臺灣博碩士論文加值系統

中文摘要
研究目的:
本研究之主要目的是要探討4到6歲學齡前兒童性別、年齡、身高與體重和最大咬合力的關係，了解學齡前兒童口腔狀況因素與最大咬合力的關係，分析不同的顏面形態因素與最大咬合力的關係並探討最大咬合力的重要相關因素。
研究方法:
本研究對象以高雄縣兩所幼稚園中大班共201位4到6歲的學齡前兒童，其中男童86人，女童115人，檢測記錄其口腔狀況及咬合型態並於第二乳臼齒處測量咬合力,每一位學童於口內左右兩側臼齒處分別測量兩次，選取其最高測量數值為其最大咬合力，並於自然頭部姿勢下以數位相機拍攝相片來進行九項顏面形態測量與記錄，最後將所有資料以JMP5.01統計套裝軟體來進行統計分析。
研究結果：
學齡前兒童在生長相關變項與咬合力關係方面，男女雖無明顯不同但不同年齡生長發育及右側咬合力卻有顯著性的差異(5、6歲顯著大於4歲)，口腔狀況顯示上下臼齒咬合接觸對數、最大張口距離與咬合力有顯著的正相關，缺齒與咬合力則呈顯著的負相關，而顏面形態方面與咬合力有顯著相關的變項包括正相關的下頦顏面高指數及下頦指數與負相關的下顎平面角。
結論與建議：
本研究為國內外第一個完整深入探討學齡前兒童乳齒列口腔狀況及顏面形態與咬合力之間的關係，並以統計分析成功地得以相片來替代側顱Ｘ光片探討顏面形態變項與咬合力之間的關係，本研究採取顏面分析之比值及角度，並首先於研究中採用下頦指數與下頦顏面指數釐清所謂下顏面長度與咬合力之間的關係，減少因長度測量與數值換算所產生之誤差，另一方面可藉由對比顏面長寬徑、顏面與顱部、下顎前後、下頦與顏面之關係，了解不同顏面型態與咬合力的影響，並藉此機會建立學齡前兒童顏面型態常規指數及數值資料庫以利日後能完成各年齡層的國人顱顏生長發育相關正常指數。
綜合本研究結果，由迴歸分析可發現，顏面形態因素並非學齡前兒童咬合力大小之決定因素，學齡前兒童咬合力與年齡、最大張口距離及上下臼齒咬合接觸對數關係較為顯著，如何教導幼童維護良好的口腔衛生，維持其完整功能性的乳齒列，才是相關單位與父母親共同努力的目標。


關鍵詞：最大咬合力、口腔狀況、顏面形態、學齡前兒童

Abstract
Study objective:
The purpose of this study was to find the correlation of bite force and associated variable factors, such as age, sex, body height, body weight, caries index, occlusal pattern, tooth contact and maximum mouth opening in 4 to 6 year-old healthy preschool children and evaluates the interrelationship between facial morphology and bite force.

Materials and Methods:
The subjects were selected from two kindergartens around Kaohsiung County. Total of 201 preschool children (86 boys and 115 girls) aged from 4 to 6 years old were studied. Oral status and occlusal pattern were evaluated and recorded by attentive examination. Bite force was measured twice at the primary molar area and the highest value will be chosen after taking two times on left and right side of each child. Facial morphology was evaluated on profile and check ‘en’ or ‘on’ face photography.

Result:
The aspect of growing variables of preschool children correlated between boys and girls with bite force, although there was no significant difference, it displayed a significant difference on growing development among three age levels. The oral status variables such as the number of maxillary posterior teeth in contact and maximum mouth opening showed a significant positive correlation with bite force and teeth missing showed a significant negative correlation with bite force. A significant correlation between bite force with facial morphologic variables including positive correlative factors such as chin-facial index and chin index and a negative correlative factor such as mandibular plane angle were also found.

Conclusion and suggestions:
This was the first comprehensive study to research into the correlation of maximum bite force with oral condition and facial morphology in preschool children. It substitutes cephalometric radiography with photography by using statistical analysis in studying facial morphology. We adopted the ratio and angle related to the facial morphological variables in this research, especially including the chin index and chin-face index which distinguish the interrelationship between lower facial height with bite force. This reduced the errors which are produced in length measures and converted with number values. In addition, we could understand the relationship and influence between the different face types with bite force, and take this opportunity to set up a normal preschool craniumfacial index and database. We will collect and complete normal facial morphological data for all ages in the future.
By synthesizing the results of our study, we can find that facial morphological factors are not the overwhelming decisive factor to bite force. Factors such as age, maximum mouth opening and the number of teeth in contact are getting more apparent comparatively in relation to bite force. How to teach children to maintain good oral hygiene and their intact and functional teeth is the goal that relevant professionals make as a joint effort with parents.

