Relationship Between Orthodontic and Articulatory Impairments in Adolosecents

Različita su istraživanja pokazala da je broj izgovornih poremećaja veći u populaciji s ortodontskim anomalijama nego u osoba bez njih. Odnos između anatomskih struktura u orofacijalnoj regiji i izgovornih kompenzacijskih mehanizama u osoba s ortodontskim anomalijama zanimljiv je i s teoretskoga i s praktičnoga stajališta. U ovom je istraživanju na uzorku od 282 srednjoškolca (203 - 72% djevojaka i 79 - 28% dječaka) u dobi od 15 do 18 godina istražen odnos između ortodontskih i izgovornih poremećaja. Procjenom ortodontskog i izgovornoga statusa , koju je učinilo dvoje specijalista, svaki za svoje područje, dobiveni su sljedeći postotci ortodontskih anomalija: primarna kompresija - 43,6%, otvoreni zagriz - 11,0%, pokrovni zagriz - 8,5% , progenijski kompleks - 5,7%, križni zagriz - 3,5%, diastema medijana - 0,0%. Također je nađeno 41,4% ispitanika s kratkim frenulumom linguae i 25,2% s gotskim nepcem. Izgovorni su poremećaji registrirani u sljedećim postotcima: sigmatizam - 64,9%, rotacizam- 36,5% i lambdacizam - 39,0%. Ukupno 78% ispitanika imalo je ortodontske anomalije, a 72% izgovorne poremećaje, a njih je 52% imalo kombinirane ortodontske i izgovorne poremećaje. Samo je 9% ispitanika bilo s urednim ortodontskim i izgovornim statusom. Također je pokazano da su sve tri kategorije izgovornih poremećaja najviše povezane s primarnom kompresijom (oko 30%), praćeno s kratkim frenulumom linguae (oko 30%) i gotskim nepcem (od 15 do 20%). Također je očito da postoji 19% ispitanika koji imaju ortodontsku anomaliju ali i normalni izgovorni status, što potvrđuje da su oni razvili djelotvorne kompenzacijske izgovorne mehanizme. S druge strane, postoji 13% ortodontski normalnih ispitanika koji imaju izgovorne poremećaje, uzrokovane nekim drugim razlozima a ne ortodontskim statusom. Iako postoji jaka povezanost između ortodontskih i izgovornih poremećaja, moguće je zaključiti da njihov odnos nije neposredan ta da se drugi psiholingvistički, razvojni, neurogeni i ostali parametri moraju uzeti u razmatranje u daljnjem objašnjenju toga odnosa.Various investigations have shows that the number of articulatory impairments is greater in a population with orthodontic anomalies than in eugnathic subjects. The relationship between anatomic structures in the orofacial region and articulatory compensatory mechanisms in persons with orthodontic anomalies is interesing from the theoretical and practical point of view. In the present investigation on a sample of 282 high school adolescents (203 - 72% male and 79 - 28% female) aged from 15 to 18 years the relationship between orthodontic and articulatory impairments was investigated. Assessment of the orthodontic and articulatory status, judged two specialists in the fields, showed the following percentages of orthodontic anomalies : primary compression -43,6%, open bite - 11,0%, closed bite -8,5%, progenia complex -5,7%, cross bite 3,5%, diastema media - 0,0%, short frenulum linguae - 41,5%, gothic palate -25,2% and tthe following percentages of ariculatory impairments: sigmatism - 64,9%, rhotacism - 36,5% and lambdacism - 39,9%. 78% of the subjects had orthodontic anomalies and 72% had articulatory impairments while 52% had combined orthodontic and articulatory impairments and only 9% were eugnathic subjects with normal articulatory status. It was also show that all three categories of articulatory impairments are mostly combined with primary compression (approximately 30%) accompanied by short frenulum linguae (approximately 30%) and gothic palate (approximately 15 to 20%). It is also obvious that there are 19% of subjetcts with orthodontic anomalies who have normal articulatory status, meaning that they developed efficient compensatory mechanisms in articulation and also that there are 13% of eugnathic subjects who have articulatory imapirments, consequently, caused by some other reasons and not by the orthodontic status. Although there is a strong connection between orthodontica and articulatory characteristics it can be concluded that the relationship between them is not straight forward and that other psycholinguistic, developmental, neurogenic and other parameters should be taken into consideration in further explication of that relationship