种植体间接支抗辅助无托槽隐形矫治远移磨牙效果的锥形束CT分析  

Cone-beam CT evaluation of the effect of indirect anchorage of mini-screw assisted clear aligner on molar distalization

作　　者：程鑫燚 桑婷[1] 伍军[1] Cheng Xinyi;Sang Ting;Wu Jun(Deparment of Orthodontics,The Affiliated Stomatological Hospital of Nanchang University&The Key Laboratory of Oral Biomedicine,Jiangxi Province&Jiangxi Province Clinical Research Center for Oral Diseases,Nanchang 330006,China)

机构地区：[1]南昌大学附属口腔医院正畸科,江西省口腔生物医学重点实验室,江西省口腔疾病临床医学研究中心,南昌330006

出　　处：《中华口腔医学杂志》2022年第7期724-732,共9页Chinese Journal of Stomatology

基　　金：江西省卫生计生委科技计划(20151084);2019年欧洲、中东、非洲和亚太地区爱齐研究奖金计划(2019)。

摘　　要：目的通过锥形束CT评价种植体支抗辅助无托槽隐形矫治远移磨牙的临床效果,为临床提供参考。方法回顾性纳入2018年1月至2021年9月就诊于南昌大学附属口腔医院正畸科并采用支抗种植体刚性连接支抗牙构建间接支抗、辅助控制无托槽隐形矫治远移上颌磨牙的成年患者26例,其中男性12例,女性14例,年龄(26.4±4.2)岁(19~31岁)。采用锥形束CT三维测量方法,测量患者矫治前(T0)、上颌第一磨牙远移到位时(T1)和前牙排齐内收到位时(T2)的上颌第一磨牙、第二前磨牙和中切牙牙根和牙尖以及牙根中心点位置,并采用单因素重复测量方差分析比较不同时间点间差异。结果上颌中切牙牙根和牙尖矢状向位置3个时间点间总体差异均有统计学意义(F=24.84,P<0.001;F=27.66,P=0.001);其中T0与T1差异均无统计学意义(P>0.05);T1与T2差异均有统计学意义(P<0.05),分别舌向内收(1.81±0.28)和(2.17±0.42)mm。上颌第二前磨牙牙根和牙尖矢状向位置3个时间点间总体差异均有统计学意义(F=17.16,P=0.001;F=57.99,P<0.001);其中T0与T1差异均无统计学意义(P>0.05);T1与T2差异均有统计学意义(P<0.05),分别向远中移动(1.95±0.42)和(2.53±0.33)mm。上颌第一磨牙牙根和牙尖矢状向位置3个时间点间总体差异均有统计学意义(F=9.37,P=0.002;F=140.26,P<0.001);其中T0与T1差异均有统计学意义(P<0.05),分别向远中移动(1.98±0.25)和(3.51±0.30)mm;而T1与T2差异均无统计学意义(P>0.05)。上颌第一磨牙牙根中心点垂直向位置3个时间点间差异有统计学意义(F=59.06,P<0.001);其中T0与T1差异有统计学意义(P<0.05),龈向压低(2.28±0.24)mm;而T1与T2差异无统计学意义(P>0.05)。其他测量指标3个时间点间总体差异均无统计学意义(P>0.05)。结论使用种植体支抗辅助无托槽隐形矫治远移磨牙可有效增强支抗牙的支抗作用。Objective To evaluate the effect of indirect anchorage with mini-screw assisted clear aligner on molar distalization.Methods Twenty-six adult patients[12 males and 14 females,aged 19 to 31 years,mean age(26.4±4.2)years],who were treated in the Department of Orthodontics,the Affiliated Stomatological Hospital of Nanchang University between January 2018 and September 2021,were included.All the patients were treated with clear aligner and mini-screw indirect anchorage to distalize maxillary molars.In the stage of molar distalization,the mini-implants were implanted between the buccal roots of the maxillary first molar and the second premolar,and rigidly connected to the maxillary second premolar as anchorage reenforcement.Until the first molar had distally moved to the designated position,the mini-implants were transferred to the buccal area between the first and the second molars and similar device was connected to the first molar.Cone-beam CT(CBCT)images were taken before the treatment(T0),at the maxillary first molar distally moved to the designated position(T1),and at the anterior teeth alignment finished(T2).The CBCT data were imported into Mimics 20.0 software for three-dimensional reconstruction.After correcting the head position,each reference point was determined in the multi-plane reconstruction view.The bilateral porion,the right orbitale,the nasion,and the anterior nasal spine were selected as reference points to construct the three-dimensional space coordinate system.The positions of the first molar,the second premolar,and the incisor were analyzed three-dimensionally.The three-dimensional position changes of maxillary first molars and maxillary second premolars during the stages of T0-T1,T1-T2,T0-T2,and the mesiodistal and vertical position changes of maxillary central incisors were analyzed.The statistical analysis was carried out using a one-way repeated measures ANOVA.Results There was a significant difference in the sagittal position changes of the root and crown of the maxillary central incisors

关 键 词：正畸矫正器 正畸矫正器 可摘式 正畸矫正器设计 磨牙 牙移动 正畸支抗 透明矫治器 

分 类 号：R783.5[医药卫生—口腔医学]