4-14岁汉族儿童颌骨生长发育的横向研究—曲面断层法
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摘要
目的：通过调查研究可以了解乌鲁木齐市儿童上下颌骨的生长发育状况,及牙齿发育时的位置变化。方法：对乌市口腔医院就诊的300例4-14岁儿童,将收录的人群按Hellman's牙齿发育阶段分为5组：1)完全的乳牙阶段(ⅡA)；2)第一恒牙萌出阶段(ⅡC)；3)乳切牙到恒切牙的过度阶段(ⅢA)；4)乳后牙(包括尖牙到磨牙)到恒后牙(包括尖牙到第二前磨牙)的过度阶段(ⅢB)；5)第二恒磨牙的萌出阶段(ⅢC)。通过Auto-CAD (CAD-computer Aided Design)对全颌曲面断层片进行画图分析,定鼻.中隔与硬腭的交点为O点,硬腭与上颌窦近中面的交点为PA点,将两点连成一线定位X轴,过O点并与X轴垂直的为Y轴,此时O点为(0,0)点,其余各点都有一个相应的坐标点(X,Y),同时对下颌的各标志点定点并将其连成线,测量线距,及角度。分析不同阶段上颌的发育及牙齿运动及下颌骨的生长发育趋势。整理录入数据,用SPSS 17.0统计软件包进行统计学分析。结果：上颌窦底的位置变化：1组(ⅡA)与5组(ⅢC)组内男女之间,(SX, SY)比较没有显著性差异(P>0.05)；1组与5组之间各组组间比较SX点1组与2(ⅡC),3(IIIA),4(IIIB),5组均有差别(P<0.01),2,3,5组之间没差别(P>0.05),4组与5组之间有差异(P<0.01),SY点除1组与2组之间没有差异外(P>0.05),其余各组之间均有显著性差异(P<0.01)。上颌窦底是向外向下,向内下侧的方向发育。上颌窦前壁点的变化从ⅡA到ⅡC期有个较明显的向后生长变化,从ⅡC到ⅢC上颌窦前壁没有明显向后的生长发育,反而有向前的趋势。上颌粗隆的后壁PP点是明显的向后方生长,并向下方的生长。上颌牙齿的位置变化：经统计学分析除了上颌尖牙远中点没有发生明显变化(P>0.05),其余各点都发生了变化(P<0.05)。上颌第一第二前磨牙在ⅢB期以前都向远中运动,但到ⅢB期牙齿停止运动,并有略向近中运动的趋势。上颌第一恒磨牙在ⅡA到ⅡC期向远中并向下运动,ⅡC到ⅢA期朝远中下方移动较明显,ⅢA到ⅢB期无明显变化,ⅢB到ⅢC未向远中移动反而略微开始向近中移动少许。上颌第二恒磨牙一直向远中下方运动。下颌的生长发育：L1与L8即下颌体部增长的较快,并且有高峰期。L2与L7即下颌升支也有较明显的变化,L9增长幅度也较大,其余的线距也都有变大,但其变化幅度较L1,L2,L7,L8小。下颌的各角度A1,A2,A3都逐渐变小,仅有A4(P>0.05)无统计学差异,即在各个阶段都没有变化。结论：上颌窦底是向外向下,向内下侧的方向发育,并且牙齿的萌出对上颌窦的发育有一定影响,同时上颌的牙齿都向远中牙合方运动,但在不同的阶段变化不同。下颌体部和升支都在增长增高,但除了下颌角的角度不变,其余的各角都变小。
Objective:this study is to investigate the growth and development of the maxillary and mandibular, and the change of teeth localization. Methods:The materials for this investigation comprise panoramic radiographs of 300 children (150 girls and 150boys) whose ages ranged from 4 to 14 years. the materials were divided into 5 groups accordingto Hellman's dental developmental stages. Auto-CAD (CAD-computer Aided Design) software was used to analyze the panoramic radiographs, The tracing of each radiograph was digitized by translating the reference points onto an X-Y coordinatesys-tem. The straight line that passes point O (the pointthat nasal septum intersects with hard palate) and point PA (the point that medial wall of maxillary sinus intersects withhard palate) was designated as the X axis. The straight line vertical to the X axis and passing through point O at a right angle was designated as the Y axis. The X and Y coordinate values of reference point were calculated. And then O point is (0,0). and every point have a coordinate values (X, Y), Statistical analysis the data. Results:Maxillary sinus floor localization change:There were on significant differences between males and females from group 1 (ⅡA) to group5 (ⅢC) in (SX, SY) (P>0.05). The differences between group 1 and other groups 2 (ⅡC),3 (ⅢA),4 (ⅢB),5were significant in SX (P<0.01), But 2,3,5 groups have no significant differences, there were significant differences betweengroup 4 and group5 (P<0.01). There were significant differences in SY among 2, 3,4,5groups (P<0.01), but groupl and group2 have no significant differences (P>0.05). The position of maxillary sinus floor grows downward and outward with age. The change of medial wall of maxillary sinus intersects with hard palate (PA) have a more evident backward growth change, from IIC to IIIC medial wall of maxillary sinus intersects with hard palate no obvious backward growth, but there is forward trend. posterior wall of maxillary tuberosity intersects with hard palate (PP). is obvious to the rear of growth and to below growth. The change of teeth localization of maxillary:by statistical analysis in addition to the maxillary canine distal point didn't happen change significantly (P>0.05), the others each point has changed (P<0.05). BeforeⅢB period the first and second premolar of maxillary have made distal movement, but to stop inⅢB period, and slightly to mesial movement trend. Maxillary first permanent molar from stage IIA to stageⅡC to distal and downward movement, fromⅡC toⅢA the movement to distal and downward is more apparent, formⅢA toⅢB without opparent change, fromⅢB toⅢC fail to move to distal and begin to made distal movement slightly instead. Maxillary second molar teeth (accessional teeth) has made the movement to distal and downward all the time. Mandibular growth:LI L8 namely with mandibular body grow faster, and have a peak. L2 L7 namely with ramus also changes obvious, the increasing of L9 is larger also, the rest of the spacing also change, but its variation range is smaller than LI, L2, L8 L7. Mandible of each Angle A1, A2, A3 are all growing smaller accordingly, only (P>0.05) A4 has no statistically different at each stage, namely no change. Conclusion:The growth direction of the maxillary sinus bottom is to outgoing, inward to the underside, and teeth eruption have certain influence on the development of the maxillary sinus, and at the same time the maxillary teeth are all to distal and oeclusal movement, but in different stage changes are different. Mandibular body and ramus are all growing, but apart from the Angle of mandibular Angle has no change, the rest of the angles all growsmaller.
