Hawley联合舌侧保持器和压膜式保持器的临床正畸保持效果比较

Clinical evaluation of lingual fixed retainer combined with Hawley retainer and vacuum-formed retainer

目的:比较Hawley联合舌侧固定保持器和压膜式保持器的临床效果,为选择合适的正畸保持方式提供参考。方法:选择正畸治疗刚结束的患者45例,随机给下颌戴用压膜式保持器(压膜式保持器组,25例)或联合保持器,即舌侧固定保持器配合夜间Hawley保持器(联合保持器组,20例)。每隔3个月复诊1次,记录矫治前、矫治结束时以及保持6个月和保持1年后的覆、覆盖及牙石指数。在模型上测量下颌牙扭转度、尖牙间和磨牙间宽度以及下前牙不齐指数。采用SAS 6.12软件包对数据进行方差分析、卡方检验和Fisher确切检验,比较2组之间的差异。结果:压膜式保持器组各测量项目在矫治后、保持6个月和保持1年后均无显著差异(P>0.05)。联合保持器组除牙石指数在保持6个月和1年后变化显著大于压膜式保持器组外(P<0.05),其余各项指标2组间均无显著差异。1年内的损坏率,压膜式保持器和联合保持器分别是24%和20%,即成功率76%和80%,两者无显著差异。结论:压膜式保持器保持和舌侧固定保持器配合夜间Hawley保持器保持的1年随访效果均良好,但综合考虑患者依从性和保持器的可靠性,后者是较好的保持方式。

PURPOSE：To evaluate the clinical efficacy of vacuum-formed retainers（VFRs） and lingual fixed retainers combined with Hawley retainers（combined retainers,CRs）.METHODS： Forty five patients immediately after orthodontic treatment were randomly allocated to either VFRs（n=25） or CRs（n=20） groups.Overbite,overjet and calculus index scores（CIS） were recorded at pretreatment（T0）,debonding（T1）,6 months（T2） and 12 months（T3） after maintenance.The tooth rotation,intercanine and intermolar width,and Little＇s index of irregularity were recorded on the study models of lower arches.The difference between the two groups was analyzed with SAS 6.12 software package.RESULTS： No significant difference was noted during retention time in VFRs（P0.05）.Likewise,there was no significant difference between VFRs and CRs,except that the change of CIS in CRs was significantly larger than those in VFRs（P0.05）.The incidence of breakage of vacuum-formed retainers was 24%,which was comparable with that of lingual fixed retainers（20%）.CONCLUSIONS： Both vacuum-formed retainers and lingual fixed retainers combined with Hawley retainers have good retention during the first 12-month retention period.Considering patients＇ compliance and retention efficacy,lingual fixed retainer with Hawley retainer at night is a better choice for retention.Supported by Research Fund of Science and Technology Commission of Shanghai Municipality（10QH1401600） and Shanghai Leading Academic Discipline Project（S30206）.