中国人群腭中缝形态特点分期与Demirjian牙龄的相关性Chinese morphological stages of midpalatal suture and its correlation with Demirjian dental age
高璐;谷岩;
摘要(Abstract)：
目的:研究中国人群腭中缝(midpalatal suture,MPS)形态特点分期与Demirjian牙龄间的相关性,以探索牙龄对腭中缝骨化闭合程度的预测能力。方法:本研究为回顾性研究,收集1 076例样本(女675例,男401例,年龄6.0～20.9岁),观察锥形束CT(cone-beam CT,CBCT)水平位腭中缝区域,记录各样本的MPS分期,同时观察并记录各样本的牙龄。采用Spearman相关系数检验与诊断试验,研究作为有序分类变量的MPS分期与牙龄间的相关关系。结果:(1)左下第二前磨牙:牙龄B～D期者绝大部分处于MPS 1～2期,占95.2%;牙龄E期者MPS 1～2期占85.3%,3期占14.7%;牙龄F期者MPS 3期、1～2期、4s1期分别占45.1%、46.1%和8.8%;牙龄G期者MPS3期、4s1期、1～2期分别占49.8%、24.9%和18.9%;牙龄H期者大部分处于MPS 4～5期,占80.1%,另16.3%处于3期。(2)左下第二磨牙:牙龄B～D期者绝大部分处于MPS 1～2期,占89.7%;牙龄E期者MPS 1～2期占67.4%,3期占26.1%;牙龄F期者MPS 3期、1～2期、4s1期分别占55.3%、34.2%和10.5%;牙龄G期者MPS 3期、4s1期、1～2期分别占50.7%、24.3%和16.8%;牙龄H期者大部分处于MPS 4～5期,占83.8%;另14.2%处于3期。(3)以牙龄诊断MPS分期,效能较好的配对有:左下第二磨牙牙龄-MPS:H-4s2、H-5、D-1;左下第二前磨牙牙龄-MPS:H-4s2、H-5、G-3。其余配对的诊断效能一般。(4) MPS分期与左下第二磨牙牙龄的Spearman系数最高,为0.68,其次是第二前磨牙,为0.64。(5)若左下第二磨牙或第二前磨牙处于牙龄H期,则该个体很可能超过MPS4s2期。结论:除少数诊断效能较好的配对外,牙龄诊断MPS分期的效能总体一般。因此,以牙龄评估腭中缝骨化闭合程度时,应酌情加拍治疗前CBCT,以明确腭中缝骨化闭合状态。
关键词(KeyWords)： 腭中缝;锥束计算机体层摄影术;Demirjian牙龄;诊断效能
基金项目(Foundation): 国家自然科学基金(81970979);; 科技部科技基础资源调查专项课题(2018FY101005)~~
作者(Author): 高璐;谷岩;
Email:
DOI: 10.19723/j.issn.1671-167X.2021.01.020
参考文献(References)：
- [1]Bjork A.Sutural growth of the upper face studied by the implant method[J].Acta Odontol Scand,1966,24(2):109-127．
- [2]Melsen B.Palatal growth studied on human autopsy material[J].Am J Orthod,1975,68(1):42-54．
- [3]Persson M,Thilander B.Palatal suture closure in man from 15 to35 years of age[J].Am J Orthod,1977,72(1):42-52．
- [4]Haas AJ.The treatment of maxillary deficiency by opening the midpalatal suture[J].Angle Orthod,1965,35:200-217．
- [5]McNamara JA Jr,Baccetti T,Franchi L,et al.Rapid maxillary expansion followed by fixed appliances:a long-term evaluation of changes in arch dimensions[J].Angle Orthod,2003,73(4):344-353．
- [6]Baccetti T,Franchi L,Cameron CG,et al.Treatment timing for rapid maxillary expansion[J].Angle Orthod,2001,71(5):343-350．
- [7]Rungcharassaeng K,Caruso JM,Kan JY,et al.Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion[J].Am J Orthod Dentofacial Orthop,2007,132(4):428．
- [8]Barber AF,Sims MR.Rapid maxillary expansion and external root resorption in man:A scanning electron microscope study[J].Am J Orthod,1981,79(6):630-652．
- [9]Rinaldi MRL,Azeredo F,de Lima EM,et al.Cone-beam computed tomography evaluation of bone plate and root length after maxillary expansion using tooth-borne and tooth-tissue-borne banded expanders[J].Am J Orthod Dentofacial Orthop,2018,154(4):504-516．
- [10]Garib DG,Henriques JF,Janson G,et al.Rapid maxillary expansion:Tooth tissue-borne versus tooth-borne expanders.A computed tomography evaluation of dentoskeletal effects[J].Angle Orthod,2005,75(4):548-557．
- [11]高璐，谷岩．中国人群腭中缝生长发育形态特点分期与其相应生理年龄分布的初步研究[J]．中华口腔正畸学杂志，2020,27(2):61-66．
- [12]Demirjian A,Goldstein H,Tanner JM.A new system of dental age assessment[J].Hum Biol,1973,45(2):211-227．
- [13]Demirjian A,Goldstein H.New systems for dental maturity based on seven and four teeth[J].Ann Hum Biol,1976,3(5):411-421．
- [14]Macha M,Lamba B,Avula JSS,et al.Estimation of correlation between chronological age,skeletal age and dental age in children:a cross-sectional study[J].J Clin Diagn Res,2017,11(9):ZC01-ZC04．
- [15]李萌，李果，王虎．Demirjian牙龄推断法及其应用与更新[J]．国际口腔医学杂志，2014,41(6):725-729．
- [16]Perinetti G,Contardo L,Gabrieli P,et al.Diagnostic performance of dental maturity for identification of skeletal maturation phase[J].Eur J Orthod,2011,34(4):487-492．
- [17]Proffit WR.Contemporary orthodontics[M].6th ed.Philadelphia:Elsevier,2018．
- [18]Ró6)zyo-Kalinowska I,Kolasa-Rczka A,Kalinowski P.Relationship between dental age according to Demirjian and cervical vertebrae maturity in Polish children[J].Eur J Orthod,2010,33(1):75-83．
- [19]Ladewig VM,Capelozza-Filho L,Almeida-Pedrin RR,et al.Tomographic evaluation of the maturation stage of the midpalatal suture in post-adolescents[J].Am J Orthod Dentofacial Orthop,2018,153(6):818-824．
- [20]Hajian-Tilaki K.Receiver operating characteristic(ROC) curve analysis for medical diagnostic test evaluation[J].Caspian J Intern Med,2013,4(2):627-635．
- [21]Korbmacher H,Schilling A,Puschel K,et al.Age-dependent three-dimensional micro-computed tomography analysis of the human midpalatal suture[J].J Orofac Orthop,2007,68(5):364-376．
- [22]Knaup B,Yildizhan F,Wehrbein H.Age-related changes in the midpalatal suture[J].J Orofac Orthop,2004,65(6):467-474．
- [23]黄悦勤．临床流行病学[M].4版．北京:人民卫生出版社，2014．
- [24]葛立宏．儿童口腔医学[M].2版．北京:北京大学医学出版社，2013.