Stereofotogrametične značilnosti hrbta pri predpubertetnih otrocih z enostranskim funkcionalnim križnim grizom

Primožič, Jasna (avtor), Ovsenik, Maja (mentor), Antolič, Vane (komentor)

Namen dela. Z namenom razviti ne invazivno, objektivno in zanesljivo presejalno metodo za ugotavljanje oblikovnih značilnosti in asimetrije hrbta pri otrocih z in brez zobnih in čeljustnih nepravilnosti, so cilji raziskave razpoznati oblikovne značilnosti hrbta in ovrednotiti stopnjo asimetrije površine hrbta in obraza otrok z in brez enostranskega funkcionalnega križnega griza v pred-pubertetnem obdobju ter ugotoviti morebitno povezanost med le-tema na tridimenzionalnih (3D) posnetkih površine hrbta in obraza z uporabo ne invazivne metode. Hipoteze. H1 Preiskovanci z enostranskim funkcionalnim križnim grizom imajo višjo stopnjo asimetrije površine hrbta kot otroci brez te nepravilnosti. H2 Asimetrija površine hrbta pri preiskovancih z enostranskim funkcionalnim križnim grizom je največja v vratnem delu, najmanjša pa v ledvenem delu hrbta. H3 Obstaja značilno pozitivna povezanost med stopnjo asimetrije površine hrbta in obraza. Preiskovanci in metode. V raziskavo smo vključili 70 preiskovancev (36 dečkov, 34 deklic; starih 6,8±1,2 let) v obdobju mlečnega in zgodnjega menjalnega zobovja. Opravili smo klinično ovrednotenje položaja glave, ramen, lopatic in bokov s preiskovancem v pokončni drži, v predklonu in sedečem položaju. Zabeležili smo razlike v položaju levega in desnega ramena, lopatic in bokov. Poleg tega smo zabeležili še razlike v prominenci lopatic in trupa ter torakalnih in ledvenih paravertebralnih mišic Asimetrijo hrbta smo ovrednotili kvalitativno in kvantitativno z uporabo barvnih zemljevidov, ki prikazujejo razlike med prezrcaljenima tri-dimenzionalinima posnetkoma površine hrbta v tolerančnem razponu 2 mm. Na enak način je bila ovrednotena tudi obrazna asimetrija v tolerančnem razponu 0,5 mm. Rezultati. Pojavnost klinično ugotovljenih odklonov hrbta se med skupinama ni statistično značilno razlikovala. Odstotek asimetrije hrbta je bil značilno višji (p=0,011) pri skupini s križnim grizom (28,6±13,3%) v primerjavi s kontrolno skupino (20,8±12,1%). Preiskovanci s križnim grizom so imeli statistično značilno (p=0,001) višji odstotek asimetrije v spodnji tretjini obraza (50,9±21,8%) v primerjavi s preiskovanci iz kontrolne skupine (35,0±16,1%). Ugotovili smo statistično značilno povezanost (p?0,05) med križnim grizom in klinično ugotovljeno razliko v višini lopatic (RO=3,41) ter na 3D posnetku ugotovljeno razliko v prominenci lopatic (RO=3,29). Nismo ugotovili povezanosti med stranjo križnega griza in stranjo prominence posameznega dela hrbta. Ugotovili smo značilno povezanost med obrazno asimetrijo in prisotnostjo križnega griza (RO=5,32 (1,56-18,07; R2=0,161 in p=0,007). Ob izključitvi križnega griza kot pojasnjevalne spremenljivke, smo ugotovili tudi značilno povezanost med obrazno asimetrijo in klinično ugotovljeno razliko v višini lopatic (RO=4,26), digitalno ugotovljeno razliko v prominenci lopatic (RO=3,33), odstotkom asimetrije srednjega dela hrbta (RO=1,04) in digitalno izmerjeno razliko višin bokov (RO=1,12). Zaključek Čeprav smo ugotovili višjo stopnjo asimetrije hrbta pri otrocih z enostranskim funkcionalnim križnim grizom v pred-pubertetnem obdobju, ta stopnja asimetrije v tem obdobju ni klinično pomembno izražena. Med preiskovanci s križnim grizom nismo ugotovili razlik v stopnji asimetrije med posameznimi deli hrbta. Ugotovili smo pozitivno povezanost, vendar le med asimetrijo v področju lopatic, neskladjem v višini bokov in obrazno asimetrijo.

