数字化排牙试验在正畸病例拔牙与否判断中的应用

Application of three-dimensional digital technology in extraction or non-extraction of orthodontic cases

目的探讨数字化排牙试验在正畸病例拔牙与否判断中的应用。方法选取40例资料完整的正畸初诊病例作为研究样本。第1组由6名医师依据牙颌模型、X线片、面颌相片及传统的常规资料测量分析结果,对以上病例进行治疗方案设计。第2组由同样6名医师,根据以上资料再加上辅助数字化排牙试验的方法进行治疗方案设计。方案设计的结果分别判断为拔牙、不拔牙、临界3种情况。对2组拔牙与否判断的一致性进行统计分析和比较。结果以6人拔牙与否判断的结果完全一致为标准,第1组中,拔牙,不拔牙、临界的例数分别为3例、1例、5例,符合率分别为7.50%、2.50%、12.50%,总体符合率为22.50%。第2组中,拔牙、不拔牙、临界的例数分别为17例、8例、1例,符合率分别为42.50%、20.00%、2.50%,总体符合率为65.00%。选择配对设计Wilcoxon符号秩检验,对第1组和第2组各40个病例的临界偏离度进行差异性分析,检验结果表明Z值为-0.756(P<0.001),说明第2组对于拔牙与否判断的一致性要显著高于第1组。结论在正畸病例治疗方案设计中辅助数字化排牙试验,可以对拔牙与否提供有益参考。

Objective To discuss the application of three-dimensional digital technology in diagnostic set-up of orthodontic cases.Methods 40 orthodontic first-visit cases with complete information were selected as the research samples. The therapeutic regimens were designed by 6 orthodontists according to the impression models,X-ray examinations,facial and oral pictures and analysis of traditional routine data measurement. Additionally,the three-dimensional digital technology,as an aiding method,was applied in the second group. Results of the therapeutic regimens were divided into tooth extraction,non-extraction and boardline cases. Statistical analysis was applied to compare the results consistency of tooth extraction situation between the two groups. Results With a standard of completely consistent results of 6 orthodontists,tooth extraction,non-extraction and boardline cases of the first group were respectively3,1,5,the consistency rates were 7.50%,2.50% and 12.50%,respectively with 22.50% general coincidence rate,while in the second group,there were respectively 17,8,1 cases of tooth extraction,non-extraction and boardline,the consistency rates were 42.50%,20.00% and 2.50%,respectively with 65.00% general coincidence rate. The paired design was performed and the data were analyzed with Wilcoxon rank test. The coincidence rates of extraction and non-extraction of the second group were higher than the first one,while the coincidence rate of boardline cases was lower,and the differences were significant based on the statistical analysis(Z =-0.756,P<0.001). Conclusions It can offer beneficial reference for tooth extraction or non-extraction by aiding three-dimensional digital technology into the design of orthodontic therapeutic regimens.