无托槽隐形矫治器伸长后牙效率的三维重叠分析  

Efficiency of clear aligners in extrusion of posterior teeth evaluated by 3-dimensional model superimposition

作　　者：赵佳媛 胡成思 金玉 张灵玲 易芳[1] 陈君捷 周娉[1] 卢燕勤[1] 李成日 ZHAO Jia-yuan;HU Cheng-si;JIN Yu;ZHANG Ling-ling;YI Fang;CHEN Jun-jie;ZHOU Ping;LU Yan-qin;LICheng-ri(Xiangya Stomatological Hospital,Central South University,Changsha 410000,Hunan Province;Affiliated Stomatology Hospital of Suzhou Vocational Health College,Suzhou 215002,Jiangsu Province;Hunan Normal University,Changsha 410081,Hunan Province,China)

机构地区：[1]中南大学湘雅口腔医院,湖南长沙410000 [2]苏州卫生职业技术学院附属口腔医院,江苏苏州215002 [3]湖南师范大学,湖南长沙410081

出　　处：《上海口腔医学》2022年第5期556-560,共5页Shanghai Journal of Stomatology

摘　　要：目的:利用三维数字化模型重叠法,探讨无托槽隐形矫治器伸长后牙的效率,为临床方案设计提供参考。方法:选择24例后牙伸长量不小于0.5 mm的Invisalign患者,共126颗观测牙。于矫治前、后分别采用i Tero扫描,获取患者数字化模型,分别命名为“实际初始”和“实际终末”模型。在ClinCheck软件中获取该方案的初始、终末模型,命名为“虚拟初始”和“预期终末”模型。以STL格式导出后分别导入Geomagic Studio,将初始模型与实际终末、预期终末模型分别重叠,得到实际伸长量与预期伸长量。采用SPSS 23.0及GraphPad Prism 5.0软件对数据进行统计学分析,计算伸长后牙的效率并分析可能的影响因素。结果:无托槽隐形矫治器伸长后牙的效率为30.2%,实际伸长量与预期设计伸长量间呈直线相关(P<0.05),直线回归方程为y=0.305x-0.010;实际伸长量与预期伸长量的差值与矫治器数量呈正相关(P<0.001),与预期伸长量呈正相关(P<0.001);低角患者实际伸长量与预期伸长量的差值比均角患者大(P<0.05)。结论:无托槽隐形矫治器伸长后牙的效率较低,约为30.2%,垂直生长型影响矫治效率,可对低角患者设计更多的过矫正。PURPOSE:To explore the efficiency of posterior teeth extrusion with clear aligners by 3-dimensional model superimposition,which provides a reference for the design of clinical programs.METHODS:We selected 24 patients with clear aligners whose posterior teeth were designed to extend more than 0.5 mm,and a total of 126 teeth were included.Digital models were obtained before and after treatment by intraoral scanning with i Tero,named as"actual initial"and"achieved"digital models.Initial and final models from the ClinCheck,labeled as"virtual initial"and"predicted"models respectively.Initial,predicted,and achieved digital dental models were exported as stereolithography files and subsequently imported into Geomagic Studio.Extrusive measurements were made from the superimposition of the initial and predicted models(predicted movement)and from the superimposed initial and achieved models(achieved movement).Statistical analysis was performed with SPSS 23.0 and GraphPad Prism 5.0 software package.The extrusion efficiency of the posterior teeth was calculated,at the meanwhile the influencing factors were analyzed.RESULTS:The mean extrusion efficiency of posterior teeth during clear aligners treatment was 30.2%.The actual extrusion was linearly related to the expected(P<0.05),and the linear regression equation was y=0.305x-0.010.The difference between the actual and the predicted extrusion was positively correlated with the number of appliances(P<0.05),and also positively correlated with the predicted extrusion value(P<0.001).This difference was larger in low-angle patients than in patients with average angle(P<0.05).CONCLUSIONS:The extrusion rate of posterior teeth is relatively low during clear aligners treatment,and the average efficiency is 30.2%.Vertical growth pattern affects the extrusion efficiency.So more overcorrections can be designed for average angle patients.

关 键 词：无托槽隐形矫治器 数字化三维重叠 后牙伸长 效率 

分 类 号：R783.5[医药卫生—口腔医学]