II級不正咬合における頸椎の骨格成熟度と歯科矯正用機能的装置の効果について

Effects of Orthodontic Functional Appliances in Relation to Skeletal Maturation of Cervical Vertebrae in Class II Malocclusion.

抄録

目的:

II級不正咬合患者の骨格の成熟度に関連して、歯および骨格レベルでの機能的矯正装置がもたらす効果を評価する。

AIM: To evaluate the effects produced by functional orthodontic appliances at dental and skeletal level in relation to the level of skeletal maturation in class II patients.

研究デザイン:

縦断的な観察研究。本研究に選ばれた患者は、Sander Bite Jumping Appliance（SBJA）を少なくとも12ヵ月間装着しており、Rickettsのセファロ分析により骨格クラスIIと最初に診断され（T1）、矯正治療の前後に横方向のセファログラムを撮影した（T2）。T1とT2で調査した変数は、顔の凸部、上下の切歯の傾き、顔の奥行きである。結果は、各変数についてT1とT2の間で比較され、Lamparski分析に従って頸部成熟段階(CVS)との関連で比較された。統計解析は、Shapiro-Wilk、t-student、分散分析（ANOVA）、多重比較検定を用いて行い、p値<0.05を統計的に有意とした。

STUDY DESIGN: Longitudinal and observational study. Patients selected for the study had been wearing Sander Bite Jumping Appliance (SBJA) for at least 12 months; they were first diagnosed (T1) with skeletal class II according to Ricketts' cephalometric analysis, and had had lateral cephalograms taken before and after orthopaedic treatment (T2). Variables studied at T1 and T2 were: facial convexity, inclination of the upper and lower incisors, and facial depth. Results were compared between T1 and T2 for each variable and in relation to cervical maturation stage (CVS) according to the Lamparski analysis. Statistical analysis was performed using Shapiro-Wilk, t-student, Analysis of Variance (ANOVA) and multiple comparison tests, taking as statistically significant a p-value <0.05.

結果:

最終的に235名の患者を対象とした。機能的装置をCVS1に装着した場合（p＝0.000）、CVS2に装着した場合（p＝0.04）、CVS5に装着した場合（p＝0.048）、T1とT2の間、および頚椎の各ステージの間で、下顎切歯の傾斜に統計的に有意な差が認められました。残りの変数についても、T1とT2の間で有意な差が見られたが、これらの差はすべての頸部ステージで同様であった。

RESULTS: A final sample of 235 patients was obtained. Statistically significant differences were found in the inclination of the mandibular incisors between T1 and T2 and among the different cervical stages when the functional appliances were placed in CVS1 (p = 0.000), CVS2 (p = 0.04) or CVS5 (p = 0.048). For the remaining variables, significant differences were also found between T1 and T2, but these differences were similar in all cervical stages.

結論:

CVS1、CVS2、CVS5のいずれかの段階で機能的装置を装着した場合、下顎切歯の有意な傾斜が認められた。機能的装置を装着した時期は、残りの変数については統計的に有意ではなかった。

CONCLUSIONS: A significant proclination of the mandibular incisors was found when the functional appliance was placed during CVS1, CVS2, or CVS5. Time of placement of the functional appliances was not statistically significant for the remaining variables studied.