不正咬合者における下顎頭形態と咬合関係および顎顔面形態の相互関連性

本研究は,下顎頭形態と咬合関係および顎顔面形態の関連性を検討することを目的として行った.281名の女性不正咬合患者を対象とし,顎関節断層X線写真,側面頭部X線規格写真および口腔内模型を資料とした.下顎頭の形態を4つの型に分類し,臼歯部の咬合関係をAngle分類に準じ3つの型に分類した.また10項目の計測項目より顎顔面形態を評価した.それらのデータより,下顎頭形態と咬合関係,下顎頭形態と顎顔面形態との関連を検討した結果,以下の結論を得た.1.下顎頭形態1型が全ての咬合関係において最も多く認められ,特にAngle III級において多く認められた.下顎頭形態2型はAngle III級において少なく,下顎頭形態3型はAngle III級においてII級に比べ多く認められた.下顎頭形態4型はいずれの咬合関係においても少なかった.2.Angle I級においては,下顎頭形態2型,3型が前歯部被蓋の浅い顎顔面形態を示した.また下顎頭形態4型では下顎の前上方回転が軽度に認められた.Angle II級においては,下顎頭形態2型および3型が下顎の後方位,後下方回転という顎顔面形態を示していた.Angle III級においては,下顎頭形態2型のみが前歯部の被蓋が正被蓋であった.3.AICによる分析の結果,下顎頭形態と最も関連の深い計測項目はramus inclinationであったことから,下顎枝の傾斜と下顎頭形態との間に最も関連があることが推定された.また下顎骨の水平的関係が垂直的関係よりも,相対的に下顎頭形態に関連していることも推定された.This study was conducted in order to investigate correlations between mandibular condyle morphology with occlusion and maxillofacial morphology. A total of 281 female were subjected to the study, and tomograms of their temporomandibular joints (TMJ), lateral cephalograms and intraoral models were studied. Mandibular condyle morphology was classified into 4 types, and molar occlusions were classified into 3 types based on Angle's classification. In addition, maxillofacial morphology was assessed by measuring 10 items. Based on these data, correlations between mandibular condyle morphology and occlusion, and correlations between mandibular condyle morphology and maxillofacial morphology were investigated, and the following conclusions were reached. 1. Type 1 mandibular condyle morphology was observed most frequently throughout all occlusions, especially in the Angle class III. Type 2 was seen less frequently in the Angle class III, and type 3 was seen more frequently in the Angle class III than in the Angle class II. Type 4 was not observed very often throughout the occlusions. 2. In the Angle class I, type 2 and 3 mandibular condyle morphology presented maxillofacial morphology featuring small incisor overbites. In addition, a slight antero-superior rotation of the mandible was observed in type 4. In the Angle class II, type 2 and 3 presented posterior or postero-inferior rotations of the mandible. In the Angle class III, positive incisor overlap was seen only with type 2. 3. According to AIC analysis, the measurement item which was associated the most with mandibular condyle morphology was ramus inclination, suggesting that the most significant correlation was between the mandibular ramus inclination and the mandibular condyle morphology. Moreover, the horizontal relationship of mandible was assumed to be relatively more associated with mandibular condyle morphology than with vertical relationship

