吹奏乐器对青少年错（牙合）畸形发生影响的探究

Influence of playing wind instrument on malocclusion in adolescents

目的 研究长期的乐器吹奏习惯对错（牙合）畸形发生的影响.方法 将210名四川音乐学院本科生根据有无吹奏乐器习惯及乐器吹奏方法,分为吹孔气鸣乐器组26人,单簧气鸣乐器组42人,唇簧气鸣乐器18人和非吹奏乐器组124人.采用问卷调查、临床检查的方法,收集、分析数据.结果 ①吹孔气鸣乐器组颏部偏斜、单簧气鸣乐器组下颌后缩、唇簧气鸣乐器组下颌前突及后缩的发生率均高于非吹奏组.组间开唇露齿发生率、上颌侧貌的分布无统计学差异.②组间颞下颌关节（TMJ）功能异常的发生率无统计学差异.③组间下中线偏斜的发生率、切牙覆盖的分布存在统计学差异,单簧气鸣乐器组切牙深覆盖的发生率高于非吹奏组.组间牙列拥挤、牙列间隙的发生率和切牙覆（牙合）、两侧尖牙及第一磨牙关系的分布无统计学差异.结论 吹奏乐器的习惯对错（牙合）畸形发生有促进作用,不同的演奏方法会引起不同的畸形.吹奏吹孔气鸣乐器可能增大颏部偏斜的发生率,吹奏单簧气鸣乐器可能增大下颌后缩、切牙深覆盖的发生率,吹奏唇簧气鸣乐器可能增大下颌前突的发生率.乐器吹奏习惯对开唇露齿、上颌侧貌、TMJ功能、牙列拥挤和间隙、切牙覆（牙合）、两侧尖牙及第一磨牙关系和后牙覆牙（牙合）尚未见明显影响.

Objective To investigate the influence of playing wind instrument on malocclusion.Methods A survey of 210 undergraduates from Sichuan Conservatory of Music was undertaken and all the subjects were divided into 4 groups （group 1：26 subjects,instruments with aperture mouthpieces;group 2：42 subjects,instruments with single-reed mouthpieces;group 3：18 subjects,instruments with cup-shaped mouthpieces;group 4：124 subjects,control group） according to playing a wind instrument or not and the categories of wind instruments.Questionnaire surveys were taken.Results 1） Chin deflection in group 3 （with cup-shaped mouthpiece）,mandibular retrusion in group 2 （with single-reed mouthpieces） and mandibular protrusion and retrusion in group 1 （with aperture mouthpieces） were more common than in the control group.No statistically significant differences were found in the rate of incompetent lips and maxillary convexity among groups.2） No statistically significant differences were found in the prevalence of temporomandibular joint dysfunction （TMJ）.3） Statistically significant difference was found in lower midline deviation among groups.The prevalence of increased overjet in group 2 （with single-reed mouthpieces）was higher than that in the control group.No statistically significant differences were found in the rate of crowding,space,overbite,and the canine as well as first molar relationships among groups.Conclusions Playing wind instrument increased the prevalence of malocclusion and the manifestations depended on the categories of wind instruments.