Abstract | Cilj istraživanja: Utvrditi kefalometrijske karakteristike pacijenata s jednostranom odnosno obostranom impakcijom gornjeg trajnog očnjaka
Materijali i metode: U ovo retrospektivno istraživanje uključili smo pacijente koji su posjetili Laboratorij za dentalnu radiologiju 3D-Dent u Splitu u razdoblju od travnja 2012. do rujna 2016. godine. Latero-lateralni kefalogrami su napravljeni po standardnom protokolu snimanja aparatom Vatech i3D Green s pripadajućim CEPH nastavkom, uz pokretni, skenirajući senzor i vrijeme snimanja od 4 sekunde (do 99 kV i 15 mA). Na odabranim kefalogramima napravljena je kefalometrijska analiza (Zagreb 82 MOD i WITS) u programu AudaxCeph (Audax, Ljubljana, Slovenija).
Rezultati: U ovo istraživanje bilo je uključeno 70 ispitanika starosti od 12 do 18 godina. Na odabranim ortopantomogramima utvrđena je impakcija gornjeg trajnog očnjaka te su potom iz istraživanja isključeni ispitanici koji nisu imali prateći latero-lateralni kefalogram. Preostalo je 26 ispitanika, 18 djevojčica i 8 dječaka s impakcijom gornjeg trajnog očnjaka. Od toga je u 12 djevojčica utvrđena jednostrana, a u 6 obostrana impakcija, za razliku od 6 dječaka s jednostranom, odnosno 2 dječaka s obostranom impakcijom. U 19 ispitanika utvrđena je skeletna klasa I, u 2 ispitanika skeletna klasa II, a u 5 ispitanika skeletna klasa III, određena po ANB kutu. U ispitivanoj populaciji 46,1% su bile djevojčice, a 27% dječaci sa skeletnom klasom I. Sa skeletnom klasom II bilo je 7,7% djevojčica i 0% dječaka, a sa skeletnom klasom III 15,4% djevojčica i 3,8% dječaka. Ne postoji statistički značajna razlika u učestalosti skeletnih klasa između dječaka i djevojčica s impakcijom. Da bi utvrdili vertikalnu klasifikaciju, analiziran je međučeljusni kut. 53,5% ispitanika s jednostranom i 12% ispitanika s obostranom impakcijom imalo je normalan međučeljusni kut, 12% s jednostranom i 3% s obostranom impakcijom smanjen međučeljusni kut te 7,5% s jednostranom i 12% s obostranom impakcijom povećan međučeljusni kut. Ne postoji statistički značajna razlika u javljanju normalnog, povećanog ili smanjenog međučeljusnog kuta u pacijenata s jednostranom odnosno obostranom impakcijom očnjaka. Što se tiče položaja inciziva, najveći broj ispitanika imao je retruziju gornjih inciziva (49,5%), slijedio je normalan položaj gornjih inciziva (34,5%) te protrudirani položaj (16%). Najveći broj ispitanika bio je s jednostranom impakcijom i retruzijom gornjih inciziva (38%), slijedili su oni s jednostranom impakcijom i normalnim položajem gornjih inciziva (23%) pa oni s obostranom impakcijom i retruzijom te normalnim položajem gornjih inciziva (11,5%) te ispitanici s jednostranom i obostranom impakcijom te protruzijom gornjih inciziva (8%). Ne postoji statistički značajna razlika u pojavljivanju retruzije, protruzije ili normalnog položaja gornjih inciziva u pacijenata s jednostranom i obostranom impakcijom gornjeg trajnog očnjaka.
Zaključak: Najveći postotak ispitanika (73,1%) s impakcijom gornjeg trajnog očnjaka imao je skeletnu klasu I, 7,7% ispitanika imalo je skeletnu klasu II, a 19,2% skeletnu klasu III, međutim, nije utvrđena statistički značajna razlika u javljanju različitih skeletnih klasa u istraživanoj populaciji. U 49,5% slučajeva impakcija postojala je retruzija gornjih inciziva, slijedio je normalan položaj inciziva u 34,5% slučajeva te protruzija u 16% slučajeva. Ipak, ne postoji statistički značajna razlika u učestalosti različitih položaja inciziva u pacijenata s jednostranom ili obostranom impakcijom gornjeg trajnog očnjaka. U ispitivanom uzorku, u najvećem postotku bili su pacijenti s normalnim međučeljusnim kutom (65,5%), slijedili su oni s povećanim kutom (19,5%) dok je 15% pacijenata imalo smanjen međučeljusni kut. Međutim, nije utvrđena statistički značajna razlika u javljanju normalnog, povećanog ili smanjenog međučeljusnog kuta u pacijenata s jednostranom ili obostranom impakcijom gornjeg trajnog očnjaka. |
Abstract (english) | Objective: To assess cephalometric characteristics of the patients with unilateral or bilateral upper permanent canine impaction.
