无托槽隐形矫治技术远移磨牙治疗上前牙轻、中度拥挤的效果

The clinical effects of Invisalign-aided molar distalization in the treatment of mild or moderate crowding in anterior teeth

目的评价无托槽隐形矫治技术远移磨牙治疗上前牙轻、中度拥挤的临床效果。方法选择11例骨性Ⅰ类安氏Ⅱ类错成年患者,磨牙远中关系不超过尖对尖。上颌前牙轻度至中度拥挤,下颌正常或轻度拥挤,侧貌为直面型。采用无托槽隐形矫治器配合Ⅱ类牵引推磨牙向远中非拔牙矫治。测量患者治疗前后的模型和头颅侧位片,配对t检验比较分析测量所得的数据。结果治疗后11例患者的上下牙列排齐,磨牙关系中性。头影测量数据显示,与治疗前相比,治疗后上颌第一磨牙牙冠平均远中移动2.32mm(t=3.315,P<0.01),磨牙长轴远中倾斜度增加3.83°(t=3.959,P<0.01),上中切牙牙轴唇倾度增加1.72°(t=3.274,P<0.01),差异有统计学意义。模型测量数据显示,与治疗前相比,治疗后上颌第一磨牙平均颊向移动1.43mm(t=2.461,P<0.05),差异有统计学意义。结论无托槽隐形矫治器配合Ⅱ类牵引可实现上颌磨牙的远中移动,纠正远中磨牙咬合的同时,排齐轻中度拥挤的上前牙。

Objective The present study evaluated the clinical effects of Invisalign.aided molar distalization in thetreatment of mild or moderate crowding in anterior teeth. Methods Eleven adults with class Ⅱ dental malocclusion anda class Ⅰ skeletal pattern were selected as subjects. The patients.. molar occlusion did not exhibit an end.to.end relation.ship. Subjects were selected for straight profile, mild or moderate crowding in maxillary teeth and normal or mild crowd.ing in mandibular teeth. Nonextraction and Invisalign.aided molar distalization were planned for treatment. Model mea.surement and cephalometric analysis were performed before and after treatment. A paired t test was used for the statisticalanalysis. Results The crowding and class Ⅱ molar relationship were corrected in all 11 patients. The upper first molarswere moved distally by 2.32 mm （t = 3.315, P 〈 0.01） and were inclined distally by 3.35° （t = 3.959, P 〈 0.01） on average.The central incisors were protruded by 1.72 ° （t = 3.274, P 〈 0.01） on average. The buccal movement of the upper first mo.lars was 1.32 mm （t = 2.461, P 〈 0.05） on average. The above differences were statistically significant. Conclusion Up.per molar distalization can be achieved using a class Ⅱ elastic.aided Invisalign technique. The end.to.end molar occlu.sion can be corrected, and front teeth with mild or moderate crowding can be aligned using our treatment protocol.