无托槽隐形和个性化舌侧矫治技术对双牙弓前突治疗效果的比较  

Comparison of clear aligners and customized lingual appliance for bimaxillary dentoalveolar protrusion:a retrospective study

作　　者：李振霞 袁玲君[1] 郑小雯 刘璐 刘超[1] 房兵[1] LI Zhen-xia;YUAN Ling-jun;ZHENG Xiao-wen;LIU Lu;LIU Chao;FANG Bing(Department of Orthodontics,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology.Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔正畸科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《上海口腔医学》2023年第5期480-484,共5页Shanghai Journal of Stomatology

基　　金：国家自然科学基金(81901029);促进市级医院临床技能与创新能力三年行动计划(SHDC2020CR3009A);上海市青年科技英才扬帆计划(20YF1422400);中华口腔医学会口腔正畸专委会中青年临床科研基金(COS-C2021-10)。

摘　　要：目的:比较无托槽隐形矫治和个性化舌侧矫治技术对双牙弓前突的临床治疗效果。方法:选择2012—2021年在上海交通大学医学院附属第九人民医院口腔正畸科完成治疗的恒牙期双牙弓前突患者54例。其中,无托槽隐形矫治组25例、个性化舌侧矫治组29例,均采用拔除4颗第一前磨牙、强支抗内收前牙的方案,通过头影测量比较治疗前、后前牙改变和软组织内收的效果。采用SPSS 26.0软件包对数据进行统计学分析。结果:无托槽隐形组总疗程为(46.32±7.37)个月,比个性化舌侧组[(35.55±5.90)个月]长约10.8个月(P<0.05)。2组间上切牙后退量、下切牙唇倾度、覆盖减少量无显著差异;上唇后退量、下唇后退量、上切牙转矩减少量、覆[牙合]减少量存在显著差异,个性化舌侧矫治的唇内收和覆[牙合]改善量更大(P<0.05);对于覆盖的矫正,2组间无显著差异(P=0.337)。上切牙切缘点在功能[牙合]平面下方的距离(U1-OP),2组间个体差异较大,数据非正态分布,无显著差异(P=0.184)。结论:2种矫治方式均可有效内收前牙和上下唇,改善侧貌。个性化舌侧矫治对双牙弓前突患者的软组织侧貌改善效果更佳,总疗程更短。PURPOSE:To compare the treatment effects of clear aligners and customized lingual appliance on treating bimaxillary dentoalveolar protrusion patients with first premolar extractions.METHODS:Fifty-four patients with bimaxillary dentoalveolar protrusion treated in Shanghai Ninth People Hospital were involved in the retrospective study.Twenty-five cases used clear aligners and 29 cases used customized lingual appliance.All of them were treated by extracting 4 first premolars and retracting anterior teeth with strong anchorage.The changes of anterior tooth and soft tissue adduction before and after treatment were compared by lateral cephalometric measurements.SPSS 26.0 software package was used for data analysis.RESULTS:The total course of treatment in the clear aligners group(46.32±7.37 months)was about 10.8 months longer than that in the customized lingual appliance group(35.55±5.90 months)(P<0.05).There was no significant difference in upper incisor retraction,lower incisor inclination and overjet reduction between the two groups(P>0.05).There were significant differences in upper lip retraction,lower lip retraction,upper incisor torque reduction,and overbite reduction between the two groups(P<0.05).Customized lingual appliance group showed a significant improvement of lips retraction and overbite reduction in orthodontic treatment.For the correction of overjet,there was no significant difference between the two groups(P=0.337).The data of U1-OP(the distance between edge of the upper central incisor and the functional occlusal plane)was not in normal distribution,and there was no significant difference between the two groups(P=0.184).CONCLUSIONS:The two techniques can both retract the anterior teeth and lips to improve the profile.However,the customized lingual appliance was more effective in improving the soft tissue profile of patients with bimaxillary dentoalveolar protrusion,with shorter treatment course.

关 键 词：双牙弓前突 无托槽隐形矫治 个性化舌侧矫治 回顾性研究 

分 类 号：R783.5[医药卫生—口腔医学]