EARLY VS LATE TREATMENT IN CLASS II MALOCCLUSION

II 类咬合不正的早期治疗与晚期治疗

• 批准号: 3222564
• 负责人: WILLIAM R PROFFIT
• 金额: $ 19.45万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 1988
• 资助国家: 美国
• 起止时间: 1988-09-01 至 1998-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3222564
• 关键词: adolescence (12-20); clinical trials; dental development; health care service utilization; human subject; human therapy evaluation; jaw; longitudinal human study; malocclusion; middle childhood (6-11); oral health; oral pharyngeal surgery; orthodontic appliances; orthodontics; social psychology; young adult human (21-34)

Ten percent of American children have Class II malocclusion ("buck teeth"), and nearly half of all orthodontic patients are treated for a problem of this type. The cause usually is disproportionate jaw growth, and the best treatment approach remains unknown. The choices are early treatment (prior to adolescence) to try to modify growth and correct the jaw relationship, or later treatment (in adolescence) to reposition the teeth to compensate for the incorrect jaw position. The important questions are whether growth modification can be accomplished, and if so, whether it makes any difference to subsequent treatment and outcomes. A prospective randomized clinical trial (RCT), which we now have in progress to compare headgear and functional appliance methods of early treatment versus no early treatment, is necessary to obtain unbiased answers. We also are addressing additional questions and a broader coverage of age groups through a larger retrospective-prospective observational sample of Class II patients. At this point, the 150 children specified initially have been enrolled in the RCT; 107 have finished phase 1 and the remainder will do so by the end of the current period. The preliminary data indicate that both types of early treatment affect growth. All these children require phase 2 treatment, which has begun for 68 patients but has been completed so far for only two. A major goal of the project now is to complete phase 2 treatment for RCT patients, comparing the outcomes at the end of phase 2 for those who had early treatment versus those who did not. Long-term outcomes are greatly affected by how posttreatment retention is managed, and in the RCT patients, we will compare the effectiveness of conventional uni-arch orthodontic retainers and a modified functional appliance as a retainer. Finally, using the larger observational group to obtain broader patient coverage for comparison with the RCT results and to provide data on questions that require a longer time span, we will evaluate the effectiveness of Class II treatment and the posttreatment skeletal and dental changes following treatment. No similar study has ever been undertaken. The data will clarify the best approach to these problems, and will be important nationally and internationally in determining treatment modalities.

百分之十的美国儿童患有 II 类咬合不正（“buck 牙齿”），近一半的正畸患者接受了正畸治疗 这种类型的问题。原因通常是下巴生长不成比例， 最好的治疗方法仍然未知。选择还早 治疗（青春期之前）尝试改变生长并纠正 颌关系，或后期治疗（青春期）以重新定位 牙齿以补偿不正确的下颌位置。重要的 问题是是否可以实现生长调节，如果可以的话， 是否对后续治疗和结果有任何影响。一个 我们正在进行前瞻性随机临床试验（RCT） 比较早期治疗的头饰和功能矫治器方法 与不早期治疗相比，有必要获得公正的答案。 我们 还正在解决其他问题和更广泛的年龄覆盖范围 通过更大的回顾性和前瞻性观察样本进行分组 II 类患者。 至此，最初指定的150名儿童已被录取 随机对照试验； 107 已完成第一阶段，其余的将在年底前完成 本期的。初步数据表明，这两种类型 早期治疗影响生长。 所有这些孩子都需要第二阶段 已开始对 68 名患者进行治疗，但目前已完成 只有两个。该项目现在的主要目标是完成第二阶段 RCT 患者的治疗，比较第 2 阶段结束时的结果 对于那些接受早期治疗的人与那些没有接受治疗的人。长期 结果很大程度上取决于治疗后保留的管理方式， 在随机对照试验患者中，我们将比较传统疗法的有效性 单弓正畸保持器和改进的功能矫治器作为 保持器。最后，使用更大的观察组来获得更广泛的 患者覆盖范围，用于与 RCT 结果进行比较并提供数据 对于需要较长时间跨度的问题，我们将评估 II类治疗的有效性以及治疗后的骨骼和 治疗后牙齿的变化。还没有类似的研究 进行。这些数据将阐明解决这些问题的最佳方法，并且 对于确定治疗方法在国内和国际上都具有重要意义 方式。