无托槽隐形矫治器设计平面导板对上牙列牙齿移动的影响  

Influence of clear aligner with bite ramps on movement of maxillary teeth

作　　者：寇秉国 许益蒙 张子瑶 李博[1] 王玉睿[1] 刘思颖[1] 顾泽旭[1] Kou Bingguo;Xu Yimeng;Zhang Ziyao;Li Bo;Wang Yurui;Liu Siying;Gu Zexu(State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Department of Orthodontics,School of Stomatology,The Fourth Military Medical University,Shaanxi Clinical Research Center for Oral Diseases,Xi'an 710032,China)

机构地区：[1]军事口腔医学国家重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,第四军医大学口腔医学院口腔正畸科,西安710032

出　　处：《中华口腔正畸学杂志》2021年第4期188-192,共5页Chinese Journal of Orthodontics

基　　金：中华口腔医学会青年临床科研基金(CSA-02020-01)。

摘　　要：目的探讨无托槽隐形矫治器设计平面导板,对上中切牙压低效率的影响及支抗前磨牙、磨牙的变化,以期对无托槽隐形矫治器设计平面导板矫治深覆拾提供参考。方法分别选取无托槽隐形矫治器设计平面导板和无平面导板矫治深覆拾的病例各6例,两组均设计上中切牙不少于0.7 mm的压低,通过前牙压低矫正深覆胎。前磨牙及磨牙作为支抗牙不设计移动。以腭穹窿为参照,重叠设计压低前后的数字化模型,比较两组上颌中切牙压低效率的差异,以及两组支抗前磨牙和磨牙的差异。结果平面导板组上中切牙压低效率为33%,无平面导板组上中切牙压低效率为8%,二者的差异无统计学意义(P>0.05);平面导板组第--前磨牙、第二前磨牙第--磨牙和第二磨牙分别伸长0.3、0.1、0.2和0.1 mm;无平面导板组第-前磨牙第二前磨牙第-磨牙和第二磨牙分别压低0.0、0.2、0.1和0.1mm,两组的差异均有统计学意义(P<0.05);平面导板组和无平面导板组未设计移动的第一-磨牙分别颊倾0.0 mm和0.3 mm,二者的差异有统计学意义(P<0.05)。结论无托槽隐形矫治器设计平面导板对上颌中切牙的压低无明显影响,但能有效伸长支抗前磨牙及磨牙,克服无托槽隐形矫治器“验垫效应”造成的后牙压低,并维持磨牙水平向的位置,对深覆邪的矫正发挥一定作用。Objective To investigate the effects of clear aligner with bite ramps for efficacy of intrusion of the upper central incisors and the changes of the anchoring premolars and molars,in order to provide reference for the treatment of overbite with clear aligner.Methods Six deep overbite cases were selected in each group.One group was with bite ramps and the other group without bite ramps.No less than 0.7 mm of intrusion of each upper central incisor was planned in both groups for correction of overbite.Premolars and molars served as anchorage without extrusion designed.Superimposition the staging digital dental casts of pre-treatment and post-treatment by third rugae and the palatal vault.The results of efficacy of intrusion of the upper central incisors and changes of the anchoring premolars and molars were compared among two groups.Results The mean accuracy of intrusion of upper central incisors were 33%and 8%respectively in group clear aligner with bite ramps and group clear aligner without bite ramps.There was no significantly difference among two groups(P>>0.05).The mean extrusion of first premolars,second premolars,first molars and second molars were 0.3 mm,0.1 mm,0.2 mm and 0.1 mm respectively in group with bite ramps,and the mean intrusion of first premolar,second premolar,first molar and second molar were is 0.0 mm,0.2 mm,0.1 mm and 0.1 mm respectively in group without bite ramps,and there was significant difference among two groups(P<0.05).The mean buccal movement were 0.0 mm and 0.3mm respectively in group with bite ramps and group without bite ramps,and there was significantly difference among two groups(P<<0.05).Conclusions Clear aligner with bite ramps has no remarka ble influence to intrusion of upper central incisors,however,it has an effect of extrusion of premolars and molars,meanwhile maintaining the sagittal positions of molars,which plays an important role in the correction of deep overbite.

关 键 词：无托槽隐形矫治器 平面导板 前牙压低 

分 类 号：R783.5[医药卫生—口腔医学]