Key words: Maximum bite force, oral condition, facial morphology, preschool children

目錄
誌謝辭…………………………………………………………..……. i
中文摘要…………………………………………………………..…. iii
英文摘要…………………………………………………………..…. v

第一章 緒論
第一節 研究背景.………………………………………………. 1
第二節 研究目的……………………………………………….. 2

第二章 文獻探討
第一節 最大咬合力之定義……………………………………… 3
第二節 咬合力之分類…………………………………………… 3
第三節 咬合力傳導裝置………………………………………… 3
第四節 最大咬合力所代表之意義……………………………… 5
第五節 最大咬合力的平均值…………………………………… 6
第六節 影響最大咬合力之相關因素…………………………… 8
第三章 材料與方法
第一節 研究對象…………………………………………………18
第二節 研究設計…………………………………………………18
第三節 研究架構…………………………………………………20
第四節 統計方法…………………………………………………21
第五節 名詞定義…………………………………………………21

第四章 結果
第一節 基本資料…………………………………………………28
第二節 身高、體重與性別、年齡之關係………………………29
第三節 最大張口距離與性別、年齡之關係……………………29
第四節 咬合力與性別、年齡之關係……………………………30
第五節 不同咬合型態、垂直覆咬、臼齒咬合接觸對數與咬合力之關係………………………………………………………31
第六節 齲齒、缺齒、填補、齲齒指數、齲齒填補率及齲齒盛行率與性別、年齡之關係……………………………………32
第七節 顏面形態變項與性別、年齡之關係……………………33
第八節 迴歸分析與咬合力顯著相關之變項……………………36
第九節 逐步分析咬合力之重要相關因素………………………38

第五章 討論
第一節 身高、體重與性別、年齡之關係………………………42
第二節 不同咬合型態、垂直覆咬、臼齒咬合接觸對數與各咬合力之關係……………………………………………………42
第三節 最大張口距離與性別、年齡之關係……………………43
第四節 咬合力與性別、年齡之關係……………………………44
第五節 齲齒、缺齒、填補、齲齒指數、齲齒填補率及齲齒盛行率與性別、年齡之關係……………………………………45
第六節 顏面形態的選擇與收集…………………………………45
第七節 顏面形態變項與性別、年齡之關係……………………47
第八節 迴歸分析與咬合力顯著相關之變項……………………48
第九節 逐步分析咬合力之重要相關因素………………………48

第六章 結論與建議
第一節 結論………………………………………………….…..52
第二節 建議………………………………………………….…..53

參考文獻………………………………………………………………55

表格目錄
表 1. 學齡前兒童基本資料分析( N = 201 )…………………..60
表 2. 比較4至6歲男女學齡前兒童的身高、體重、咬合力與最大張口距離之差異………………………………………61
表 3. 比較4、5、6歲學齡前兒童的身高、體重、咬合力與最大張口距離之差異…………………………………………62

表 4. 比較4至6歲男女學齡前兒童左右側咬合力之差異….63
表 5. 比較咬合型態、垂直覆咬、臼齒咬合接觸對數與咬合力之關係……………………………………………………….64
表 6. 比較齲齒顆數、缺牙顆數、填補顆數、齲齒指數、齲齒填補率、齲齒盛行率與性別、年齡之關係……………….65
表 7. 比較性別與顏面形態各變項的關係………………….…66
表 8. 比較不同年齡與各顏面形態變項的關係…………….…66
表 9. 咬合力與各變項迴歸分析……………………………….67
表10.經逐步分析對左側咬合力相關之重要影響因素…….….68
表11.經逐步分析對右側咬合力相關之重要影響因素……..…68
表12.經逐步分析對最大咬合力相關之重要影響因素………..69
表13.以相片與Ｘ光片進行顏面型態因素之相關分析比較…..69


圖目錄
圖一. Bite force MPM－3000咬合力測量儀組。…………….70
圖二. Bite force MPM－3000咬合力測量儀之主機。……….70
圖三. Bite force MPM－3000咬合力測量儀之咬力數值列印機。………………………………………………………..71
圖四. Bite force MPM－3000咬合力測量儀之咬力傳導接受器。……………………………………………………….71

圖五. 九項顏面型態變項圖形說明…………………………….72

附錄目錄
附錄一. 台灣地區學齡前兒童(4~6歲)口檢調查表…………….... 77

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