小臼歯早期喪失後の短期および長期の歯列弓空間変化：システマティックレビュー

Short- and long-term dental arch spatial changes following premature loss of primary molars: A systematic review.

抄録

目的:

本研究の目的は、小臼歯早期喪失後の上顎アーチおよび下顎アーチの空間的変化を評価することである。

AIM: The aim of this study was to evaluate the dental arch spatial changes in maxillary and mandibular arches after premature loss of primary molars.

はじめに:

乳歯列から混合歯列、そして永久歯列へと変化する過程において、乳歯は歯列弓を維持・維持するために維持されなければならない。この正常な過程が妨げられると、通常、重度の虫歯が原因で正常な剥離が起こる前に抜歯が必要となり、隣接歯が欠損部へ移動する結果、永久歯列における歯列弓長の減少や不正咬合を引き起こす可能性がある。

INTRODUCTION: Primary teeth must be maintained during the change from primary to mixed and then permanent dentition, to preserve and maintain the dental arch. When this normal process is disturbed, usually due to severe decay requiring extraction before normal exfoliation, it can result in migration of adjacent teeth toward the missing space resulting in decreased arch length and malocclusion in the permanent dentition.

材料と方法:

PubMed Central、Cochrane Database of Systematic Reviews、Google Scholar、LILACS、ScienceDirectなどの電子データベースを用いて包括的な検索を行った。タイトルと抄録をスクリーニングして関連論文を見つけ、その論文を含める価値があるかどうかを全文レビューした。第一大臼歯または第二大臼歯の喪失後の腔の変化を調べたすべての縦断的研究および観察研究を対象とした。すべての研究が非ランダム化研究であったため、研究の質評価はNewcastle-Ottawaスケールに基づいて行われた。

MATERIALS AND METHODS: A comprehensive search was conducted using electronic databases such as PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, LILACS, and ScienceDirect. The title and abstract were screened to find relevant articles, which were then reviewed in full to see if they were worthy of inclusion. All longitudinal and observational studies that looked at space changes after the loss of primary first or second molars were included. Quality assessment of the studies was done based on the Newcastle-Ottawa scale as all the included studies were non-randomized studies.

結果:

電子データベースのスクリーニングにより4,578件の論文が同定され、適格性が評価され、12件のフルテキスト論文が評価され、4件のフルテキスト論文が組み入れ基準に合致しなかったため除外された。その結果、8件の論文がこのシステマティックレビューに含まれた。上顎臼歯と下顎臼歯の短期的および長期的なスペースの変化と喪失を個別に調査した。短期的な変化では、下顎第一大臼歯の早期喪失後、1ヶ月以内に第一大臼歯の遠位が欠損部へ移動するのは、早期のスペース変化に起因しており、最大のスペース喪失は早期喪失後3ヶ月に記録された。上顎第一大臼歯の早期喪失後、第一犬歯の遠位側への移動により、1mmの即時スペースロスが記録された。下顎第一大臼歯の早期喪失では、第一犬歯の遠位側への移動がスペースロスの原因であること、第二大臼歯の早期喪失では、下顎弓のスペースロスが大きいことが明らかになった。

RESULTS: Four thousand five hundred and seventy-eight articles were identified by screening electronic database and assessed for eligibility, 12 full-text articles were assessed, and 4 full-text articles were excluded as they did not match the inclusion criteria. Thus, eight articles were included in this systematic review. Short term and long term space changes and loss of maxillary and mandibular molars were studied individually. In the short term changes, the distal migration of the primary cuspid towards the missing space within 1 month was attributable to early space changes after premature loss of the mandibular first molar, and the greatest space loss was recorded in the first 3 months after premature loss. After the premature loss of the maxillary first molar, immediate space loss of 1mm was documented due to distal migration of the primary canine. Studies found that space loss was caused by the distal migration of primary canines in the case of mandibular primary first molar loss, and that space loss was larger in the mandibular arch after premature loss of second primary molars.

結論:

下顎第二乳臼歯の早期喪失は、第一永久臼歯の近心移動につながるため、多くの症例でスペースメインテナーが推奨された。

CONCLUSION: The greatest repercussions occurred during the first 3 months after the deciduous molars were extracted, and a space maintainer was recommended in the majority of cases, mainly when there is premature loss of mandibular second primary molar as it leads to mesial displacement of the first permanent molar.