无托槽隐形矫治器与自锁托槽对牙列拥挤患者临床疗效的对比研究

A Comparative Study on the Clinical Effect of Bracketless Invisible Appliance and Self-ligating Bracket on Crowded Dentition Patients

目的:对比无托槽隐形矫治器与自锁托槽对牙列拥挤患者的临床疗效。方法:选择2017年12月-2018年6月于笔者医院口腔科就诊的110例牙列拥挤患者为研究对象,以随机数字表法分为隐形组(55例)和自锁组(55例)。自锁组接受Damon Q自锁托槽矫治器正畸治疗,隐形组接受Invisalign隐形矫治器正畸治疗,两组均随访24个月。观察两组矫治前、矫治3、6、9、12、18、24个月后的牙髓电活力(EPT)值,比较两组矫治前、矫治24个月后的头影测量指标及牙周指标。结果:矫治前、矫治3、6、9、12、18、24个月后,两组EPT值依次升高,且隐形组高于自锁组,差异有统计学意义(P<0.05);矫治24个月后,两组SNA、SNB、U1-NA、U1-NA距、ULP、N'-Sn-Pg'均较矫治前降低,且隐形组低于自锁组(P<0.05);U1-FH、OP-FH、U1-L1、Cm-Sn-Ls、SnLs-SiL、Li-E、Ls-E均较矫治前升高,且隐形组高于自锁组(P<0.05)。矫治24个月后,两组PD、PLI、BI水平较矫治前升高,但隐形组低于自锁组(P<0.05)。结论:相较于自锁托槽矫治器而言,Invisalign隐形矫治器可有效改善牙列拥挤患者牙髓组织活力及头影测量指标,进而维护患者牙周健康,提高临床矫治效果。

Objective To compare the clinical effect of bracketless invisible appliance and self-ligating bracket on crowded dentition patients.Methods 110 patients with crowded dentition who visited the department of stomatology of our hospital from December 2017 to June 2018 were selected as the research objects,and they were divided into the invisible group(55 cases)and the self-locking group(55 cases)by random number table method.The self-locking group received Damon Q self-locking bracket appliance for orthodontic treatment,and the invisible group received Invisalign invisible appliance for orthodontic treatment.Both groups were followed up for 24 months.The electrical activity of dental pulp(EPT)before and 3,6,9,12,18 and 24 months after treatment was observed,and the cephalometric indexses and periodontal clinical indexses before and 24 months after treatment were compared between the two groups.Results Before treatment,3,6,9,12,18,24 months after treatment,the EPT value of the two groups increased in turn,and the value of the invisible group was higher than that of the self-locking group(P<0.05).After 24 months of treatment,SNA,SNB,U1-NA,U1-NA distance,ULP,N’-Sn-PG’of the two groups decreased compared with those before treatment,and the invisible group was lower than those of the self-locking group(P<0.05).U1-FH,OP-FH,U1-L1,Cm-Sn-Ls,SnLs-SiL,Li-E,Ls-E were all higher than those before treatment,and they were higher in invisible group than in self-locking group(P<0.05).After 24 months of treatment,the levels of PD,PLI and BI in the two groups were higher than those before treatment,but the levels in the invisible group were lower than those in the self-locking group(P<0.05).Conclusion Compared with self-ligating bracket appliance,Invisalign invisible could effectively improve the vitality of dental pulp tissue and cephalometric indexses of patients with crowded dentition,maintain the periodontal health of patients and improve the clinical treatment effect.