Zusammenfassung:
Bei 459 klinisch diagnostizierten Klasse-II-Fällen wurde die Okklusion von bukkal und von lingual beurteilt und der Einfluss der Mesialrotation der ersten oberen Molaren auf diese Klassifikation überprüft. Insgesamt 99 Seiten (10,78%) wiesen von bukkal und lingual eine neutrale Molarenrelation auf. Keiner dieser in Klasse I verzahnten Molaren stand gedreht. Die 175 Seiten (19,06%) mit von bukkal gering ausgeprägter Klasse II, zeigten alle eine Klasse-I-Molarenrelation bei Bewertung von lingual. In 85% dieser Fälle waren die Molaren nach mesial rotiert. In den Fällen mit von bukkal betrachtet moderater Klasse-II-Okklusion, standen von lingual bewertet 55% in einer Klasse-I-Beziehung und 45% in einer geringen Klasse-II-Verzahnung (Ausprägungsgrad 1), wobei in 81% dieser Fälle die Molaren rotiert waren. Bei von bukkal stark ausgeprägter Klasse II war das Ausmaß der Klasse-II-Verzahnung auch auf der Lingualseite erhöht (83% Ausprägungsgrad 2; 17% Ausprägungsgrad 3). Hier waren die Molaren in 74% der Fälle rotiert.
Die Auswertung zeigt, dass die oberen ersten Molaren häufig um den mesiopalatinalen Höcker rotiert stehen. Dieser Höcker hat in der Mehrzahl der Fälle Kontakt mit der zentralen Fossa des Antagonistenzahns, seltener mit der mesio-triangulären Fossa und nur gelegentlich noch weiter vorn. In der erstgenannten Kontaktposition waren 85% der Zähne rotiert, im zweiten Fall 81% und im letzten Fall 74%.
Die Beziehungen zwischen bukkaler und lingualer Molarenrelation, sowie deren Korrelation mit einer Mesialrotation der OK-Molaren waren alle statistisch signifikant (p < 0,001). Außerdem ergab sich eine lineare Korrelation zwischen der Eckzahnverzahnung und der konventionell (von bukkal) diagnostizierten Klasse-II-Molarenverzahnung, die mit der Formel YEckzahnbeziehung = 1,423 + 0,47 XMolarenbeziehung (p < 0,001) beschrieben wird. Unsere Ergebnisse zeigen, dass eine differenziertere Diagnostik der Molarenrelation zu einer verbesserten kausalen Therapie beitragen kann.
Summary
The buccal and lingual molar relationships in 459 clinically diagnosed Class II cases and the impact of upper first permanent molar rotation on this classification were assessed. Of the 459 Class II cases, 99 (10,78%) sides exhibited unilateral neutral molar relationship assessed from both the buccal and the lingual aspect. None of the molars exhibiting Class I relationship were rotated. The 175 (19.06°) sides with mild Class II molar relationship from the buccal aspect were all judged to be Class I lingually and 85% of these molars were rotated mesially. In the case of a moderate buccal Class II tendency, 55% of the molars were in a Class I relationship when evaluated from the lingual side, whereas 45% belonged to mild (1st°) Class II with molar rotations present in 81% of the cases. When a severe (3rd°) Class II was present from the buccal side. Its corresponding lingual Class II tendencies were accordingly elevated (83% 2nd°, 17% 3rd°). Among these cases, the molar rotations occurred in 74% of the cases. The results suggested the upper mesiopalatal cusp as a pivotal axis around which the upper first molar rotated. This cusp occluded most frequently in the central fossa, less frequently in the mesio-triangular fossa and rarely anterior to the mesio-triangular fossa. Rotations that correspond to these types of lingual occlusion were 85, 81 and 74%, respectively. The correlation between buccal and lingual molar relationships and their correlation with molar rotation were all significant (p < 0.001). Moreover, canine relationship was linearly correlated with the conventional (buccal) molar relationship in Class II cases, expressed by
Ycanine relation = 1.423 + 0.47 Xmolar relation (p < 0.001).
The results indicate that a more differentiated diagnosis of the molar relationship will allow for a more causally directed correction of Class II molar relationship.
Schlüsselwörter:
Angle-Klassifikation - Molarenrotation
Key words:
Angle classification - molar rotation
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1 * Mit freundlicher Genehmigung von Verlag und Autoren. Original erschienen in Clin Orthod Res 4, 2001; © 2001 by Munksgaard
Prof. Dr. Birte Melsen
Department of Orthodontics
Royal Dental College
University of Aarhus
Vennelyst Boulevard
DK-8000 Aarhus C
Denmark
Phone: + 45 89424037
Fax: + 45 86196029
Email: orthodpt@odont.au.dk
