Étude des relations entre la morphologie cranio-faciale et l'occlusion en denture temporaire : remodelages occipitaux et singularités basicrâniennes déterminantes pour l'occlusion

DESHAYES, Marie-Josèphe; DESHAYES, Julie
March 2013
Orthodontie Française;2013, Vol. 84 Issue 1, p97
Academic Journal
Before performing any procedure or initiating early intervention on children in lacteal dentition, it is crucial to closely investigate a few key elements of the cranial base of the child. A first step of diagnostics is needed - the classification of the dysharmony ie its squelettal and/or functional element - before we prescribe a major orthopedic treatment or just stop dysfunctions using simple functional appliances. To confront these constraints of diagnostic, a set of 243 children in the lacteal dentition was examined. Our clinical expertise made it possible to select cephalometric measurements that would be supposedly linked with the type of skeletal dysharmony (based on cranial and facial osseous landmarks located on the profile-view of a digital tele-X-ray). The occlusal classification takes into account occlusal criteria and the design of the masticatory function. Statistical analysis (namely linear discriminant analysis of cephalometric variables) indicates that in lacteal dentition, some cranial architectural features have preferred links with specific occlusions. We noticed that the amplitude of basicranial "flexure" (hence the sphenoidal angle) is influenced by the occipital remodeling: the ontogenic process of flexion of the base and the amplitude of closure of the sphenoid angle are under controlled by the remodeling of the occipital bone in three main modalities. Correlations exist between these groups and the facial equilibrium, like a forward or backward position of the chin. The important clinical deduction is that the masticatory function in lacteal dentition is organized by architectural constraints that arise from the remodeling of the cranial base; the squelettal effect of dysfunctions is certainly specific to each type of dysfunction, nonetheless it also depends on the architectural uniqueness of the cranial base.


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