DENTOKRANIOFASIAL ANAK DISABILITAS INTELEKTUAL DAN PERAN FAKTOR UMUR SERTA JENIS KELAMIN PADA SUKU JAWA

Dewi Elianora, Prof. Dr. Iwa Sutardjo RS, drg, S.U, Sp. KGA (K); Dr. dr. Bambang Udji Djoko R, M.Kes, Sp.THT (K)

2014 | Disertasi | S3 Kedokteran Gigi

Disabilitas intelektual merupakan ketidaksempurnaan perkembangan mental berakibat pada keterlambatan perkembangan motorik, bicara dan keterlambatan dalam penyesuaian diri dengan lingkungannya. Gejala umum dijumpai gangguan pertumbuhan otak, selain berpengaruh pada fungsi intelektual (rendah di bawah rata-rata <70), kemungkinan besar dapat mempengaruhi pertumbuhan tulang kranial. Penyebabnya multifaktorial. Pada kedokteran gigi anak, masalah kesehatan gigi mulut anak disabilitas intelektual yang sering terlihat salah satunya adalah maloklusi. Kendala serta masalah gigi mulut anak disabilitas intelektual lebih kompleks dibanding anak normal. Tujuan penelitian adalah menentukan perbedaan dan hubungan profil dan komponen dentokraniofasial anak disabilitas intelektual dan faktor yang berperan terhadap dentokraniofasial anak disabilitas umur 7-12 tahun. Penelitian ini merupakan penelitian epidemiologi analitik observasional dengan rancang case control. Sebagai kelompok kasus: anak SLBN tipe C sedangkan kelompok kontrol adalah anak SDN Kota Yogyakarta umur 7-12 tahun. Jumlah subyek 168 anak (84 anak disabilitas intelektual sedang dan 84 normal). Diambil secara random dari 142 subyek disabilitas intelektual dan 204 subyek normal yang masuk kriteria. Penelitian dilakukan mulai bulan Juli 2013 sampai semua subyek terpenuhi. Hasil penelitian didapatkan profil dentokraniofasial anak disabilitas intelektual umur 7-12 tahun bentuk kepala brakisefali odds ratio 2.43, wajah euryprosop 1.57 dan rahang broad 0.68, berdasarkan jenis kelamin odds ratio 1.26, 1.76 dan 1.09. Komponen dentokraniofasial didapatkan ukuran kranial lebih kecil, ukuran fasial lebih pendek dan ukuran dental lebih pendek secara bermakna dibanding anak normal. Terdapat hubungan bermakna antara bentuk kepala dengan bentuk wajah dan bentuk rahang dengan kejadian disabilitas intelektual, demikian juga ukuran kranial dengan bentuk kepala dan bentuk wajah. Umur dan jenis kelamin berpengaruh terhadap profil dan komponen dentokraniofasial anak disabilitas intelektual. Kesimpulan; Terdapat perbedaan secara bermakna profil dentokraniofasial anak disabilitas intelektual berdasarkan umur dan jenis kelamin dibanding anak normal. Ditemukan ukuran anteroposterior kepala anak disabilitas intelektual lebih pendek, ukuran ke arah lateral lebih lebar ditandai dengan terjadinya penurunan IQ lebih awal umur 9 tahun dibanding anak normal. Ukuran komponen dentokraniofasial anak disabilitas intelektual lebih pendek dibanding anak normal. Terdapat hubungan bermakna antara bentuk kepala, wajah dan rahang dengan kejadian disabilitas intelektual, demikian juga dengan ukuran kranial berhubungan secara bermakna dengan bentuk kepala dan bentuk wajah. Umur dan jenis kelamin berpengaruh terhadap profil dan komponen dentokraniofasial anak disabilitas intelektual.

Intellectual disabilities is condition in imperfection of mental ability developmental which resulted in delay of motoric development, speech and delay in adaption with its environment. Common symptoms that was encounterd is brain growth disorder, that to the effects on intellectual function (below average <70), and may affect the cranial bone growth. The cause of this symptoms multifactorial. In dentistry, the dental health issue in intellectual disabilities children's teeth often seen as malocclusion. The problems and management with intellectual disabilities children teeth are more complex than normal children. The purpose of the research is to determine the differences and relationship between the dentocraniofacial profiles and it’s component in intellectual disabilities children, and factors that contribute to dentocraniofacial of this child from age 7-12 years old. This research is a case control study done by observational and analytic epidemiology study. As groups of case used SLBN type C children are taken for the control group children from SDN Yogyakarta from age 7-12 years old are taken. This study was carried out on 168 children (of these 84 are moderatelly mental retarded and the other 84 child normal). It was randomizelly taken from 142 intellectual disabilities subjects and 204 normal subjects who fulfill the criteria. The research was conducted in July 2013 untill all subjects are fulfilled. The results of this research were found that the profiles of the dentocraniofacial of this mentally retarded children was from age 7-12 years old are head shape brachicephali with odds ratio 2.43, face shapes euryprosop odds ratio 1.57 and the jaw shape broad 0.68, while based on the gender of the odds ratio 1.26, 1.76 and 1.09. Component of dentocraniofacial was found to be a smaller cranial size, the size of the facial is shorter and the dental size is less smaller compare to its control is significantly. There is a significant relationship between the shape of the head, the face shape and the shape of the jaw with the incidence of intellectual disabilities, as well as the size of the cranial is associated significantly with the shape of the head and face shape. Age and gender influence on the dentocariofacial profile and its components in children with intellectual disabilities. Conclusion; there is a significant difference in dentocraniofacial profile of mentally retarded children compare to normal child based on age and gender. Found the size of the child’s head of intellectual disability antero-posterior shorter, lateral the size of the wider decline marked by the IQ earlier aged 9 years than normal children. The size components of the dentocraniofacial mentally retarded children is significant more shorter than normal children. Age and gender influence on dentocraniofacial profile and component of the child's intellectual disabilities. There is a significant relationship between the shape of the head, face and jaw with the incidence of intellectual disabilities, as well as the related cranial size significantly with the shape of the head and face.

Kata Kunci : Profil dan komponen dentokraniofasial, disabilitas intelektual, anak normal, IQ (Intellegence Quetient), umur dan jenis kelamin.