Mechanobehavior distinguishes mandibular growth differences in two facial types

机械行为区分两种面部类型的下颌生长差异

• 批准号: 10664884
• 负责人: Laura R Iwasaki
• 金额: $ 55.89万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10664884
• 关键词: 20 year old; Address; Affect; Animals; Behavior; Benchmarking; Cartilage; Categories; Cells; Child; Childhood; Clinical; Clinical Treatment; Controlled Study; Data; Dental; Dental Care; Dimensions; Electromyography; Environment; Exclusion; Extracellular Matrix; Face; Failure; Financial cost; Foundations; Frequencies; Future; Goals; Growth; Health; Height; Heterogeneity; Human; Individual; Jaw; Knowledge; Laboratories; Malocclusion; Mandible; Mandibular Condyle; Measurable; Measures; Mechanics; Methods; Mission; Mitotic; Modeling; Morbidity - disease rate; Muscle; Observational Study; Operative Surgical Procedures; Oral; Orthodontic; Orthopedics; Outcome; Outcome Measure; Outcomes Research; Patient Noncompliance; Patients; Persons; Phenotype; Population; Prognosis; Protocols documentation; Quality of life; Records; Research; Risk; Role; Shapes; Social Well-Being; Subgroup; Techniques; Technology; Temporomandibular Joint; Testing; Time; Tooth structure; Treatment Cost; United States; Work; age group; aged; bullying; cost; craniofacial; dentofacial; energy density; improved; in vivo; joint loading; mechanical load; novel; orthognathic; personalized approach; prospective; psychosocial; skeletal; success; systematic review

In the United States, >9% of children are orthodontic patients who are treated for crooked teeth and jaw discrepancies known as malocclusions (AAO, 2017). Costs for this treatment are >$9.5 billion annually (Guay et al. 2008; Laniado et al. 2017). Management of jaw growth via dentofacial orthopedics is indicated in >30% of orthodontic patients but 13-36% of mandibular growth enhancement therapies fail to correct the malocclusion (Hedlund and Feldmann 2016; O'Brien et al. 2003). Hence, the costs of poor results are considerable. Orthopedic therapies for mandibular enhancement try to promote growth of the load-sensitive secondary cartilages of the jaw through changes in temporomandibular joint (TMJ) loading mechanics and behaviors. Mandibular growth is expected to be less in amount and expressed more vertically (Buschang et al. 2017; Karlsen 1997) with poorer prognoses for orthopedic therapies in children with dolichofacial (long-narrow) compared to brachyfacial (short-wide) phenotypes (Deen and Woods 2015; Pancherz and Michailidou 2004; Rogers et al. 2018). However, differences in the TMJ loading mechanics and behaviors (mechanobehavior) in these phenotypes during growth and treatment are unknown. The broad, long-term goals of this research are to provide evidence-informed dentofacial orthopedic therapies with predictable results. Thus, this application proposes a prospective observational study in selected populations of dolichofacial and brachyfacial children before, during and after orthodontic treatment. This study will contribute to the mission of improving dental, oral, and craniofacial health by addressing three Specific Aims: 1. Test the hypothesis that dolichofacial compared to brachyfacial children have energy densities (energy input per volume of cartilage, mJ/mm3) that are significantly larger for the same jaw tasks and, thus, limit mandibular growth earlier. 2. Test the hypothesis that dolichofacial compared to brachyfacial children have duty factors (% time of jaw muscle activity/total recording time) that are significantly smaller and, thus, promote less mandibular growth per year. 3. Test the hypothesis that phenotypic dentofacial subgroups exist, differentiated by mechanobehavior scores ((energy densities)2 X duty factors) that correspond with significant differences in mandibular growth. Longitudinal clinical treatment records and data collected via validated techniques, including numerical modeling, dynamic stereometry, and laboratory and in-field electromyography, will be used to compare mechanobehavior variables between phenotypes and test if these variables predict mandibular growth as indicated by ramus height. The novel outcomes of this research will be critical foundations for future clinical approaches that modify mechanobehavior to achieve more successful and predictable orthopedic therapies in children with jaw discrepancies.

在美国，9%的儿童是正畸患者，他们接受过畸形牙齿和下巴的治疗 被称为错(牙合)的不一致(AAO，2017)。这种治疗每年的费用为95亿美元(Guay 等人的研究。2008年；Laniado等人。2017年)。30%的人指出，通过牙面矫形术来管理颌骨发育 正畸患者但13-36%的下颌骨生长促进疗法未能纠正错牙合 (Hedlund和Feldmann 2016；O‘Brien等人)。2003年)。因此，糟糕结果的代价是相当大的。 下颌骨增强的矫形治疗试图促进负荷敏感型继发性下颌骨的生长 通过改变颞下颌关节(TMJ)的负载力学和行为来影响颌骨软骨的功能。 预计下颌骨的生长在数量上会更少，并且更多地垂直表达(Buschang等人。2017年； Karlsen，1997)，儿童面部畸形的矫形治疗预后较差(长而窄) 与短面(短宽)表型相比(Deen和Wood，2015；PanCherz和Michailidou，2004； Rogers等人。2018年)。然而，TMJ加载机制和行为(力学行为)的差异 生长和处理过程中的这些表型是未知的。这项研究的广泛、长期目标是 提供循证的牙面矫形疗法，结果可预测。因此，此应用程序 建议在选定的指面部和近面部儿童人群中进行前瞻性观察研究 正畸治疗前、中、后。这项研究将有助于改善牙科的使命， 通过解决三个具体目标，实现口腔和颅面部健康： 1.检验这样一种假设，即与近脸部儿童相比，指面部儿童具有能量密度(能量输入 每软骨体积，MJ/mm3)，对于相同的颌骨任务，明显更大，因此限制了 下颌骨发育较早。 2.检验这样一种假设，即与近脸儿童相比，长脸儿童有责任因素(下巴时间百分比 肌肉活动/总记录时间)明显较小，因此对下颌生长的促进较少 每年。 3.检验表型牙面亚群存在的假设，通过机械行为得分来区分 ((能量密度)2X占空因数)，对应于下颌骨生长的显著差异。 通过经过验证的技术收集的纵向临床治疗记录和数据，包括数字 将使用建模、动态立体测量以及实验室和现场肌电图仪进行比较 表型和检验之间的力学行为变量是否可以预测下颌骨生长 由分枝高度表示。这项研究的新结果将成为未来临床的重要基础。 改变机械行为以实现更成功和可预测的整形外科治疗的方法 有颌骨畸形的儿童。