无托槽隐形矫治拔牙病例的临床研究进展  

Clinical research progress of clear aligner technique in extraction cases

作　　者：张昕怡 华先明[1] Zhang Xinyi;Hua Xianming(The State Key Laboratory Breeding Base of Basic Science of Stomatology(Hubei-MOST)&Key Laboratory of Oral Biomedicine Ministry of Education,School&Hospital of Stomatology,Wuhan University,Wuhan 430079,China)

机构地区：[1]口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室,武汉大学口腔医学院,武汉430079

出　　处：《中华口腔正畸学杂志》2024年第3期158-162,共5页Chinese Journal of Orthodontics

摘　　要：无托槽隐形矫治技术在拔牙病例中的运用越来越广泛,但因隐形矫治器材料特性,在内收前牙关闭拔牙间隙的过程中常常发生前牙伸长、舌倾,后牙近中倾斜的“过山车”效应,所以隐形矫治拔牙病例中牙移动的实际表达与方案设计间存在差异。研究表明上颌磨牙近中移动和压低的实际值均大于设计值,矫治后的牙冠表现为近中倾斜,这主要与磨牙支抗的丢失和矫治器的“[牙合]垫效应”.有关,而尖牙和切牙矫治后常表现为远中倾斜和舌倾伸长。磨牙的备抗,前牙的压低和转矩的过矫正,附件的正确选择,以及微种植体的合理应用均可预防“过山车”效应的发生。目前关于无托槽隐形矫治拔牙病例的研究内容主要集中在后牙、尖牙和前牙在三维方向上的移动和表达效率,以及如何避免“过山车”效应的发生。本文主要对无托槽隐形矫治拔牙病例中磨牙、尖牙和切牙在三维方向移动中的相关设计和研究进展作一综述,为临床应用提供参考。Nowadays,clear aligner technique is increasingly used in tooth extraction cases.During the retraction of anterior teeth and space closure,lingual tipping and extrusion of incisors and mesial tipping of posterior teeth may occur,a phenomenon known as the roller-coaster effect.Therefore,there is a specific difference between actual tooth movement and virtual tooth movement.Previous research showed that the actual values of the mesial movement and intrusion of the maxillary molars were higher than the designed values,and the crowns exhibited mesial tipping after orthodontic treatment.This was mainly related to the loss of molar anchorage and the'occlusal pad effect'of clear aligners.Canines and incisors often showed distal tipping,lingual tipping and intrusion after treatment.The roller-coaster effect can be prevented by preparing the anchorage of the molars,overcorrection design of the torque and intrusion of anterior teeth,the correct attachment design,and the rational application of micro-implants.Currently,most research on clear aligner extraction cases focus on the three-dimensional movement and efficiency of posterior teeth,canines and anterior teeth,as well as how to avoid the roller-coaster effect.This paper mainly summarizes the three-dimensional movement and the treatment of molars,canines,and incisors in tooth extraction cases with clear aligner,providing some ideas and clinical references for clinical practice.

关 键 词：无托槽隐形矫治 拔牙病例 牙移动 正畸 治疗设计 

分 类 号：R783.5[医药卫生—口腔医学]