不同牵引方式对无托槽隐形矫治磨牙远移影响的三维临床研究  

A three-dimensional clinical study on the effect of different elastic tractions on molar distalization treatment with clear aligners

作　　者：张子瑶 史睿颖 王玉睿 胡忆戎 刘思颖 顾泽旭 Zhang Ziyao;Shi Ruiying;Wang Yurui;Hu Yirong;Liu Siying;Gu Zexu(State Key Laboratory of Military Stomatology&National Clinical Research Center for Oral Diseases&Shanxi Clinical Research Center for Oral Diseases,Department of Orthodontics,School of Stomatology,The Fourth Military Medical University,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院正畸科,西安710032

出　　处：《中华口腔正畸学杂志》2022年第2期66-69,共4页Chinese Journal of Orthodontics

基　　金：中华口腔医学会青年临床科研基金口腔正畸研究项目(CSA-02020-01);国家口腔疾病临床医学研究中心资助课题(LCA202009)。

摘　　要：目的分析上颌磨牙、前磨牙远移时的轴倾度、转矩和扭转变化,以及不同的牵引方式防止前牙唇倾和磨牙远移复发的作用。方法纳入患者16例,牙齿146颗。收集并重叠初诊研究模型(T0),上颌磨牙远移阶段模型(T1),以及上颌前磨牙远移阶段模型(T2)。测量磨牙和前磨牙远移效率和角度变化,对比矫治器牵引、尖牙牵引和对照组前牙唇展量以及T1至T2磨牙远移效率是否下降。结果上颌磨牙远移效率为81.03%;远移后平均远中倾斜4.37°(P=0.000),颊倾1.65°(P=0.000),差异有统计学意义;无明显扭转(P=0.160)。上颌前磨牙远移效率为78.79%;远移后平均远中倾斜5.96°(P=0.000),颊倾3.91°(P=0.000),颊尖远中向扭转1.98°(P=0.000),以上差异均有统计学意义。推磨牙远移后(T1),矫治器牵引组前牙无明显唇倾;尖牙牵引组前牙唇倾0.77 mm,对照组前牙唇倾0.52 mm。上颌第二磨牙矫治器牵引组T1至T2远移效率无明显下降;尖牙牵引组效率下降16.37%;对照组效率下降13.23%。上颌第一磨牙不同牵引方式组T1至T2远移效率均无明显下降。结论矫治器牵引能够有效防止前牙唇倾以及第二磨牙远移效率下降。Objective To analyze the inclination,torque and rotation variation during upper molars and premolars distalization and the effects of different kinds of elastic traction on preventing anterior proclination and relapse of distalization.Methods Sixteen patients and 146 teeth were involved in the study.Digital study models of pretreatment(T0),upper molars distalization(T1)and premolars distalization(T2)were collected and superimposed.The efficacy and angle variation of molars and premolars distalization were analyzed.Elastics on aligners and elastics on canines and no elastic groups were compared by measuring the anterior teeth proclination.And distalization relapse between T1 and T2 were also measured.Results The mean distalization efficacy of upper molars was 81.03%,tilting distally by 4.37°(P=0.000)and buccally by 1.65°(P=0.000),and the difference was statistically significant;no obvious rotation was observed(P=0.160).The mean distalization efficacy of upper premolars was 78.79%,tilting distally by 5.96°(P=0.000)and buccally by 3.91°(P=0.000),the buccal cusps rotated distally by 1.98°(P=0.000),and the differences were statistically significant.The elastics on aligner group didn't show significant incisors proclination at T1;but incisors proclined by 0.77 mm in canine elastics group and 0.52 mm in non-elastic group.The efficacy of upper second molar distalization didn't show significant relapse from T1 to T2 in elastics on aligner group;the efficacy declined by 16.37%in canine elastics group,and 13.23%in control group.The efficacy of upper first molars didn't show any significant relapse in all groups from T1 to T2.Conclusions Elastics on aligners could prevent incisors proclination and the relapse of upper second molars distalization.

关 键 词：无托槽隐形矫治 三维重叠 磨牙远中移动 弹性牵引 

分 类 号：R783.5[医药卫生—口腔医学]