機能的矯正装置を用いた上顎前突症例 : 双生児における成長促進の比較  [in Japanese] Maxillary Protrusion Cases Treated with Functional Appliances : A Comparison of Growth Acceleration in Twins  [in Japanese]

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Abstract

成長期にある骨格性上顎前突を認める二卵性双生児に対し, 機能的矯正装置を使用し, その治療効果を比較・検討した.双生児の妹は, 初診時年齢8歳11か月で, 機能的矯正装置を, 11歳0か月から8か月間使用した.姉は初診時年齢9歳0か月で, 機能的矯正装置を, 11歳9か月から6か月間使用した.その結果, 姉妹ともに機能的矯正装置により∠SNAが減少し, 上顎骨では, わずかな前方成長の抑制傾向がみられた.また装置使用期間の年間成長速度を, 楠元らの標準成長速度と比較すると, 成長速度の低下が認められたが, その変化はわずかであった.姉妹ともに下顎骨では, ∠SNBは増加し, 前方成長がみられるとともに, 下顎骨の大きさも増大していた.特に下顎枝高 (CDGO) と下顎骨全体長 (GN-CD) の長さに, 著明な増大が認められた.その増加量を姉妹で比較すると, それぞれ経過観察中である姉妹の自然成長量より, 大きいものであった.また姉妹の装置使用期間の年間成長速度を, 楠元らの標準成長速度と比較すると, 下顎枝高 (CD-GO) と下顎骨全体長 (GN-CD) においては, 2倍以上の著明な成長速度の増加を示していた.以上のことより機能的矯正装置は, 下顎骨の成長を, 自然成長量を超えて, 前方方向へ促すとともに, その大きさ自体をも増大させる効果を有することが示唆された.特に本症例におけるその効果は, 下顎枝高を中心とした垂直的な高さにおいてより顕著であったと推察された.

Dizygotic twins with skeletal Class II malocclusion in the growing period, were treated with functional appliances, and the treatment results were compared and evaluated.<BR>The younger sister was 8 years and 11 months old at the first examination, and was treated with a functional appliance from the age of 11 years 0 months for a period of 8 months. The elder sister was 9 years and 0 months old at the first examination, and was treated with functional appliances from the age of 11 years 9 months for a period of 6 months.<BR>As a result, ∠SNA decreased in both sisters as the result of treatment with functional appliances, showing a slight inhibition in the forward growth of the maxilla. Furthermore, comparing the annual growth velocity during the use of the appliances with the standard growth velocity by Kusumoto et al., although decreases in the maxillary growth velocity were noted, the changes were slight.<BR>In the mandible, ∠SNB increased in both sisters, showing forward growth, and the size of the mandible also increased. In particular, there were marked increases in the length of the ramus height (CD-GO) and the mandibular total length (GN-CD). The increases were larger than the natural growth rate during observation for both sisters. Furthermore, comparing the annual growth velocity during the use of appliances with the standard growth velocity by Kusumoto et al., the length of the ramus height (CD-GO) and the mandibular total length (GN-CD) showed marked increases in the growth velocity, being more than two fold higher than the standard growth velocity.<BR>These findings suggest that functional appliances not only accelerate the forward growth of the mandible exceeding the natural growth rate, but also increase the size of the mandible. In particular, the increases in these cases were marked in the vertical height around the ramus height

Journal

  • The Journal of Showa University Dental Society

    The Journal of Showa University Dental Society 25(2), 107-121, 2005-06-30

    Showa University Dental Society

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