• Jezik: Slovenski jezik
• Ključne besede: asimetrija, stereofotogrametrija, križni griz
• Vrsta gradiva: Doktorsko delo/naloga
• Organizacija: MF - Medicinska fakulteta
• Leto izida: 2023
• PID: 20.500.12556/RUL-144569
• Datum objave v RUL: 02.03.2023

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Stereophotogrammetric characteristics of the back among prepubertal children with unilateral functional crossbite

Izvleček

Aim. The aim was to develop a non-invasive, objective, and reliable screening method for assessing morphological characteristics and asymmetries of the back among children with and without malocclusion. The objectives were to evaluate the morphological characteristics of the back and determine the degree of back and face asymmetry. A further aim was to assess if there is any association between the degree of back and facial asymmetry among subjects with and without unilateral functional crossbite in the pre-pubertal growth phase using a non-invasive three-dimensional method. Hypothesis. H1: Subjects with unilateral functional crossbite have a greater degree of back asymmetry than subjects without this malocclusion. H2: The degree of back asymmetry in subjects with unilateral functional crossbite is higher at the cervical part and smaller at the lumbar region. H3: There is a significant positive association between back and face asymmetry. Subjects and Methods. A group of 70 subjects (36 boys, 34 girls; 6.8 ±1.2 years) in the primary or early mixed dentition phase was included. Clinical assessment of head posture, shoulder, scapula, and hip height was performed with the subject standing, and differences between the left and right shoulder, scapula, and hip were recorded. Moreover, differences in scapula, trunk and thoracic and lumbar paravertebral musculature were also recorded. Back asymmetry was assessed qualitatively and quantitatively on colour deviation maps of superimposed mirrored three-dimensional back images at a tolerance level of 2 mm. Similarly, face asymmetry was assessed on three-dimensional face images at a tolerance level of 0.5 mm. Results. No significant differences were observed between the groups regarding the frequency of clinically assessed back anomalies. The percentage of back asymmetry was significantly higher in the crossbite (28.6±13.3%) than in the Control group (20.8±12.1%). Crossbite subjects (50.9±21.8%) had significantly higher (p=0.001) percentages of asymmetry compared to Control subjects (35.0%±16.1%) in the lower face region. A significant association (p<0.05) was seen between the clinically assessed scapula plane inclination (OR=3.41) and unilateral functional crossbite, as well as between digitally qualitatively assessed scapula prominence inequalities (OR=3.29) and crossbite. No associations were detected between the side of the crossbite and the side of the prominence of back parameters. Moreover, a significant association was seen between face asymmetry and the presence of crossbite OR=5.32 (1.56-18.07; R2=0.161 and p=0.007). When excluding crossbite as an explanatory variable, a significant association was also seen between face asymmetry and clinically assessed scapula plane inclination (OR=4.26), digitally qualitatively assessed scapula prominence inequalities (OR=3.33), middle back part percentage of asymmetry (OR=1.04) and digitally measured hip height inequality (OR=1.12). Conclusions. Although some degree of back asymmetry was detected in the Crossbite group during the pre-pubertal growth phase, this asymmetry does not appear to be clinically relevant. No significant differences regarding back asymmetry of its specific parts were identified among the Crossbite subjects. only asymmetry of the middle back part (scapulas) and hip height inequality were positively associated with facial asymmetry.

• Ključne besede: asymmetry, stereophotogrammetry, crossbite