Der Einfluss von Malokklusionen auf die Kauleistung – eine systematische Übersicht^[*]

Zusammenfassung

Zielsetzung:

Systematische Übersicht über den Zusammenhang zwischen Malokklusionen und der Kauleistung. Zusätzlich wird eine qualitative Analyse der Studien auf ihre methodische Tragfähigkeit hin durchgeführt.

Material und Methoden:

In der Datenbank „Medline“ (www.ncbi.nlm.nih.gov) wurde eine Literatursuche für den Zeitraum zwischen Januar 1965 und Juni 2009 durchgeführt. Dabei wurde die Datenbank nach dem Begriff „Malokklusion“ (malocclusion) der „Medical Subject Headings“ (MeSH) und den Begriffen „Kauleistung“ (masticatory performance) und „Kaueffektivität“ (masticatory/chewing efficiency) in verschiedenen Kombinationen durchsucht. Die Veröffentlichungen wurden in 2 Gruppen aufgeteilt:

1) Einfluss einer Behandlung von Malokklusionen (kieferorthopädische Chirurgie) und

2) Einfluss von Art und Schwere der Malokklu­sionen.

Ergebnisse:

Die Literatursuche ermittelte 78 Veröffentlichungen. Nach Überprüfung anhand der Einschluss-/Ausschlusskriterien verblieben für die eigentliche Auswertung noch 12 Publikationen. Die Qualität der Untersuchung und die methodische Tragfähigkeit waren bei einer der Studien hoch, bei 10 Studien mittel und bei einer Studie niedrig. Die größten Mängel betrafen das Design der klinischen und der kontrollierten klinischen Untersuchungen mit zu geringem Stichprobenumfang und mangelhafter Beschreibung der Auswahlkriterien. Weitere Mängel betrafen das Fehlen einer Fehleranalyse der Methoden und das Fehlen einer Verblindung vor der Messwerterhebung.

Schlussfolgerungen:

Malokklusionen sind die Ursache für eine verminderte Kauleistung, insbesondere in Bezug auf einen reduzierten okklusalen Kontaktbereich. Der Einfluss einer kieferorthopädischen Korrektur von Malokklusionen (kieferorthopädische Chirurgie) auf die Kauleistung lässt sich erst 5 Jahre nach Abschluss der Behandlung beurteilen.

Abstract

Objective:

To systematically review the rela­tionship between malocclusions and masticatory performance. In addition, we will perform a qualitative analysis of the methodological soundness of the studies.

Materials and methods:

A literature survey was done by applying the Medline database (www.ncbi.nim.nih.gov) in the period from January 1965 to June 2009, using the “Medical Subject Headings”’ term malocclusion crossed with various combinations of the following terms: masticatory performance, masticatory efficiency, and chewing efficiency. The articles were separated into 2 main topics:

1) the influence of malocclusion treatment (orthognathic surgery) and

2) the influence of malocclusion type and severity.

Results:

The search strategy used identified 78 articles. After selection according to the inclu­sion/exclusion criteria, 12 articles qualified for the final analysis. The research quality and methodological soundness were high in 1 study, medium in 10 studies, and low in 1 study. The most serious shortcomings comprised the clinical trials and controlled clinical trials designs with small sample sizes and inadequate description of selection criteria. Lack of method error analysis and the absence of blinding in measurements were other examples of shortcomings.

Conclusions:

Malocclusions cause decreased masticatory performance, especially as it relates to reduced occlusal contacts area. The influence of malocclusion treatment (orthognathic surgery) on masticatory performance is only measurable 5 years after treatment.

Schlüsselwörter

Kauleistung - Malokklusionen - kieferorthopädische Chirurgie

Key words

masticatory performance - malocclusion - orthognathic surgery

*

^* Der Artikel wurde im englischen Original veröffentlicht in: Angle Orthod 2010; 80: 981–987.

