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％的儿童是牙齿牙齿和下巴治疗的正畸患者 差异称为厌氧含量（AAO，2017年）。这种治疗的费用每年> 95亿美元（Guay） 等。 2008; Laniado等。 2017）。在30％的情况下，通过牙本质骨科对下颌生长进行管理 正畸患者，但下颌生长增强疗法的13-36％无法纠正变质牙合 （Hedlund and Feldmann 2016； O'Brien等，2003）。因此，结果不佳的成本相当可观。 下颌增强的骨科疗法试图促进对载荷敏感的次级的生长 下颌软骨通过颞下颌关节（TMJ）加载力学和行为的变化。 预计下颌生长的数量较小，并且在垂直方面的表达更为垂直（Buschang etal。2017; Karlsen 1997）在Dolichofacial（长narrow）的儿童的骨科疗法的预后较差 与肱（短宽）表型相比（Deen and Woods 2015; Pancherz and Michailidou 2004; 罗杰斯等。 2018）。但是，TMJ加载力学和行为的差异（机械obhavior） 这些在生长和治疗过程中的表型尚不清楚。这项研究的广泛长期目标是 提供可预测结果的证据信息牙面骨科疗法。因此，此应用程序 提出了一项针对多质和肱生儿童选定人群的前瞻性观察性研究 正畸治疗前，期间和之后。这项研究将有助于改善牙齿的使命， 口服，以及针对三个具体目标： 1。检验以下假设：与腕足儿童相比，多质叶面具有能量密度（能量输入 对于相同的下巴任务的每卷软骨，MJ/MM3），因此限制 下颌生长更早。 2。检验以下假设，即与腕足儿童相比，多质叶面具有关税因素（百分比 肌肉活动/总记录时间）明显较小，因此促进下颌生长较少 每年。 3。检验表型牙本质亚组存在的假设，通过机械ob虫评分而分化 （（（能量密度）2 X占名因子）与下颌生长的显着差异相对应。 通过经过验证的技术收集的纵向临床治疗记录和数据，包括数值 建模，动态刻度法以及实验室和场内肌电图将用于比较 机械贝哈维尔变量与表型之间的变量测试这些变量是否预测下颌生长为 由Ramus高度指示。这项研究的新结果将是未来临床的关键基础 修改机械的方法以实现更成功和可预测的骨科疗法 下巴差异的孩子。