臺灣博碩士論文加值系統

目的：調查臺灣發展遲緩兒童之口腔習癖和異常咬合，並探討兩者之間相關性。
方法：本橫斷性研究包含180位2-5歲的發展遲緩兒童，平均年齡為3.72 ± 0.93歲。本研究採立意取樣，在2013年12月到2014年12月期間，由訓練過一致性的牙醫師，針對臺灣24間早期療育機構內的發展遲緩兒童進行口腔檢查，並將咬合狀態予以紀錄。包含口腔習癖調查表的自填式問卷，由發展遲緩兒童的父母或主要照護者填寫。所有參與研究的發展遲緩兒童，均由其父母或主要照護者在研究開始前簽署同意書。本研究通過高雄醫學大學附設中和紀念醫院人體試驗委員會認可。使用卡方檢定和多變項對數迴歸進行統計分析。
結果：臺灣發展遲緩兒童最常見的現有或曾有過的口腔習癖為非營養性吸吮習癖(n=111, 63.79%)。前牙開咬的盛行率為15%(n=27)，是最常見的異常咬合。在調整過性別和年齡後，非營養性吸吮習癖超過24個月的發展遲緩兒童，是非營養性吸吮習癖未超過24個月的發展遲緩兒童3.70倍的機率會前牙開咬(95% CI = 2.47 to 34.69)。
結論：
1. 臺灣發展遲緩兒童最常見的口腔習癖為非營養性吸吮習癖。
2. 臺灣發展遲緩兒童最常見的異常咬合為前牙開咬。
3. 非營養性吸吮習癖超過24個月為臺灣發展遲緩兒童前牙開咬的決定因素。

Aim: To investigate the oral habits and malocclusion of children with developmental delay (CDD) in Taiwan.

Methods: In this cross-sectional survey included 180 two to five-year-old
(3.72 ± 0.93) CDD. Those children recruited from 24 early intervention institutions in Taiwan by purposive sampling were examined by trained dentists between Dec. 2013 and Dec. 2014. The occlusal status was recorded by inspection, and a questionnaire, including oral habits, was completed by the care giver. Informed consent was obtained. This survey was approved by the Institutional Review Board of Kaohsiung Medical University Hospital. The chi-square and multiple logistic regression were performed for statistical analysis.

Results: The most common oral habit since born among CDD in Taiwan was non-nutritive sucking habit (n=111, 63.79%). The prevalence of anterior open bite was 15.00% (n=27), which was the most common malocclusion. While adjusting for sex and age, CDD with non-nutritive sucking habit more than 24 months were 3.70 times of the chance for anterior open bite (95% CI = 2.47 to 34.69).

Conclusion:
1. The most common oral habit since born among the CDD in Taiwan was non-nutritive sucking habits.
2. The most common malocclusion of CDD in Taiwan was anterior open bite.
3. Non-nutritive sucking habit more than 24 months is the determinant factor of anterior open bite among the CDD in Taiwan.

摘要 2
Abstract 3
致謝 4
第壹章、緒論 8
第一節 研究動機 8
第二節 研究目的 10
第貳章、文獻討論 11
第一節 發展遲緩兒童的定義 11
第二節 發展遲緩兒童的成因與特徵 12
第三節 國內外兒童異常咬合情形之相關研究調查 13
第四節 國內外兒童口腔習癖之相關研究調查 16
第五節 國內外兒童口腔習癖與異常咬合之相關研究調查 17
第參章、研究方法與材料 21
第一節 研究設計 21
第二節 研究對象 21
第三節 抽樣方法 22
第四節 研究工具 23
第五節 研究步驟 24
第六節 統計架構 25
第七節 統計分析 25
第八節 名詞界說 26
第九節 研究限制 27
第肆章、結果 28
第一節 發展遲緩兒童基本資料 28
第二節 發展遲緩兒童口腔習癖與咬合狀態之調查 28
第三節 發展遲緩兒童口腔習癖與咬合狀態之相關性 30
第四節 發展遲緩兒童前牙開咬相關因素之分析 31
第伍章、討論 33
第一節 資料蒐集情況 33
第二節 發展遲緩兒童的咬合狀態與異常咬合 34
第三節 發展遲緩兒童的口腔習癖 37
第四節 口腔習癖與異常咬合之關係 39
第陸章、結論與建議 46
第一節 結論 46
第二節 發展遲緩兒童牙科口腔習癖與異常咬合之建議 46
第三節 未來相關研究之建議 46
參考文獻 47
表格附錄 Index of Table 50
附錄一 受訪者同意書 60
附錄二 問卷 63
附錄三 口腔檢查表 75

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