第二磨牙正锁[牙合]相关危险因素的病例对照研究

Risk factors for second molar scissors-bite in patients:a case-control study

目的 分析第二磨牙正锁[牙合]患者与头影测量指标的关系,评估第二磨牙正锁[牙合]致病的相关危险因素,探寻不同人群中的敏感指标。方法 采用病例对照研究,选取第二磨牙正锁[牙合]患者106例作为病例组。对照组为无锁[牙合]且双侧磨牙及尖牙为中性关系的患者102例。比较2组患者年龄、性别、骨性和牙性测量指标差异。使用多因素Logistic回归进一步分析第二磨牙正锁[牙合]致病的相关危险因素。结果 单因素分析结果显示,ANB角(∠ANB)、Wits值、覆(OB)、覆盖(OJ)、SNB角(∠SNB)是第二磨牙正锁[牙合]的敏感指标。Logistic回归结果显示,对于整个研究人群,低角(OR=2.907,95%CI:1.157~7.307)、∠ANB(OR=1.643,95%CI:1.203~2.245)和OB(OR=1.442,95%CI:1.116~1.862)增大是第二磨牙正锁[牙合]的危险因素。男性中,∠ANB增大是主要危险因素;女性的主要危险因素为高角、较大∠ANB和OB值。青少年中较大的∠ANB和OB值,以及成年人中较大的∠ANB和低角是该病的危险因素。结论 骨性Ⅱ类是第二磨牙正锁[牙合]最主要的危险因素。此外,女性高角和深覆[牙合],青少年深覆[牙合]以及成年人低角是第二磨牙正锁[牙合]的高风险人群。

Objective To analyze the relationship between patients with second molar scissors-bite and cephalometric indicators,to assess risk factors associated with the pathogenesis of second molar scissors-bite,and to explore the sensitive indicators in different populations.Methods A case-control study was conducted with 106 patients with second molar scissors-bite(the case group).The control group was 102 patients without scissors-bite and with bilateral molars and cusps in a neutral relationship.Differences in age,sex,skeletal and dental measurements were compared between the two groups of patients.Risk factors associated with second molar scissors-bite were further analyzed using multifactor Logistic regression.Results Univariate analysis showed that five measures,∠ANB,Wits value,OB,OJ and∠SNB were sensitive indicators of second molar scissors-bite.Logistic regression showed that for the entire study population,low angle(OR=2.907,95%CI:1.157-7.307),∠ANB(OR=1.643,95%CI:1.203-2.245)and OB(OR=1.442,95%CI:1.116-1.862)were risk factors for the pathogenesis of second molar scissors-bite.In males,large∠ANB was the main risk factor for the pathogenesis of second molar scissors-bite.In females,the main risk factors for the pathogenesis of second molar scissors-bite were high angle and larger∠ANB and OB.In adolescents,∠ANB and OB value,and in adults,∠ANB and low angle were risk factors for the pathogenesis of second molar scissors-bite.Conclusion Skeletal classⅡis the most important risk factor for second molar scissors-bite.In addition,high angle and deep overbite in women,deep overbite in adolescents and low angle in adults are all at high risk of the pathogenesis of second molar scissors-bite.