• Literatur

• 1 Pereira LJ, Gavião MBD, van der Bilt A. Influence of oral characteristics and food products on masticatory function. Acta Odontol Scand 2006; 64 (04) 193-201
• 2 van der Bilt A, Engelen L, Abbink J et al. Effects of adding fluids to solid foods on muscle activity and number of chewing cycles. Eur J Oral Sci 2007; 115 (03) 198-205
• 3 Carlsson GE. Masticatory efficiency: the effect of age, the loss of teeth and prosthetic rehabilitation. Int Dent J 1984; 34 (02) 93-97
• 4 Bates JF, Stafford GD, Harrison A. Masticatory function – a review of the literature. III. Masticatory performance and efficiency. J Oral Rehabil 1976; 3 (01) 57-67
• 5 Slagter AP, Bosman F, van der Glas HW et al. Human jaw-elevator muscle activity and food comminution in the dentate and edentulous state. Arch Oral Biol 1993; 38 (03) 195-205
• 6 Fontijn-Tekamp FA, Slagter AP, van der Bilt A et al. Biting and chewing in overdentures, full dentures, and natural dentitions. J Dent Res 2000; 79 (07) 1519-1524
• 7 Hatch JP, Shinkai RS, Sakai S et al. Determinants of masticatory performance in dentate adults. Arch Oral Biol 2001; 46 (07) 641-648
• 8 Owens S, Buschang PH, Throckmorton GS et al. Masticatory performance and areas of occlusal contact and near contact in subjects with normal occlusion and malocclusion. Am J Orthod Dentofacial Orthop 2002; 121 (06) 602-609
• 9 Buschang PH. Masticatory ability and performance: the effects of mutilated and maloccluded dentitions. Semin Orthod 2006; 12 (02) 92-101
• 10 English JD, Buschang PH, Throckmorton GS. Does malocclusion affect masticatory performance?. Angle Orthod 2002; 72 (01) 21-27
• 11 Antczak AA, Tang J, Chalmers TC. Quality assessment of randomized control trials in dental research I. Methods. J Periodontal Res 1986; 21 (04) 305-314
• 12 Jadad AR, Moore RA, Carroll D et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996; 17 (01) 1-12
• 13 Andrade Ada S, Gameiro GH, Derossi M et al. Posterior crossbite and functional changes. A systematic review. Angle Orthod 2009; 79 (02) 380-386
• 14 Gambareli FR, Serra MD, Pereira LJ et al. Influence of measurement technique, test food, teeth and muscle force interactions in masticatory performance. J Texture Stud 2007; 38 (01) 2-20
• 15 van den Braber W, van der Glas H, van der Bilt A et al. Masticatory function in retrognathic patients, before and after mandibular advancement surgery. J Oral Maxillofac Surg 2004; 62 (05) 549-554
• 16 van den Braber W, van der Bilt A, van der Glas HW et al. The influence of orthognathic surgery on masticatory performance in retrognathic patients. J Oral Rehabil 2005; 32 (04) 237-241
• 17 van den Braber W, van der Bilt A, van der Glas H et al. The influence of mandibular advancement surgery on oral function in retrognathic patients: a 5-year follow-up study. J Oral Maxillofac Surg 2006; 64 (08) 1237-1240
• 18 Zarrinkelk HM, Throckmorton GS, Ellis 3rd E et al. A longitudinal study of changes in masticatory performance of patients undergoing orthognathic surgery. J Oral Maxillofac Surg. 1995; 53 (07) 777-782 discussion 782–783
• 19 Finn RA, Throckmorton GS, Bell WH et al. Biomechanical considerations in the surgical correction of mandibular deficiency. J Oral Surg 1980; 38 (04) 257-264
• 20 van der Bilt A, Engelen L, Pereira LJ et al. Oral physiology and mastication. Physiol Behav 2006; 89 (01) 22-27
• 21 Castelo PM, Gavião MBD, Perreira LF et al. Masticatory muscle thickness, bite force, and occlusal contacts in young children with unilateral posterior crossbite. Eur J Orthod 2007; 29 (02) 149-156
• 22 Pancherz H, Anehus M. Masticatory function after activator treatment. An analysis of masticatory efficiency, occlusal contact conditions and EMG activity. Acta Odontol Scand 1978; 36 (05) 309-316
• 23 Tate GS, Throckmorton GS, Ellis 3rd E et al. Masticatory performance, muscle activity, and occlusal force in preorthognathic surgery patients. J Oral Maxillofac Surg 1994; 52 (05) 476-481 discussion 482
• 24 Henrikson T, Ekberg EC, Nilner M. Masticatory efficiency and ability in relation to occlusion and mandibular dysfunction in girls. Int J Prosthodont 1998; 11 (02) 125-132
• 25 van den Braber W, van der Glas HW, van der Bilt A et al. Chewing efficiency of pre-orthognathic surgery patients: selection and breakage of food particles. Eur J Oral Sci 2001; 109 (05) 306-311
• 26 Gavião MB, Raymundo VG, Sobrinho LC. Masticatory efficiency in children with primary dentition. Pediatr Dent 2001; 23 (06) 499-505
• 27 Toro A, Buschang PH, Throckmorton G et al. Masticatory performance in children and adolescents with Class I and II malocclusions. Eur J Orthod 2006; 28 (02) 112-119
• 28 Fontijn-Tekamp FA, van der Bilt A, Abbink JH et al. Swallowing threshold and masticatory performance in dentate adults. Physiol Behav 2004; 83 (03) 431-436
• 29 Rodrigues CH, Mori M, Rodrigues AA et al. Distribution of different types of occlusal contacts at maximal intercuspal position in deciduous dentition. J Clin Pediatr Dent 2003; 27 (04) 339-346
• 30 Ferrario V, Serrao G, Dellavia C et al. Relationship between the number of occlusal contacts and masticatory muscle activity in healthy young adults. Cranio 2002; 20 (02) 91-98
• 31 Sonnesen L, Bakke M, Solow B. Bite force in pre-orthodontic children with unilateral crossbite. Eur J Orthod 2001; 23 (06) 741-749
• 32 Sonnesen L, Bakke M. Molar bite force in relation to occlusion, craniofacial dimensions, and head posture in pre-orthodontic children. Eur J Orthod 2005; 27 (01) 58-63