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Informationen aus Orthodontie & Kieferorthopädie 2002; 34(4): 243-252
DOI: 10.1055/s-2002-36885
Articles

© Georg Thieme Verlag

Veränderung der Molarenbeziehung während der Gebissentwicklung bei unterschiedlichen skelettalen Wachstumsmustern[*]

Transition of molar relationships in different skeletal growth patternsYong E. Kim1 , Ram S. Nanda1 , Pramod K. Sinha1
  • 1Department of Orthodontics, University of Oklahoma, USA
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Publication History

Publication Date:
24 January 2003 (online)

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Zusammenfassung:

Die Studie untersuchte unterschiedliche maxilläre und mandibuläre Wachstumsmuster und deren jeweiligen Auswirkungen auf die Veränderung der Molarenrelation während der Entwicklung vom frühen Wechselgebiss zur bleibenden Dentition des Erwachsenen. Dazu wurden fortlaufend angefertigte Fernröntgenaufnahmen von 40 Probanden ausgewertet. Die Probanden wurden in Abhängigkeit von ihrem Wachstumsmuster in drei Gruppen eingeteilt. In Gruppe A war das Unterkieferwachstum im Vergleich zum Oberkiefer stärker ausgeprägt, in Gruppe B wuchsen beide Kiefer gleichmäßig und in Gruppe C übertraf das Oberkieferwachstum das des Unterkiefers.

Die Ergebnisse zeigten, dass während des Zahnwechsels die Molarenrelation durch unterschiedliches Wachstum der Kiefer signifikant beeinflusst wird. Das Wachstumsmuster beeinflusst aber nicht nur die sagittale Lage der Kieferknochen, sondern auch das Ausmaß der physiologischen Mesialdrift der Zähne. Dagegen veränderte im bleibenden Gebiss ein unterschiedliches Ausmaß von Ober- und Unterkieferwachstum die Molarenrelation nicht mehr. Hier wurde das ungleiche Wachstum von dentoalveolären Kompensationsmechanismen ausgeglichen. Die Zahnbewegungen zeigten ein charakteristisches Muster in Abhängigkeit vom Ausmaß des Wachstumsunterschieds: (1) Übertraf das Unterkieferwachstum das des Oberkiefers, wurde der Wachstumsunterschied durch eine Mesialwanderung der oberen ersten Molaren und eine Kippung der Okklusionsebene gegen den Uhrzeigersinn ausgeglichen. In der Front kam es zur Vorverlagerung und Labialkippung der Oberkieferfront und zum Steilstand der Unterkieferfront. (2) Bei überschießendem Oberkieferwachstum wurde die skelettale Differenz hauptsächlich durch eine Mesialwanderung der unteren ersten Molaren kompensiert. Die Mesialdrift der oberen Molaren war in diesem Fall minimal. Die Neigung der Okklusionsebene veränderte sich ebenfalls nur unwesentlich. Die skelettale Wirkung auf die Frontzahnbeziehung wurde kompensiert durch einen Steilstand der oberen Schneidezähne und eine Vorverlagerung sowie Labialkippung der Unterkieferfront.

Summary

This study investigated maxillary and mandibular growth differences and their effect on the changes in molar relationships from early transitional dentition to adult permanent dentition. Various landmarks were identified and measurements made on the longitudinal cephalometric radiographs of 40 people. The subjects were classified into 3 groups based on the amount of sagittal skeletal growth difference between the jaws. In group A, the mandible grew more than did the maxilla; in Group B, growth was about the same; and in group C, the maxilla grew more than did the mandible. The results revealed that skeletal growth differences between the jaws significantly influenced the changes in molar relationship during the transitional dentition, not only by translating basal bones but also by altering the amount of physiologic mesial shift in the dentition. However, the skeletal growth difference during the permanent dentition did not influence the changes in molar relationship. The sagittal growth difference between the jaws was largely absorbed by a dentoalveolar compensation. Tooth movement showed different characteristic features depending on the amount of the skeletal growth difference; (1) If the mandible grew more than did the maxilla, the growth difference was mostly absorbed by mesial displacement of the maxillary first molars and counterclockwise rotation of the occlusal plane. Anterior occlusion was adjusted by mesial displacement and labial inclination of the maxillary incisors and lingual inclination of the mandibular incisors. (2) If the maxilla grew more than did the mandible, the growth difference was mainly absorbed by mesial displacement of the mandibular molars. Then the maxillary molars showed minimal mesial displacement. The occlusal plane also showed minimal rotational change. Anterior occlusion was adjusted by lingual tipping of the maxillary incisors and mesial displacement and labial tipping of the mandibular incisors.

Schlüsselwörter:

Molarenrelation - Kieferwachstum - dentoalveoläre Kompensation

Key words:

Molar relationship - jaw growth - dentoalveolar compensation

1 * Mit freundlicher Genehmigung von Verlag und Autoren. Original erschienen im Am J Orthod Dentofacial Orthop 2002; 121: 280-290.

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1 * Mit freundlicher Genehmigung von Verlag und Autoren. Original erschienen im Am J Orthod Dentofacial Orthop 2002; 121: 280-290.

Prof. Dr. Ram S. Nanda

Department of Orthodontics

College of Dentistry

University of Oklahoma

1001 Stanton L. Young Blvd

USA-Oklahoma City

OK 73190

Email: ram-nanda@ouhsc.edu