正畸附件或托槽的去除对牙釉质裂纹的影响  

Effect of orthodontic attachment or bracket removal on enamel cracks

作　　者：范皓 张欢 袁瑞 司敏敏 刘佳[2] 冯志远 Fan Hao;Zhang Huan;Yuan Rui;Si Minmin;Liu Jia;Feng Zhiyuan(ShanXi Medical University School and Hospital of Stomatology,Shanzi Province Key Laboratory of Oral Diseases Prevention and New Materials,Taiyuan 030001,China;Department of Orthodontics,The Fifth Clinical Medical College of Shanri Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学口腔医学院,口腔疾病防治与新材料山西省重点实验室,太原030001 [2]山西医科大学第五临床医学院口腔正畸科,太原030001

出　　处：《中华口腔正畸学杂志》2023年第1期27-31,共5页Chinese Journal of Orthodontics

基　　金：中华口腔医学会中西部口腔正畸临床研究项目(CSA-MW02021-14)。

摘　　要：目的探讨无托槽隐性矫治矩形附件磨除和固定矫治金属托槽脱粘对附件及托槽粘接区域牙釉质裂纹的影响.方法收集80颗离体恒牙进行随机对照试验,以牙冠中心为中心,选择5 mm×5 mm的正方形粘接区域,并按照该区域内或通过该区域是否有裂纹分为无裂纹组和有裂纹组.其中无裂纹组随机分为附件A组和托槽B组,有裂纹组随机分为附件C组和托槽D组,每组各20例.比较各组实验前后粘接区域牙釉质裂纹特征测量值(裂纹数量、裂纹总长度及最长裂纹的长度和宽度)的差异;有裂纹组内C、D组间牙釉质裂纹变化的差异.结果附件A组树脂附件和托槽B组金属托槽及残余粘接剂去除并进行牙面抛光后,粘接区域牙釉质裂纹特征测量值实验前后对比差异无统计学意义.附件C组实验后牙釉质裂纹数量的M(Q1,Q3)为1.00(0.25,1.00)(P=0.007),裂纹总长度的均值为(1548.69±1230.37)μm(P<0.001),最长裂纹的长度均值为(1471.56±1163.87)μm(P<0.001),宽度均值为(7.34±5.62)μm(P=0.034),较实验前略有减小;托槽D组实验后裂纹总长度M(Q1,Q3)为2184.00(849.80,3097.36)μm(P=0.023)、最长裂纹的长度M(Q1,Q3)为1676.98(638.59,2493.69)μm(P=0.006),宽度均值为(7.74±4.89)μm(P=0.037),较实验前也略有减小.结论矩形附件和金属托槽的去除过程并不会导致粘接区域新裂纹的出现;原本粘接区域有裂纹的牙齿,在矩形附件或金属托槽去除并进行牙面抛光后,粘接区域原有的牙釉质裂纹特征测量值可能会略微减小.Objective To investigate the effect of clear aligner rectangular attachment grinding or metal bracket debonding in orthodontic treatment on enamel cracks in the bonding area.Methods Eighty isolated permanent teeth were collected for randomized controlled study,and a 5×5 mm^(2) square bonding area centered at the crown center was selected.According to whether cracks existed in or through the bonding area or not,the teeth were divided into group without crack and group with crack.The group without crack was randomly divided into attachment group A and bracket group B,and the group with crack was randomly divided into attachment group C and bracket group D,with 20 cases in each group.The characteristics of enamel cracks(the number of cracks,the total length of cracks and the length and width of the longest crack)were compared before and after each experiment.The changes of enamel cracks between group C and group D were compared.Results After the removal of group A resin attachment or group B metal bracket,removal of residual adhesive and the polishing of tooth surface,there was no statistical significance in the measurement values of enamel crack characteristics in the bonding area before and after the experiment.In group C,the characteristics of enamel cracks were slightly decreased compared with before the experiment.the median of enamel cracks number M(Qi,Q)was reduced to 1.00(0.25,1.00)(P=0.007)and the mean of enamel cracks total length was reduced to 1548.69±1230.37μm(P<0.001).The mean length of longest crack was reduced to 1471.56±1163.87μm(P<0.001)and mean width was reduced to 7.34±5.62μm(P=0.034).In group D,the median of enamel cracks total length M(Q,Q)was reduced to 2184.00(849.80,3097.36)μm(P=0.023).The median length of longest crack M(Qi,Q)was reduced to 1676.98(638.59,2493.69)μm(P=0.006)and the mean width was reduced to 7.74±4.89μm(P=0.037).Conclusions The removal of rectangular attachments and metal brackets does not result in new cracks in the bonding area.When the rectangular attachment or

关 键 词：正畸 附件 金属托槽 牙釉质裂纹 

分 类 号：R783.5[医药卫生—口腔医学]