Materials and Methods: In this retrospective study, we included patients who visited the 3D-Dent Dental Radiology Laboratory in Split between April 2012 and September 2016. Craniograms were produced using the Vatech i3D Green device and its pertaining CEPH extension in accordance with the standard screening protocol, with a moving scanning sensor and a recording time of 4 seconds (up to 99 kV and 15 mA). Cephalometric analysis (Zagreb 82 Mod and WITS) was performed on selected craniograms using AudaxCeph software (Audax, Ljubljana, Slovenia).
Results: The study included 70 children between 12 and 18 years of age. After the impaction of upper permanent canine had been determined on selected orthopantomograms, patients who did not have lateral craniograms were excluded from further research. The remaining 26 children (18 girls and 8 boys) had all been diagnosed with impaction of permanent maxillary canine. Twelve girls had been diagnosed with unilateral impaction, whereas 6 girls had bilateral impaction. There were 6 boys with unilateral impaction and 2 boys with bilateral impaction. Nineteen patients were diagnosed with skeletal Class I, 2 patients with skeletal Class II and 5 with skeletal Class III, determined by ANB angle. In the observed population, 46.1% were girls and 27% were boys with skeletal Class I. There were 7.7% girls and 0% boys with skeletal Class II while skeletal Class III was found in 15.4% girls and 3.8% boys. There is no statistically significant difference in incidence of skeletal Classes between boys and girls with impaction of the upper permanent canine. To determine the vertical classification, the basal plane angle was analysed. 53.5% of patients with unilateral impaction and 12% of patients with bilateral impaction had a normal basal plane angle, whereas 12% of patients with unilateral impaction and 3% of patients with bilateral impaction had a reduced angle, and 7.5% of patients with unilateral impaction and 12% of those with bilateral impaction had an enlarged basal plane angle. There is no statistically significant difference in incidence of normal, enlarged or reduced basal plane angle in patients with unilateral or bilateral impaction of the upper permanent canine. As for the position of incisors, the largest number of the patients had retrusion of upper incisors (49.5%); in 34.5% of the patients the position of upper incisors was normal and protrusion of maxillary incisors was found in 16% of children. The largest number of patients had unilateral impaction and retrusion of upper incisors (38%), followed by 23% of the children who had unilateral impaction and normal position of upper incisors. The number of children with bilateral impaction and retrusion of incisors was the same as the number of those with bilateral impaction and normal position of upper incisors (11.5%). Furthermore, the number of patients with bilateral impaction and protrusion of incisors was equal to the number of children with unilateral impaction and protrusion of maxillary incisors (8%). There is no statistically significant difference between incidence of retrusion, protrusion or normal position of the maxillary incisors in patients with unilateral and bilateral impaction of the upper permanent canine.
Conclusion: The highest percentage of children with impaction of upper permanent canine had skeletal Class I (73.1%). There were 7.7% patients with skeletal Class II and 19.2% patients with skeletal Class III. However, there was no statistically significant difference in incidence of skeletal Classes in the observed population. Retrusion of the upper incisors was found in 49.5% of patients with impaction, followed by 34.5% of patients with normal position of upper incisors and 16% of patients with protrusion of upper incisors. Still, there is no statistically significant difference in incidence of different positions of maxillary incisors in patients with unilateral and bilateral impaction of the upper permanent canine. In the observed population, the largest number of patients had a normal basal plane angle (65.5%), followed by those with an enlarged angle (19.5%), whereas 15% of patients had a reduced angle. However, there is no statistically significant difference in incidence of normal, enlarged or reduced basal plane angle in patients with unilateral or bilateral impaction of the upper permanent canine. |