Objective:this study is to investigate the growth and development of the maxillary and mandibular, and the change of teeth localization. Methods:The materials for this investigation comprise panoramic radiographs of 300 children (150 girls and 150boys) whose ages ranged from 4 to 14 years. the materials were divided into 5 groups accordingto Hellman's dental developmental stages. Auto-CAD (CAD-computer Aided Design) software was used to analyze the panoramic radiographs, The tracing of each radiograph was digitized by translating the reference points onto an X-Y coordinatesys-tem. The straight line that passes point O (the pointthat nasal septum intersects with hard palate) and point PA (the point that medial wall of maxillary sinus intersects withhard palate) was designated as the X axis. The straight line vertical to the X axis and passing through point O at a right angle was designated as the Y axis. The X and Y coordinate values of reference point were calculated. And then O point is (0,0). and every point have a coordinate values (X, Y), Statistical analysis the data. Results:Maxillary sinus floor localization change:There were on significant differences between males and females from group 1 (ⅡA) to group5 (ⅢC) in (SX, SY) (P>0.05). The differences between group 1 and other groups 2 (ⅡC),3 (ⅢA),4 (ⅢB),5were significant in SX (P<0.01), But 2,3,5 groups have no significant differences, there were significant differences betweengroup 4 and group5 (P<0.01). There were significant differences in SY among 2, 3,4,5groups (P<0.01), but groupl and group2 have no significant differences (P>0.05). The position of maxillary sinus floor grows downward and outward with age. The change of medial wall of maxillary sinus intersects with hard palate (PA) have a more evident backward growth change, from IIC to IIIC medial wall of maxillary sinus intersects with hard palate no obvious backward growth, but there is forward trend. posterior wall of maxillary tuberosity intersects with hard palate (PP). is obvious to the rear of growth and to below growth. The change of teeth localization of maxillary:by statistical analysis in addition to the maxillary canine distal point didn't happen change significantly (P>0.05), the others each point has changed (P<0.05). BeforeⅢB period the first and second premolar of maxillary have made distal movement, but to stop inⅢB period, and slightly to mesial movement trend. Maxillary first permanent molar from stage IIA to stageⅡC to distal and downward movement, fromⅡC toⅢA the movement to distal and downward is more apparent, formⅢA toⅢB without opparent change, fromⅢB toⅢC fail to move to distal and begin to made distal movement slightly instead. Maxillary second molar teeth (accessional teeth) has made the movement to distal and downward all the time. Mandibular growth:LI L8 namely with mandibular body grow faster, and have a peak. L2 L7 namely with ramus also changes obvious, the increasing of L9 is larger also, the rest of the spacing also change, but its variation range is smaller than LI, L2, L8 L7. Mandible of each Angle A1, A2, A3 are all growing smaller accordingly, only (P>0.05) A4 has no statistically different at each stage, namely no change. Conclusion:The growth direction of the maxillary sinus bottom is to outgoing, inward to the underside, and teeth eruption have certain influence on the development of the maxillary sinus, and at the same time the maxillary teeth are all to distal and oeclusal movement, but in different stage changes are different. Mandibular body and ramus are all growing, but apart from the Angle of mandibular Angle has no change, the rest of the angles all growsmaller.
引文
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