无托槽隐形矫治器与固定矫治器在上颌前突拔牙病例中的疗效对比  

Retrospective clinical study on treatment effectiveness with clear aligners and fixed appliances in extraction cases

作　　者：齐娟 李淑芳 QI Juan;LI Shu-fang(Department of Orthodontics,School of Stomatology,Wuhan University,Hubei Wuhan 430071,China.)

机构地区：[1]武汉大学口腔医学院,湖北武汉430071

出　　处：《临床口腔医学杂志》2023年第3期163-167,共5页Journal of Clinical Stomatology

摘　　要：目的:对比研究无托槽隐形矫治器和固定矫治器对上颌拥挤前突拔牙病例的临床效果。方法:收集40例上颌拥挤前突患者,分别采用无托槽隐形矫治器和自锁托槽固定矫治器完成拔牙矫治,每组20例。对两组患者治疗前(T0)和治疗后(T1)的头颅侧位片进行测量分析。结果:两组治疗后侧貌均改善明显,各软组织指标(UL-E Line,LL-E Line,H角,鼻唇角)改变趋势相似,两组间差异无统计学意义。两组治疗后上下切牙凸距和唇倾度均较治疗前明显减小(P<0.01),其中U1-NA、L1-NB凸距减少量(T1-T0)两组间差异无统计学意义,但U1-PP、U1-NA、L1-NB、L1-MP角度减少量(T1-T0)隐形组明显大于固定组(P<0.05)。治疗后隐形组上下切牙角度指标略小于正常值,固定组各角度均在正常范围内。治疗后两组上颌第一磨牙均发生前移,隐形组磨牙前移量(3.51 mm)明显大于固定组(2.83 mm)(P<0.05)。隐形组治疗后SN-MP、PP-MP减小趋势较固定组明显,但两组间差异无统计学意义。结论:上颌前突、拥挤患者减数治疗,自锁托槽固定矫治器和隐形矫治器均能较好地改善患者软组织侧貌;自锁托槽固定矫治器能更好地控制前牙转矩,同时保护后牙支抗;但隐形矫治器更有利于磨牙垂直向高度的控制。Objective:To evaluate the clinical effect of extraction correction of patients with maxillary protrusion and crowding by using clear aligners and fixed appliances.Methods:Forty patients with extraction of four first premolars due to maxillary protrusion and crowding were selected and divided into two groups(n=20),one group treated with clear aligners and the other treated with Damon Q fixed appliance.Computerized cephalometric analysis were carried out before(T0)and after treatment(T1),the differences between the two groups were analyzed.Results:After treatment,the soft tissue profile wasimproved significantly in both groups,and the amount of change in soft tissue index(UL-E Line,LL-E Line,H angle,nasolabial angle)was similar between the two groups(P>0.05).The amount of retraction of upper and lower incisors U1-NA,L1-NB(T1-T0)was significant but similar in both groups(P>0.05).However,the reduction of incisor inclination U1-PP,U1-NA,L1-NB and L1-MP(T1-T0)in clear aligner group were significantly greater than that in fixed appliance group(P<0.05).Moreover,the inclination angles of upper and lower incisors in fixed appliance group in T1were all within the normal range,while theinclination anglesin invisible aligner group in T1were all lower than normal value.Regarding molar position,significant difference in the upper first molar mesialization was detected between invisible aligner group(3.51 mm)and fixed appliance group(2.83 mm)(P<0.05).Conclusion:Damon Q fixed applianceand clear aligners can both improve patients’profile in extraction caseswith maxillary protrusion.Damon Q fixed appliance can provide better control of the labial crown torque of anterior teeth and better anchorage protection of posterior teeth.However,clear alignersseem to be more effective in vertical control.

关 键 词：无托槽隐形矫治 固定矫治 拔牙 头影测量 转矩 上颌前突 支抗 

分 类 号：R783.5[医药卫生—口腔医学]