隐形矫治与固定矫治在成人拔牙正畸治疗中前牙区牙齿变化情况比较

Comparison of bracket-free invisible appliance and fixed appliances in the anterior region of orthodontic extraction cases assessed by CBCT

目的比较无托槽隐形矫治器和固定矫治器在成人拔牙正畸治疗中前牙区的变化情况,对比不同矫治器对前牙牙根的控制情况。方法选取2017年6月至2018年6月于保定市第二医院口腔科就诊的安式Ⅱ类Ⅰ分类正畸拔牙患者40例,年龄18~30岁。将40例患者按照患者意愿分为无托槽隐形矫治器组和固定矫治器组(每组20例),并设计种植钉增强支抗。应用CBCT测量上下前牙到Y轴的距离(U1-Y、L1-Y、Y1、Y2)即矢状距离,到X轴的距离(U1-X、L1-X、X1、X2)即垂直距离,上下前牙长轴与Y轴所成角度(∠1、∠2)及上下中切牙、上下侧切牙牙轴长度(V1、V2、V3、V4)的变化情况。结果矫治前,无托槽隐形矫治组与固定矫治器组各指标差异均无统计学意义(P>0.05)。无托槽隐形矫治组矫治前后各指标差异有统计学意义(P<0.01)。固定矫治器组矫治前后各指标数据差异有统计学意义(P<0.01)。矫治后,无托槽隐形矫治组与固定矫治器组Y1、Y2、V1、V3、∠1、∠2差异有统计学意义(P<0.05)。结论隐形矫治更利于保护前牙牙根,并且更有利于前牙控根移动。

Objective To study the root changes of bracket-free invisible appliance and fixed appliance by CBCT in adult orthodontic tooth extraction cases,and compare the control of different appliances on the root of anterior teeth.Methods Forty tooth extraction patients with ClassⅡdivisionⅠmalocclusion,aged 18-30 years,in our hospital from June 2017 to June 2018 were selected and divided into invisible appliance group and fixed appliance group(n=20 in each group),and implant nails were designed to strengthen anchorage.The changes of sagittal distance(U1-Y,L1-Y,Y1,Y2),vertical distance(U1-X,L1-X,X1,X2),angle between upper and lower anterior teeth and Y axis(∠1,∠2),upper central incisor,upper lateral incisor,lower central incisor and lower lateral incisor were measured by CBCT.Results There was no significant difference between the bracket-free invisible orthodontic group and the fixed appliance group before treatment(P>0.05).The data of each index in the bracket-free invisible group before and after treatment had statistical significance(P<0.01).The data of each index in the fixed appliance group before and after treatment had statistical significance(P<0.01).Comparison of the two groups after treatment showed significant differences in Y1,Y2,V1,V3,∠1 and∠2.Conclusion Compared with the fixed appliance group,the invisible appliance is more conducive protecting the root of the anterior teeth and controlling the root movement of the anterior teeth.