Title Utjecaj hipodoncije na izgled profila lica - kefalometrijska analiza Title (english) Skeletal pattern in subjects with hypodontia - a cephalometric study Author Daša Nikolov Borić305783782 Mentor Senka Meštrović (mentor)Committee member Sandra Anić Milošević (predsjednik povjerenstva)Committee member Hrvoje Jurić (član povjerenstva)Committee member Marina Lapter-Varga (član povjerenstva)Committee member Stjepan Špalj (član povjerenstva)Committee member Martina Šlaj (član povjerenstva)Committee member Tomislav Škrinjarić (član povjerenstva)Granter University of Zagreb Defense date and country 2020, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616.31 - Stomatology Abstract Cilj je ovoga istraživanja bio odrediti profil mekih tkiva, skeletne i dentalne odnose kod
ispitanika s hipodoncijom, utvrditi utjecaj opsežnosti i lokalizacije hipodoncije, kao i
procijeniti jesu li opsežnost i lokalizacija hipodoncije značajni prediktori skeletnih
karakteristika. Uzorak od 194 ispitanika (75 muškoga i 119 ženskoga spola; dobi 10-18
godina, medijan 14) izdvojen je iz baze podataka pacijenata Zavoda za ortodonciju
Stomatološke klinike Kliničkoga bolničkog centra Zagreb. Prema opsežnosti hipodoncije
ispitanici su podijeljeni u tri skupine: blaga (nedostatak 1–2 zuba), umjerena (nedostatak 3–5
zuba) te ozbiljna hipodoncija (nedostatak 6 ili više zuba). Prema lokalizaciji hipodoncije u
zubnom luku ispitanici su također podijeljeni u tri skupine: anteriorna (interkanina regija),
posteriorna (regija premolara i molara) te antero-posteriorna hipodoncija (kombinacija
prethodnih dviju skupina). U istraživanju je napravljena rentgenkefalometrijska analiza
laterolateralnih kraniograma snimljenih kao dio standardnoga postupka prije početka
ortodontske terapije. Razmatrana su trideset i tri angularna i linearna parametra, podijeljena u
tri kategorije: skeletni odnosi, dentalni odnosi i profil mekih tkiva. Prilikom analize u obzir
se uzela i lokalizacija hipodoncije po čeljustima. U obradi podataka primijenjene su
diskriminacijska analiza i multipla linearna regresija. Povećanjem broja zuba koji nedostaju
povećavala se sklonost prema maksilarnom retrognatizmu (smanjenjem vrijednosti kuta
SNA), smanjivala prednja donja visina lica, povećavala retruzija gornjih i donjih inciziva te
povećavala udaljenost usnica od E linije. Ozbiljna antero-posteriorna hipodoncija pokazala je
najveća odstupanja kefalometrijskih parametara u odnosu na blagu i umjerenu anteriornu i
posteriornu hipodonciju. Bila je povezana s tendencijom prema razvoju malokluzija Kl III,
smanjenom donjom prednjom visinom lica, konkavnijim profilom, retruzijom gornjih i
donjih inciziva, povećanim interincizalnim kutom te povećanom udaljenošću usnica od E
linije. Neprisutnost hipodoncije u objema čeljustima pokazala se kao značajan prediktor
povećanoga nagiba gornjih inciziva. Rezultati ovoga istraživanja ortodontima bi u budućnosti
mogli biti vrlo korisni tijekom kliničkoga rada, s obzirom na to da bilo koji od dijagnostičkih
parametara profila te skeletnoga i dentalnoga razvoja može biti ključan u planiranju terapije.
Abstract (english) Introduction: Hypodontia is the congenital absence of one or more teeth and is the most
common developmental anomaly of human dentition. Treating hypodontia is in general
considered to be the most difficult among orthodontists and multidisciplinary approach is
often required. Identification of potential common craniofacial characteristics of subjects with
hypodontia would greatly facilitate complicated treatment plan.
Objective: The objective of this study was to determine the soft tissue profile, skeletal and
dental relationships in subjects with hypodontia by using cephalometric radiographic
methods. Furthermore, the objective was to analyze the effects of severity and pattern as well
to evaluate whether severity and pattern of hypodontia are significant predictors of
cephalometric parameters.
Materials and methods: The sample was gained from the patients' database of the
Department of Orthodontics, Dental Clinic, Clinical Hospital Center Zagreb. It consisted of
194 subjects (75 males and 119 females) aged 10-18, with a mean age of 14 years, diagnosed
with permanent dentition hypodontia. Based on the severity of hypodontia sample was
divided into mild (1-2 missing teeth), moderate (3-5 missing teeth) and severe groups (6 or
more missing teeth). The location of missing teeth was used to further divide the sample into
anterior (intercanine region), posterior (premolars and molars) and anteroposterior groups. In
addition, jaw localization of hypodontia was also considered. Customized cephalometric
analysis was performed by DOLPHIN IMAGE software (v.11.5) on lateral cephalograms that
were taken as a part of a standard procedure prior to treatment. On each cephalogram, twenty
two hard and soft tissue landmarks were identified, from which thirty three angular and linear
parameters were recorded and analysed. Parameters were classified into three categories:
skeletal, dental and soft tissue profile relationships. Discriminant analysis and multiple linear
regression were used in order to process the data. The results were compared to Croatian
cephalometric standards according to Zagreb 82 MOD2 analysis.
Results: Decrease of SNA angle values (tendency towards maxillary retrognathism), decrease
of anterior lower facial height, retrusion of the incisors, and retrusion of the lips were
observed to be proportional to the increase of number and location of tooth agenesis.
Aneroposterior and severe hypodontia groups showed the largest cephalometric differences,
compared to other subgroups: smaller ANB angle values (tendency towards Class III
malocclusion), smaller anterior lower facial height (ANS-Me), retrusion of both upper and
lower incisors, greater interincisal angle (U1:L1), and a greater Li-E distance. The absence of
hypodontia in both jaws was shown to be a significant predictor of increased inclination of
upper incisors.
Conclusion: Hypodontia has a significant effect on craniofacial morphology. Due to increase
in number and location of missing teeth it could be expected that alveolar bone development
would be more and more insufficient. As a result, maxillary retrognathism and shortening of
anterior face height occur. When many teeth are missing, others tend to fulfill the gaps by
inclinating, which was demonstrated by a larger retrusion of the incisors, especially the lower
ones. Consequently, the lower lip is retruded, which, in combination with a tendency towards
Class III, leads to a more concave profile.
Keywords
kefalometrija
ortodoncija
hipodoncija
Keywords (english)
cephalometry
orthodontics
anodontia
Language croatian URN:NBN urn:nbn:hr:127:534697 Promotion 2020 Study programme Title: dental medicine Type of resource Text Extent 80 str. File origin Born digital Access conditions Open access Terms of use Created on 2020-11-13 13:45:10
