Zusammenfassung:
Die Studie untersuchte unterschiedliche maxilläre und mandibuläre Wachstumsmuster
und deren jeweiligen Auswirkungen auf die Veränderung der Molarenrelation während
der Entwicklung vom frühen Wechselgebiss zur bleibenden Dentition des Erwachsenen.
Dazu wurden fortlaufend angefertigte Fernröntgenaufnahmen von 40 Probanden ausgewertet.
Die Probanden wurden in Abhängigkeit von ihrem Wachstumsmuster in drei Gruppen eingeteilt.
In Gruppe A war das Unterkieferwachstum im Vergleich zum Oberkiefer stärker ausgeprägt,
in Gruppe B wuchsen beide Kiefer gleichmäßig und in Gruppe C übertraf das Oberkieferwachstum
das des Unterkiefers.
Die Ergebnisse zeigten, dass während des Zahnwechsels die Molarenrelation durch unterschiedliches
Wachstum der Kiefer signifikant beeinflusst wird. Das Wachstumsmuster beeinflusst
aber nicht nur die sagittale Lage der Kieferknochen, sondern auch das Ausmaß der physiologischen
Mesialdrift der Zähne. Dagegen veränderte im bleibenden Gebiss ein unterschiedliches
Ausmaß von Ober- und Unterkieferwachstum die Molarenrelation nicht mehr. Hier wurde
das ungleiche Wachstum von dentoalveolären Kompensationsmechanismen ausgeglichen.
Die Zahnbewegungen zeigten ein charakteristisches Muster in Abhängigkeit vom Ausmaß
des Wachstumsunterschieds: (1) Übertraf das Unterkieferwachstum das des Oberkiefers,
wurde der Wachstumsunterschied durch eine Mesialwanderung der oberen ersten Molaren
und eine Kippung der Okklusionsebene gegen den Uhrzeigersinn ausgeglichen. In der
Front kam es zur Vorverlagerung und Labialkippung der Oberkieferfront und zum Steilstand
der Unterkieferfront. (2) Bei überschießendem Oberkieferwachstum wurde die skelettale
Differenz hauptsächlich durch eine Mesialwanderung der unteren ersten Molaren kompensiert.
Die Mesialdrift der oberen Molaren war in diesem Fall minimal. Die Neigung der Okklusionsebene
veränderte sich ebenfalls nur unwesentlich. Die skelettale Wirkung auf die Frontzahnbeziehung
wurde kompensiert durch einen Steilstand der oberen Schneidezähne und eine Vorverlagerung
sowie Labialkippung der Unterkieferfront.
Summary
This study investigated maxillary and mandibular growth differences and their effect
on the changes in molar relationships from early transitional dentition to adult permanent
dentition. Various landmarks were identified and measurements made on the longitudinal
cephalometric radiographs of 40 people. The subjects were classified into 3 groups
based on the amount of sagittal skeletal growth difference between the jaws. In group
A, the mandible grew more than did the maxilla; in Group B, growth was about the same;
and in group C, the maxilla grew more than did the mandible. The results revealed
that skeletal growth differences between the jaws significantly influenced the changes
in molar relationship during the transitional dentition, not only by translating basal
bones but also by altering the amount of physiologic mesial shift in the dentition.
However, the skeletal growth difference during the permanent dentition did not influence
the changes in molar relationship. The sagittal growth difference between the jaws
was largely absorbed by a dentoalveolar compensation. Tooth movement showed different
characteristic features depending on the amount of the skeletal growth difference;
(1) If the mandible grew more than did the maxilla, the growth difference was mostly
absorbed by mesial displacement of the maxillary first molars and counterclockwise
rotation of the occlusal plane. Anterior occlusion was adjusted by mesial displacement
and labial inclination of the maxillary incisors and lingual inclination of the mandibular
incisors. (2) If the maxilla grew more than did the mandible, the growth difference
was mainly absorbed by mesial displacement of the mandibular molars. Then the maxillary
molars showed minimal mesial displacement. The occlusal plane also showed minimal
rotational change. Anterior occlusion was adjusted by lingual tipping of the maxillary
incisors and mesial displacement and labial tipping of the mandibular incisors.
Schlüsselwörter:
Molarenrelation - Kieferwachstum - dentoalveoläre Kompensation
Key words:
Molar relationship - jaw growth - dentoalveolar compensation
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1 * Mit freundlicher Genehmigung von Verlag und Autoren. Original erschienen im Am
J Orthod Dentofacial Orthop 2002; 121: 280-290.
Prof. Dr. Ram S. Nanda
Department of Orthodontics
College of Dentistry
University of Oklahoma
1001 Stanton L. Young Blvd
USA-Oklahoma City
OK 73190
Email: ram-nanda@ouhsc.edu
