自锁托槽和传统结扎托槽对拔牙矫治效果的比较

Comparison of Extraction Treatment Outcome between Self-ligating and Conventional Brackets

目的使用自锁托槽和传统结扎托槽进行拔牙矫治,比较两种托槽治疗前后磨牙支抗丧失和上切牙位置变化的情况,评价两种托槽系统的临床效果。方法选择52例需要拔除4个第一双尖牙矫治的病例,分为传统结扎托槽组(CB组)25例和自锁托槽组(SLB组)27例。在治疗前后头颅侧位定位片上分别测量、比较矢状向第一磨牙前移量、上颌中切牙内收量,垂直向上颌第一磨牙和上颌中切牙位置的变化及上颌中切牙冠转矩的变化。采用t检验进行统计学分析。结果CB组和SLB组矢状向上颌第一磨牙前移量分别为(2.90±1.58),(2.26±0.92)mm;矢状向上颌中切牙内收量分别为(2.99±1.44),(3.45±1.88)mm;垂直向上颌第一磨牙移动量伸长分别为(0.18±0.94),(0.49±1.38)mm;垂直向上颌中切牙移动量伸长分别为(0.17±1.56),(0.64±1.24)mm;上颌中切牙冠转矩变化舌倾分别为(4.76±3.93)°,(4.62±2.15)°。两组病例所有测量项目治疗前后的变化比较,差别无统计学意义(P>0.05)。结论使用传统结扎托槽和自锁托槽进行拔除上颌第一双尖牙矫治后,无论时矢状向还是垂直向的磨牙支抗保护和前牙内收效果差别均无统计学意义,低摩擦力的自锁托槽并不能获得更好的临床效果。

Objective To compare the differences of the molar anchorage loss and the changes of the maxillary incisors position among the extraction orthodontic patients treated by self-ligating brackets(SLBs)and conventional brackets(CBs)in order to evaluate the different clinical efficiency.Methods Fifty-two cases requiring extraction of 4 first premolars were divided into two groups according to the brackets ligation type.The traditional ligation bracket group(CB group)had 25 patients and the self-ligating bracket group(SLB group)contained 27 patients.Before and after treatment,lateral cephalograms were traced and analyzed to obtain the sagittal and vertical changes of the maxillary first molar and central incisor.Statistical comparisons were performed with Student's t-tests.Results Before and after treatment,there was no statistically significant difference in the maxillary first moral and central incisor movement between the two groups.The mean sagittal change of the maxillary first molar was(2.90±1.58)mm and(2.26±0.92)mm,respectively,in the SLB group and the CB group.The maxillary central incisor sagittal retraction in the CB group was(2.99±1.44)mm versus(3.45±1.88)mm in the SLB group.In the vertical plane,maxillary molars extruded(0.18±0.94)mm in the CB group and intruded(0.49±1.38)mm in the SLB group.The mean vertical extrusion of the upper incisor was(0.17±1.56)mm and(0.64±1.24)mm for the CB group and SLB group,respectively.As for the inclination of the incisor,tipping was(4.76±3.93)and(4.62±2.15)in the CB group and SLB group,respectively.There was no statistically significant difference between the changes of all measurement items before and after treatment in the two groups of cases(P>0.05).Conclusion The maxillary morals anchorage loss in sagittal and vertical plant were not influenced by the type of bracket used.There was no difference in the upper incisor movement between the CB group and SLB group.The self-ligating brackets system do not achieve better clinical results.