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2-6歳児の内臓嚥下パターンに関連する因子の観察:横断研究
Observation of factors associated with visceral swallowing pattern in 2-6 year old children: A cross-sectional study.
PMID: 38690392
抄録
はじめに:
内臓嚥下パターン(VSP)と歯顎顔面異常との関連については、依然として議論の余地がある。本断面研究では、乳歯列および混合歯列初期の小児を対象に、VSPと様々な因子(出生形態、性別、舌の姿勢、口唇閉鎖不全、乳臼歯の萌出、習癖、不正咬合の有無など)との関連を検討することを目的とした。
INTRODUCTION: The association between the visceral swallowing pattern (VSP) and dentofacial abnormalities remains controversial. This cross-sectional study aimed to investigate the association between the VSP and various factors including type of birth, gender, tongue posture, lip incompetence, eruption of primary molars, habits and the presence of malocclusions in children with primary and early mixed dentition.
材料と方法:
合計219名の小児(男児102名、女児117名)を対象に、小児歯科専門医1名による質問票と構造化臨床検査を組み合わせて評価を行った。Kittelによる舌の姿勢評価法とPayneによる嚥下パターン評価法を筋機能状態の臨床検査に組み入れた。正規性を確認した後、正規分布データは二標本検定、非正規分布データはMann-Whitney検定を用いて分析した。カテゴリー変数の解析にはカイ二乗検定を用い、多重比較の補正にはボンフェローニ補正を用いた。
MATERIAL AND METHOD: A total of 219 children (102 boys and 117 girls) were evaluated using a combination of a questionnaire and a structured clinical examination by one pediatric specialist dentist. Kittel's method of tongue posture evaluation and the Payne technique for assessment of swallowing pattern were included in the clinical examination of myofunctional status. After checking for normality, normal and non-normal distributed data were analyzed using two-sample -test and Mann-Whitney test, respectively. Analysis of categorical variables was done using a chi-square test, and Bonferroni correction was used as correction for multiple comparisons.
結果:
調査対象者の56.2%がVSPであった。カイ二乗検定の結果、男性におけるVSPの存在が統計学的に有意に高いことが示された。VSPと口唇閉鎖不全、病的な安静時舌位、癖、前方開咬、オーバージェットの増加との間に統計学的に有意な関連が認められた。一方、VSPと小児の年齢、出生形態、片側または両側の交叉咬合、過蓋咬合の増加、端から端までの前歯咬合、小臼歯および永久切歯の萌出完了との間には、統計学的に有意な関連は認められなかった。
RESULTS: A total of 56.2 % of the study population had a VSP. The chi-square test indicated a statistically significant higher presence of VSP in male gender. Statistically significant associations were seen between the VSP and lip incompetency, pathologic resting tongue position, habits, anterior open bite and increased overjet. On the other hand, no statistically significant associations were found between VSP and children's age within the sample population, type of birth, uni- or bilateral crossbites, increased overbite, edge-to-edge anterior bite or completion of eruption of primary molars and/or permanent incisors.
結論:
VSPと男性性、病的な舌の姿勢、口唇閉鎖不全、癖、および前歯部開咬や前歯部オーバージェットの増加などの咬合形質との関連は、本研究の結果によって支持された。
CONCLUSIONS: The association between VSP and male gender, pathologic tongue posture, lip incompetency and habits and occlusal traits such as anterior open bite and increased anterior overjet is supported by the results of the present study.