LsN′Li decreased significantly. The indications in the skeletal profile at the removal showed however mandibular retrusion still in the subjects alone with the expected effects. The judgment of the effects was made based on changes in the soft tissue profile following therapy. Among the changes in the skeletal profile from the removal of the B-FKO to 1 year after the removal, the diffbrence between the removal and the 1 year after the removal as for ∠LsN′Li increased significantly again. Among the qualitative changes from the onset to 1 year after a time of the removal, ∠SNB, Go-Me, ∠A′N′B′, and ∠LsN′Li demonstrated the tendency to retum.<BR>These findings indicated that the B-FKO was a useful appliance for changing the skeletal profile. The effect was not enough however to improve and to be stable. Moreover, it was suggested that the skeletal profile changes during B-FKO therapy were often not maintained thereafter.

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  • 小児歯科学雑誌

    小児歯科学雑誌 36(4), 595-603, 1998-09-25

    The Japanese Society of Pediatric Dentistry

参考文献:  17件中 1-17件 を表示

被引用文献:  1件中 1-1件 を表示

各種コード

  • NII論文ID(NAID)
    10013868636
  • NII書誌ID(NCID)
    AN00116228
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    05831199
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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