乳歯列反対咬合への機能的矯正装置による治療効果の三次元的評価 Evaluation of Functional Orthodontic Appliance in Children with Anterior Crossbite in Primary Dentition using Three-dimensional Analysis

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<p>乳歯列期反対咬合小児に対して機能的矯正装置ムーシールドによる治療を行い,治療前後における上顎歯列の変化を左右計14 か所について,歯の移動方向と移動距離から三次元的に分析し,臨床的効果について評価した。対象は,機能性反対咬合を示し,本装置で治療を行い咬合が改善した小児20 名からの治療前後の歯列模型を対象とした。</p><p>1 .水平方向(x 座標)では左右に拡大する方向で変化し,前後方向(y 座標)は前方への有意な変化が認められ(p<0.000),乳中切歯ほど変化が大きかった。上下方向(z 座標)は,乳前歯部で上方へ,乳犬歯は変化なく,乳臼歯は挺出する方向への変化を示していた(p<0.000)。</p><p>2 .総変化量は,前歯Am 点が最も大きく平均1.4 mm であり,Do, Eo 点が平均0.7 mm と臼歯部では小さかった(p<0.000)。</p><p>3 .変化方向について,θx は,計測点間に差はみられず,θz はAm 点での-0.6 rad の変化(歯頚側方向)から乳犬歯部での0radに近い値,さらにEo 点での+0.6 rad の変化(挺出する方向)まで,一定方向の有意な変化が認められた(p<0.000)。</p><p>4 .各計測点とセファロ分析結果との相関では,∠FH­Occ とREo 点の総変化量およびθx との間に,それぞれr=-0.482, r=-0.502 の負の相関が認められ,Eo の変化と咬合平面角との間に負の相関が認められた。</p><p>以上より,乳歯列反対咬合は,本装置により,上顎乳前歯は前上方へ変化しながら側方にも拡大し,乳犬歯は外側へ,また臼歯部は外側へ拡大しながら挺出する方向へと乳歯列反対咬合が改善している様相が明らかとなった。</p>

<p>The aim of this study was to investigate changes in tooth positions in the maxilla before and after treatment for anterior crossbite in patients with primary dentition using three-dimensional (3D) analysis in order to evaluate the effectiveness of use of a functional orthodontic appliance (FOA-M). Twenty pairs of cast models obtained before and after treatments were analyzed. Dentition models were superimposed digitally using a reference plane and 14 reference points were dimensionally measured. Differences of each of the 3 coordinates x, y, and z in dentition in measurements taken before and after treatment were determined. The following results were obtained.</p><p>1)In the anterior-posterior direction (y-coordinate), we found a significant movement of anterior teeth, in which the primary central incisor showed the greatest amount of forward motion (p <0.000). In the vertical direction (z-coordinate), primary anterior teeth changed to an upper direction, while the primary canine did not show change and the primary molar showed a significant change to extrusion (p<0.000).</p><p>2)The amount of 3D tooth movement was the greatest at the Am-point of the frontal teeth (average 1.4 mm), while movement of the molar Do- and Eo- points was smaller (average 0.7 mm).</p><p>3)There was a significant change of direction in the θz angle, as θz of the Am-point showed -0.6 rad, indicating a change to the upper direction, that of the Co-point showed a value that was nearly 0 rad, indicating nearly no change for the primary canines, and that of the Eo-point showed a change of +0.6 rad, indicating that the second primary molar showed a change to extrusion (p <0.000).</p><p>4)There was a negative correlation between the amount of 3D movement of the Eo-point, and θxand the occlusal plain angle (p<0.05).</p><p>In conclusion, when patients with an anterior crossbite in primary dentition were treated by FOAM, their crossbite improved by movement of the maxillary primary anterior teeth in an upper and anterior direction, while also spreading laterally and enlarging the primary canine to the outside. As a result, the molars changed to extrusion while spreading in a lateral manner.</p>

収録刊行物

  • 小児歯科学雑誌

    小児歯科学雑誌 54(4), 423-432, 2016

    一般財団法人 日本小児歯科学会

各種コード

  • NII論文ID(NAID)
    130006219773
  • 本文言語コード
    JPN
  • ISSN
    0583-1199
  • データ提供元
    J-STAGE 
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