直丝弓矫治器和Invisalign矫治器在错[牙合]畸形拔牙患者排齐阶段支抗需求的应用效果观察  

Observation on Application Effect of Straight Wire Appliance and Invisalign Appliance in the Anchorage Demand of Tooth Extraction Patients with Malocclusion in the Alignment Stage

作　　者：蒋勇 顾郁嘉 陈雪 王天丛[2] JIANG Yong;GU Yujia;CHEN Xue;WANG Tiancong(The Fifth Outpatient Clinic,the Affiliated Stomatological Hospital of Nanjing University School of Medicine,Nanjing Stomatological Hospital,Nanjing University Institute of Stomatology,Nanjing 210000,China;Department of Orthodontics,the Affiliated Stomatological Hospital of Nanjing University School of Medicine,Nanjing Stomatological Hospital,Nanjing University Institute of Stomatology,Nanjing 210000,China)

机构地区：[1]南京大学医学院附属口腔医院、南京市口腔医院、南京大学口腔医学研究所第五门诊部,南京210000 [2]南京大学医学院附属口腔医院、南京市口腔医院、南京大学口腔医学研究所口腔正畸科,南京210000

出　　处：《临床误诊误治》2025年第6期78-84,共7页Clinical Misdiagnosis & Mistherapy

基　　金：2021年度江苏省药学会一天晴医院药学基金立项课题(Q202137)。

摘　　要：目的比较直丝弓矫治器和Invisalign矫治器在错[牙合]畸形拔牙患者排齐阶段支抗需求的应用效果。方法回顾性分析2019年7月至2023年9月收治的错[牙合]畸形拔牙排齐阶段支抗需求患者,根据正畸方式不同分为直丝组(应用直丝弓矫治器)与隐形组(应用Invisalign矫治器),倾向性匹配排除基线资料混杂因素,2组各60例。2组均通过iTero扫描仪扫描石膏模型并重建三维模型,应用三维模型重叠测量各参数变化,对比2组排齐后三维模型重叠测量值、对比2组颌骨变化[下颌平面角(FMA)、下中切牙长轴延长线和下颌平面交角(IMPA)、下中切牙长轴延长线与眶耳平面交角(FMIA)、上齿槽座点-鼻根点-下齿槽座点夹角(ANB)]、软组织变化[上唇后缩度(UL To E Line)、下唇后缩度(LL To E Line)]、牙齿变化[上中切牙唇倾(U1-NA)、中下切牙舌倾(L1-NB)]以及并发症发生情况。结果隐形组排齐后U1X、U3Y、U3转矩、U5倾角重叠测量值显著低于直丝组,而U3X、U5X、U5Y、U5Z、U6X、U6Y、U6Z、U1转矩、U5转矩、U6转矩、U3倾角、U6倾角显著高于直丝组(P<0.05,P<0.01)。排齐后,2组FMA角、IMPA角、ANB角均较排齐前显著上升,FMIA角较排齐前下降(P<0.05)。排齐后,2组UL To E Line、LL To E Line均较排齐前显著下降(P<0.05)。排齐后,2组U1-NA较排齐前显著下降,L1-NB较排齐前上升,且隐形组U1-NA低于直丝组,L1-NB高于直丝组(P<0.05);隐形组与直丝组并发症发生率[3.33%(2/60)vs 6.67%(4/60)]比较差异无统计学意义(P>0.05)。结论直丝弓矫治器和Invisalign矫治器均可用于错[牙合]畸形拔牙患者排齐阶段支抗需求,然二者均存在部分支抗丢失,临床应合理选择矫治方案。Objective To compare the application effect of straight wire orthodontic appliance and Invisalign orthodontic appliance in the anchorage demand of tooth extraction patients with malocclusion in the alignment stage.Methods A retrospective analysis was performed on patients with malocclusion in anchorage demand in the alignment stage of tooth extraction from July 2019 to September 2023.According to different orthodontic methods,they were divided into straight wire group(using straight wire appliance)and invisible group(using Invisalign appliance).Propensity matching method was used to exclude the confounding factors of baseline data;thus,there were 60 patients in each group.The plaster model of the two groups was scanned by iTero scanner and the three-dimensional(3-D)model was reconstructed.The 3-D model overlap was used to measure the changes of each parameter.The 3-D model overlap measurement values before and after alignment,jaw bone changes(FMA angle,IMPA angle,FMIA angle,ANB angle),soft tissue changes(UL To E Line,LL To E Line),tooth changes(U1-NA,L1-NB)and complications were compared between both groups.Results The measurement values of U1X,U3Y,U3 torque and U5 tilt angle overlap after alignment in invisible group were significantly lower than those in straight wire group,while the U3X,U5X,U5Y,U5Z,U6X,U6Y,U6Z,U1 torque,U5 torque,U6 torque,U3 tilt angle and U6 tilt angle were significantly higher than those in straight wire group(P<0.05,P<0.01).After alignment,the FMA angle,IMPA angle,and ANB angle in both groups significantly increased,while the FMIA angle significantly decreased,compared with those before alignment(P<0.05).After alignment,both groups showed a significant decrease in UL To E Line and LL To E Line,as compared with that before alignment(P<0.05).After alignment,U1-NA in both groups decreased significantly,while L1-NB increased significantly,U1-NA in the invisible group was significantly lower than that in the straight wire group,while L1-NB was significantly higher than that in the straight wire

关 键 词：拔牙 支抗需求 直丝弓矫治器 Invisalign矫治器 三维模型 FMA角 IMPA角 错[牙合]畸形 

分 类 号：R783.5[医药卫生—口腔医学]