成年拔牙患者隐形矫治牙齿移动效率的三维测量分析

The clinical evaluation of clear aligners in tooth movements efficiency with first premolar extraction treatment in adults

目的:通过数字化模型三维重叠测量分析,观测成年拔牙患者采用隐形矫治前后的牙齿距离和角度的变化,探讨隐形矫治对该类患者牙齿的移动效率。方法:选取32名拔牙矫治的安氏Ⅰ类成年患者,采用隐适美G6治疗方案进行矫治,收集患者治疗初始、预期矫治结果和实际矫治结果的数字化模型,导入3D Slicer软件进行模型重叠,对比观测上下颌切牙和尖牙预期和实际的三维方向上距离和角度的变化情况。结果:上下前牙在三维方向的实际位移距离均显著小于矫治设计的目标位移距离,上下切牙转矩角和上下尖牙轴倾角的预计目标改变角度明显小于实际改变角度,除上述角度之外的轴倾角、转矩角和旋转角的实际改变角度明显小于目标改变角度。结论:成年拔牙患者隐形矫治,上下前牙三维方向上实际移动距离均不足,且切牙更易舌倾,尖牙更易远中倾斜。

Objective:To evaluate the efficiency of distance and angles of tooth movements in adults treated with clear aligners by superimposing the digital modes.Methods:Thirty-two ClassⅠadults with 4 first premolar extraction were included in this study,and each patient was treated with Invisalign G6 system.Initially,predicted treatment and actual treatment digital models were collected,imported into 3D Slicer software,superimposed the modes,and compared the predicted with the actual changes of distances and angles of upper and lower incisors and canines.Results:Actual changes of distance of all the incisors and canines were much less than predicted changes of distance.The predicted changes of torque angles of upper and lower incisors,and axial inclinations of upper and lower canines were much less than the actual ones.Actual changes of other torque angle,axial inclination and rotation angle were much less than predicted changes.Conclusions:In the adults treated with clear aligners after extraction,actual distances of three-dimensional movements of upper and lower anterior teeth are not enough,the incisors become more lingually inclined,and the canines become more distally inclined.