无托槽隐形矫治技术在成人骨性Ⅱ类拔牙中的临床应用

Clinical Application of Invisible Orthodontic System for Adult Skeletal Class Ⅱ Malocclusion with Extraction

目的:应用无托槽隐形矫治技术治疗成人骨性Ⅱ类拔牙病例,通过头影测量分析对比治疗前后的软硬组织变化,以期为临床提供参考。方法:选择8名骨性Ⅱ类错牙合患者,所有患者均拔除2～4颗前磨牙,应用无托槽隐形矫治技术进行正畸治疗,选择15项测量指标进行头影测量分析,评价治疗前后软硬组织的变化。结果:经过28～36个月的正畸治疗,所有患者的上下前牙内收,拔牙间隙关闭,前牙覆牙合、覆盖正常,后牙咬合关系良好,面凸度减小,面型改善明显。治疗后U1-SN、L1-MP、Ls-E、Li-E减小;U1-L1、CmSnLs、A’Ls-FH、B’Li-FH、Li B’Pg增大,差异有统计学意义(P<0.05)。结论:对于成人骨性Ⅱ类错牙合,无托槽隐形矫治技术可以通过上前牙的回收及代偿舌倾,改善软组织侧貌,无托槽隐形矫治技术的优势在于其个性化和数字化,但在支抗控制、前牙转矩及牙齿整体移动方面还有待改善。

Objective To treat the adult skeletal class Ⅱmalocclusion with extraction with invisible aligners, and evaluate the treatment effects through cephalometric ananlysis. Methods The sample included 8 adults skeletal class Ⅱmalocclusion who were extracted 2-4 premolors,15 hard and soft tissue variables were measured and compared cephalometricly. Results All the 8 patients completed orthodontic treatment with satisfying outcomes, presenting straight teeth, closed space, normal overbite and over jet and good molar relationship. The treatment span was 28-36 months.Signifcant differences were found in U1-SN,L1-MP,Ls-E,Li-E,U1-L1,CmSnLs,A’Ls-FH,B’Li-FH,LiB’Pg（P〈0.05）. Conclusion The invisible orthodontic system can improve soft tissue profle through anterior teeeth rocovery.Its advantagesare person alization and digitization,but it need to be improved in anchorage control ,anterior tooth torque and overall movement.