背景:咀嚼对于分解食物很重要,帮助吞咽和营养吸收,因此对儿童的发展至关重要。研究表明咀嚼功能差与年龄较小和龋齿的存在有关。然而,对咀嚼功能与错牙合之间关联的研究得出了矛盾的结果。因此,本研究的目的是研究三维咬合特征与咀嚼功能之间的关系,在香港的学龄前儿童中。
方法:关于三个领域咀嚼功能的自我管理问卷,即一般咀嚼困难,需要帮助时,吃不同的食物类型和增加偏好的软食物是由父母完成。问卷中还收集了有关非营养性吸吮习惯和基本人口统计的信息。进行临床检查以记录三维咬合特征和龋齿的存在。对1,566名和996名学龄前儿童进行了基线调查和一年随访。咀嚼功能不良与咬合特征的关联,使用卡方检验调查了吸吮习惯和龋齿。然后进行二项逻辑回归,纳入任何确定的重要因素。对一年的随访数据进行纵向分析,以调查是否改善咬合特征,吸吮习惯和龋齿导致更好的咀嚼功能。
结果:在横断面研究中,一般咀嚼困难的第一个领域与龋齿和拇指/手指吸吮有关.吃不同食物时需要帮助的第二个领域与男性有关,年龄较小,龋齿和安抚奶嘴的使用。对软食物偏好增加的最后一个领域与龋齿和拇指/手指吸吮有关。咬合特征,包括异常过度喷射和不接触的单侧恒磨牙,在双变量分析中与咀嚼功能差显著相关,但在逻辑回归中并不显著。在纵向分析中,发现老年人和前牙咬合解决者的一般咀嚼困难有所改善。龋齿较少的人吃肉需要较少的帮助。同样,在安抚奶嘴使用量减少的人群中,食用含有骨骼的食物所需的帮助较少。在那些出现正常过度喷射的人中,食用软食的偏好降低了。
结论:研究发现咀嚼困难与年龄相关因素之间存在显著关系,性别,活动性龋齿,和非营养的口腔习惯,如拇指/手指吸吮和安抚奶嘴的使用。年龄较小的儿童和男性需要更多的食物援助。活跃的龋齿和拇指/手指吸吮习惯导致了一般的咀嚼困难和对软性食物的偏爱。一年的随访表明,咀嚼功能的改善因年龄组而异,并且与咬合特征的改善有关。如前牙咬合和归一化喷射术的分辨率,减少安抚奶嘴的使用,和腐烂牙齿数量的减少。
BACKGROUND: Mastication is important for breaking down food, aiding swallowing and nutrients absorption, and is therefore fundamental to a child\'s development. Studies have shown poor masticatory function to be associated with younger age and presence of caries. However, studies of the association between masticatory function and malocclusion yielded contradictory results. The aim of this study is therefore to investigate the association between three-dimensional occlusal features with masticatory function, among preschool children in Hong Kong.
METHODS: Self-administered questionnaires on masticatory function in three domains, namely general chewing difficulty, requiring help when eating different food types and increased preference for soft food were completed by parents. Information on non-nutritive sucking habits and basic demographics were also collected in the questionnaire. Clinical examinations were conducted to record three-dimensional occlusal features and presence of caries. Baseline investigations and one-year follow-ups were undertaken for 1,566 and 996 preschool children. Association of poor masticatory function with occlusal features, sucking habits and caries was investigated using chi-squared tests. Binomial logistic regressions were then carried out incorporating any significant factors identified. Longitudinal analysis of the one-year follow-up data was carried out to investigate whether improved occlusal features, sucking habits and caries resulted in better masticatory function.
RESULTS: In the cross-sectional study, the first domain of general chewing difficulty was associated with caries and thumb/digit sucking. The second domain of requiring help when eating different food types was associated with the male sex, younger age, caries and pacifier use. The last domain of increased preference for soft foods was associated with caries and thumb/digit sucking. Occlusal features, including abnormal overjet and unilateral permanent molars not in contact, were significantly associated with poor masticatory function in the bivariate analyses, but were not significant in the logistic regressions. In the longitudinal analysis, general chewing difficulty was found to improve in those of older age and those with resolved anterior crossbite. Less help was required to eat meat in those with fewer caries. Similarly, less help was required to eat food containing bones in those with reduced pacifier use. Preferences for eating soft foods was reduced in those who developed a normal overjet.
CONCLUSIONS: The study identified significant relationships between masticatory difficulties and factors associated with age, gender, active caries, and non-nutritive oral habits such as thumb/digit sucking and pacifier use. Younger children and males required more assistance with certain food types. Active caries and thumb/digit sucking habits contributed to general masticatory difficulties and preference for soft foods. The one-year follow-up indicated that improvement in masticatory function varies across age cohorts and were associated with improved occlusal features, such as resolution of anterior crossbite and normalized overjet, reduced pacifier use, and a decrease in the number of decayed teeth.