南臺灣雙側唇顎裂學齡患者之先天性缺牙發生率

The Prevalence and Patterns of Permanent Teeth Agenesis in Bilateral Cleft Lip and Palate Children of Southern Taiwan

目的：針對南臺灣雙側唇顎裂兒童齒列，以回溯性之研究方式，了解其恆牙齒列先天性缺牙發生率。對象：選自高雄長庚醫院齒顎矯正科自西元1983年7月至2008年6月間，年齡介於 4-18歲之間，平均年齡為9歲（±3.14歲）的雙側唇顎裂患者。方法：以臨床牙科記錄，搭配牙齒模型、環口X光片、前牙區根尖片以及上顎咬合片加以檢視。結果：總計156位符合研究條件的雙側唇顎裂患者。其中99位為男性，57位為女性，男女比為1.74：1。發生先天恆牙缺失的機率為78.8%，最常見的恆牙缺牙依序為上顎側門齒、上顎第二小臼齒、下顎第二小臼齒、上顎犬齒以及下顎側門牙，牙弓兩側並未見差異顯著性。共計觀察到28種缺牙型態，最常見的三種型態為雙側側門牙同時缺失（36.5%）、單獨左側側門牙缺失（9%），以及單獨右側側門牙缺失（5.1%）。嘗試將雙側唇顎裂恆牙缺牙型態與性別做比對連結時，大致皆與母群體男性略多於女性的趨勢相符，惟在單獨右側側門牙缺失的群體中，可見女性的比例略高於男性。結論：雙側唇顎裂患者，先天性缺牙存在極大的變異性。雙側唇顎裂的恆牙先天性缺失型態表現受到多種因素影響；本次研究顯示雙側唇顎裂患者個別牙齒缺失的盛行率及恆牙先天性缺失型態，似乎因不同區域族群而有不同的表現。然而，雙側唇顎裂性別比例則不受區域族群的影響。

Objective: To retrospectively investigate the prevalence and patterns of tooth agenesis in permanent dentition of bilateral cleft lip and palate (BCLP) children in Southern Taiwan. Patients: 156 Taiwan children (99 males and 57 females) with BCLP aged from 4 to18 years were selected from the craniofacial records between July, 1983 and June, 2008 in the Department of Orthodontics, Kaohsiung Chang Gung Memorial Hospital. Materials and methods: Dental records including the panoramic radiographs, periapical films of anterior teeth, upper occlusal films and dental models of the selected patients were examined. Results: The prevalence of tooth agenesis of permanent dentition is 78.8%. The most common missing teeth arranged in order are maxillary lateral incisor, maxillary second premolar, mandibular second premolar, maxillary canine and mandibular lateral incisor. There is no obvious difference in prevalence between both sides in individual arch. Twenty eight agenesis patterns are revealed in this study. The three most common types are missing maxillary bilateral lateral incisors (36.5%), maxillary left lateral incisor (9%) and maxillary right lateral incisor (5.1%). The contribution of gender difference in agenesis pattern reveals male dominant tendency in each pattern, except the group with missing maxillary right lateral incisor. Conclusion: Extreme variations exist in the prevalence and patterns of tooth agenesis in permanent dentition of BCLP patients in this study. The tooth agenesis pattern of permanent dentition seems to be affected by multiple factors. The results of this study show that the missing rate of each tooth and agenesis pattern in permanent dentition tend to be influenced by racial factor and the gender difference does not play an important role.