不正咬合者における下顎頭形態と咬合関係および顎顔面形態の相互関連性

本研究は,下顎頭形態と咬合関係および顎顔面形態の関連性を検討することを目的として行った.281名の女性不正咬合患者を対象とし,顎関節断層X線写真,側面頭部X線規格写真および口腔内模型を資料とした.下顎頭の形態を4つの型に分類し,臼歯部の咬合関係をAngle分類に準じ3つの型に分類した.また10項目の計測項目より顎顔面形態を評価した.それらのデータより,下顎頭形態と咬合関係,下顎頭形態と顎顔面形態との関連を検討した結果,以下の結論を得た.1.下顎頭形態1型が全ての咬合関係において最も多く認められ,特にAngle III級において多く認められた.下顎頭形態2型はAngle III級において少なく,下顎頭形態3型はAngle III級においてII級に比べ多く認められた.下顎頭形態4型はいずれの咬合関係においても少なかった.2.Angle I級においては,下顎頭形態2型,3型が前歯部被蓋の浅い顎顔面形態を示した.また下顎頭形態4型では下顎の前上方回転が軽度に認められた.Angle II級においては,下顎頭形態2型および3型が下顎の後方位,後下方回転という顎顔面形態を示していた.Angle III級においては,下顎頭形態2型のみが前歯部の被蓋が正被蓋であった.3.AICによる分析の結果,下顎頭形態と最も関連の深い計測項目はramus inclinationであったことから,下顎枝の傾斜と下顎頭形態との間に最も関連があることが推定された.また下顎骨の水平的関係が垂直的関係よりも,相対的に下顎頭形態に関連していることも推定された.This study was conducted in order to investigate correlations between mandibular condyle morphology with occlusion and maxillofacial morphology. A total of 281 female were subjected to the study, and tomograms of their temporomandibular joints (TMJ), lateral cephalograms and intraoral models were studied. Mandibular condyle morphology was classified into 4 types, and molar occlusions were classified into 3 types based on Angle\u27s classification. In addition, maxillofacial morphology was assessed by measuring 10 items. Based on these data, correlations between mandibular condyle morphology and occlusion, and correlations between mandibular condyle morphology and maxillofacial morphology were investigated, and the following conclusions were reached. 1. Type 1 mandibular condyle morphology was observed most frequently throughout all occlusions, especially in the Angle class III. Type 2 was seen less frequently in the Angle class III, and type 3 was seen more frequently in the Angle class III than in the Angle class II. Type 4 was not observed very often throughout the occlusions. 2. In the Angle class I, type 2 and 3 mandibular condyle morphology presented maxillofacial morphology featuring small incisor overbites. In addition, a slight antero-superior rotation of the mandible was observed in type 4. In the Angle class II, type 2 and 3 presented posterior or postero-inferior rotations of the mandible. In the Angle class III, positive incisor overlap was seen only with type 2. 3. According to AIC analysis, the measurement item which was associated the most with mandibular condyle morphology was ramus inclination, suggesting that the most significant correlation was between the mandibular ramus inclination and the mandibular condyle morphology. Moreover, the horizontal relationship of mandible was assumed to be relatively more associated with mandibular condyle morphology than with vertical relationship

Williams症候群患者における口腔顎顔面領域の形態学的検討

Williams症候群は,1961年にWilliamsらが精神遅滞,大動脈弁上部狭窄および特異顔貌を有する症候群として報告した疾患で,染色体7q11.23にあるエラスチン遺伝子,LIMキナーゼ1遺伝子などを始めとする約20種類の遺伝子を含む領域の微小欠失が原因の隣接遺伝子症候群と考えられている.今回われわれは,本疾患群に対し口腔顎顔面領域の形態学的検討を行ったので報告する.対象は当院附属日本心臓血圧研究所循環器小児科でFISH法により染色体7q11.23の微細欠失が確認されWilliams症候群と確定診断された患者15例で,方法は頭部X線規格写真,顎態模型,口腔内およびX線所見による分析を行い,頭部X線規格写真分析の方法はRicketts法を使用した.結果は,頭部X線規格写真分析では下顎のアーク,下顎中切歯突出量,上顎大臼歯の位置,前頭蓋底の長さ,下唇の突出量が高値で日本人平均値と比較し有意差を認め,その結果,上顎前突,下顎前歯の唇側傾斜,下唇の突出および顔面形態ではdolicofacial patternなどがWilliams症例の顔貌上の特徴と考えられた,顎態模型,口腔内およびX線所見による分析では歯の先天性欠如が10例26歯に認められ,下顎側切歯が11歯(42.3%)と最も多かった.歯の奇形は10例(48歯)に認め,矮小歯が6例(14歯),短根歯が6例(34歯)であり,矮小歯では上顎側切歯が12歯(85.7%)と最も多く,短根歯では上顎第二小臼歯が9歯(26.5%)と最も多かった.このように顎顔面口腔領域の異常が高率に認められることからWilliams症候群においては定期的な歯科口腔外科的チェックと早期からの歯科矯正学的治療が重要であると考えられる.Williams syndrome was reported in 1961 by Williams and coworkers as a syndrome characterized by mental retardation, supravalvular aortic stenosis, and specific facies. It is thought to be a contiguous gene syndrome that is a neurocognitive disorder commonly caused by a 1.5 Mb deletion containing about 20 genes, for example the elastin gene, the LIM kinase 1 gene, on chromosome band 7q11.23. Accordingly, in the present study we conducted a morphological study of the oral and maxillofacial area in patients with Williams syndrome. The subjects were 15 patients found to have a microdeletion of chromosome 7q11.23 and diagnosed as having Williams syndrome. The methods used consisted of conducting analyses of cephalometric radiograms of the head and gnathostatic models, and the oral and radiographic findings. An analysis of cephalometric radiograms of the head revealed significantly higher values for mandibular arch, mandibular incisor protrusion, upper molar position, cranial length anterior, and lip protrusion than the mean values in Japanese, and as a result the facies of Williams syndrome patients appeared to be characterized by maxillary protrusion, labial inclination of the lower incisor, protrusion of the lower lip, and, in terms of facial description, a dolicofacial pattern. Analysis of gnathostatic models and the oral and radiographic findings showed congenitally missing teeth, microdontia, short-rooted teeth

