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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

基本信息

批准号：
10449217
负责人：
Laura R Iwasaki
金额：
$ 56.78万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
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/10449217
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 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 Wood material Work age group aged base bullying cost craniofacial dentofacial energy density improved in vivo joint loading mechanical load novel orthognathic personalized approach prospective psychosocial skeletal success systematic review

项目摘要

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，约有60%的儿童因牙齿和下颚弯曲而接受正畸治疗