无托槽隐形矫治技术远移磨牙对不同垂直骨面型患者垂直向控制的效果  

Effect of molar distalization with clear aligners on occlusal vertical dimension in different vertical craniofacial patterns

作　　者：彭怡 李晓龙[2] Peng Yi;Li Xiaolong(Department of Stomatology,Pingxiang People’s Hospital,Pingxiang 337000,Jiangxi Province,China;Department of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]萍乡市人民医院口腔科,江西省萍乡市337000 [2]四川大学华西口腔医院正畸科,四川省成都市610041

出　　处：《中国组织工程研究》2024年第28期4559-4564,共6页Chinese Journal of Tissue Engineering Research

基　　金：爱齐科研专项基金(AQKY22-2-3),项目负责人:李晓龙。

摘　　要：背景:已有研究证实,无托槽隐形矫治技术能够有效实现磨牙的远中移动,但是对于远移磨牙后不同垂直骨面型患者垂直向如何变化尚未明确。目的:探讨无托槽隐形矫治技术推磨牙向远中对不同垂直骨面型患者在垂直向上的影响。方法:选择40例(安氏Ⅰ类13例,安氏Ⅱ类20例,安氏Ⅲ类7例)错牙合畸形患者,其中高角组13例,均角组17例,低角组10例;年龄10-53岁,平均28.5岁。应用无托槽隐形矫治技术进行正畸治疗,均采取推磨牙向远中的方法,治疗前后拍摄头颅侧位片,由同一位专业正畸医师对牙齿和颌骨的矢状向及垂直向相关指标进行测量,每个数据测量3次取平均值。结果与结论:①40例患者矫治后牙列拥挤解除,前牙建立正常覆合覆盖,面型得到一定改善;②高角组的下颌平面与前颅底平面的交角(GoGn-SN)减小0.4°,均角组、低角组的下颌平面与前颅底平面的交角(GoGn-SN)增加小于1°,3组中的前下面高(ANS-Me)增加小于1 mm,治疗前后差值均无统计学意义;③低角组上颌第一磨牙的近中颊尖点至上腭平面的距离(U6-PP)减小0.47 mm(P<0.01),均角组下颌中切牙切端至下颌平面的距离(L1-MP)减小0.83 mm(P<0.05),上中切牙长轴与前颅底平面相交的下内角(U1-SN)减小6.46°(P<0.001),差异有显著性意义;④提示无托槽隐形矫治技术推磨牙向远中能有效进行垂直向控制,防止下颌平面顺时针旋转,维持下面高,高角患者也能采用隐形矫治远移磨牙;隐形矫治器上下前牙压低实现率不足,临床设计方案时应该对前牙压低进行过矫治设计。BACKGROUND:Previous studies have shown that clear aligners can achieve molar distalization effectively,but it is not yet clear how the vertical dimension change in patients with different vertical craniofacial patterns after molar distalization.OBJECTIVE:To evaluate the effect of molar distalization with clear aligners on occlusal vertical dimension in different vertical craniofacial patterns.METHODS:Forty patients(13 cases of Class I malocclusion,20 cases of Class II malocclusion,and 7 cases of Class III malocclusion)were selected,including 13 cases in the high angle group,17 cases in the average angle group,and 10 cases in the low angle group.Among them,the age ranged from 10 to 53 years,with an average of 28.5 years.All patients were subjected to clear aligners for molar distalization.Lateral cephalometric films were taken before and after treatment.Cephalometric measurements,including the sagittal and vertical indicators of teeth and jaws,were measured by the same orthodontist,and each indicator was measured 3 times and averaged.RESULTS AND CONCLUSION:After orthodontic treatment,the crowded dentition was corrected,the overbite and overjet were back to normal and the lateral profile was improved significantly in all 40 patients.The GoGn-SN in the high angle group decreased by 0.4°,while the GoGn-SN in the average and low angle groups increased by less than 1°,the ANS-Me in the three groups increased by less than 1 mm.There was no statistically significant difference before and after treatment.There was a statistically significant decrease in the U6-PP in the low angle group by 0.47 mm(P<0.01).The L1-MP and the U1-SN in the average angle group significantly decreased by 0.83 mm(P<0.05)and by 6.46°(P<0.001),respectively.In conclusion,molar distalization with clear aligner treatment can control the vertical dimension effectively,prevent clockwise mandibular rotation,and maintain the lower face height.Patients with high angle can also undergo invisible orthodontics to distal molars.The realization rate of the a

关 键 词：错牙合畸形 垂直骨面型 无托槽隐形矫治技术 磨牙远中移动 垂直向 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R783