Williams症候群患者における口腔顎顔面領域の形態学的検討

Williams症候群は,1961年にWilliamsらが精神遅滞,大動脈弁上部狭窄および特異顔貌を有する症候群として報告した疾患で,染色体7q11.23にあるエラスチン遺伝子,LIMキナーゼ1遺伝子などを始めとする約20種類の遺伝子を含む領域の微小欠失が原因の隣接遺伝子症候群と考えられている.今回われわれは,本疾患群に対し口腔顎顔面領域の形態学的検討を行ったので報告する.対象は当院附属日本心臓血圧研究所循環器小児科でFISH法により染色体7q11.23の微細欠失が確認されWilliams症候群と確定診断された患者15例で,方法は頭部X線規格写真,顎態模型,口腔内およびX線所見による分析を行い,頭部X線規格写真分析の方法はRicketts法を使用した.結果は,頭部X線規格写真分析では下顎のアーク,下顎中切歯突出量,上顎大臼歯の位置,前頭蓋底の長さ,下唇の突出量が高値で日本人平均値と比較し有意差を認め,その結果,上顎前突,下顎前歯の唇側傾斜,下唇の突出および顔面形態ではdolicofacial patternなどがWilliams症例の顔貌上の特徴と考えられた,顎態模型,口腔内およびX線所見による分析では歯の先天性欠如が10例26歯に認められ,下顎側切歯が11歯(42.3%)と最も多かった.歯の奇形は10例(48歯)に認め,矮小歯が6例(14歯),短根歯が6例(34歯)であり,矮小歯では上顎側切歯が12歯(85.7%)と最も多く,短根歯では上顎第二小臼歯が9歯(26.5%)と最も多かった.このように顎顔面口腔領域の異常が高率に認められることからWilliams症候群においては定期的な歯科口腔外科的チェックと早期からの歯科矯正学的治療が重要であると考えられる.Williams syndrome was reported in 1961 by Williams and coworkers as a syndrome characterized by mental retardation, supravalvular aortic stenosis, and specific facies. It is thought to be a contiguous gene syndrome that is a neurocognitive disorder commonly caused by a 1.5 Mb deletion containing about 20 genes, for example the elastin gene, the LIM kinase 1 gene, on chromosome band 7q11.23. Accordingly, in the present study we conducted a morphological study of the oral and maxillofacial area in patients with Williams syndrome. The subjects were 15 patients found to have a microdeletion of chromosome 7q11.23 and diagnosed as having Williams syndrome. The methods used consisted of conducting analyses of cephalometric radiograms of the head and gnathostatic models, and the oral and radiographic findings. An analysis of cephalometric radiograms of the head revealed significantly higher values for mandibular arch, mandibular incisor protrusion, upper molar position, cranial length anterior, and lip protrusion than the mean values in Japanese, and as a result the facies of Williams syndrome patients appeared to be characterized by maxillary protrusion, labial inclination of the lower incisor, protrusion of the lower lip, and, in terms of facial description, a dolicofacial pattern. Analysis of gnathostatic models and the oral and radiographic findings showed congenitally missing teeth, microdontia, short-rooted teeth