正畸微种植体支抗稳定性因素的临床应用研究

Clinical Application of Anchorage Stability Factors of Orthodontic Micro Implant

目的研究口腔正畸治疗过程中,对微种植体支抗稳定性造成影响的主要因素。方法选择2019年10月-2021年10月在中国科学院大学深圳医院(光明)需要采用种植体支抗技术进行正畸治疗的患者79例,共计植入支抗钉165颗。用Fisher精确概率比较各变量成功率之间的差异(P<0.001),将10个变量(性别、年龄、垂直骨面型、植入部位、卫生情况、有无肿胀、种植体长度、植入方式、植入角度、加力方式)中有显著性差异的变量纳入Logistic回归模型计算优势比,差异有统计学意义(P<0.05)。结果165枚种植体中,成功152枚,脱落13枚,成功率92.12%。18岁以上的患者植入成功率高于18岁以下的患者(P<0.05);不同垂直骨面型对植入成功率有影响;均角型患者植入成功率较高(P<0.05);口腔卫生情况好的患者植入成功率高于口腔卫生情况差的(P<0.05);无肿胀的患者植入成功率高于有肿胀的患者(P<0.05)。性别、植入部位、种植体长度、植入方式、植入角度、加力方式等变量对成功率的影响无显著性差异(P>0.05)。年龄、垂直骨面型、卫生情况、肿胀的为种植体种植成功率的影响因素(P<0.05),经Logistic回归分析年龄、口腔卫生状况与种植成功率呈正相关,垂直骨面型、肿胀与种植成功率呈负相关。结论在临床运用过程中,需要针对不同风险因素,采取有效的应对措施,保证口腔正畸期间微种植体支抗的稳定性,达到预期的治疗效果。

Objective To study the main factors affecting the anchorage stability of microimplants during orthodontic treatment.Methods A total of 79 patients who needed implant anchorage technology for orthodontic treatment in our hospital from October 2019 to October 2021 were selected,and a total of 165 anchorage screws were implanted.Fisher's exact probability was used to compare the difference between the success rate of each variable(P<0.001),the variables with significant difference among the 10 variables(gender,age,vertical bone profile,implantation site,hygiene,swelling,implant length,implantation mode,implantation angle and force application mode)were included in the Logistic regression model analysis,and the odds ratio was calculated,and P<0.05 was considered to have a significant difference.Results Among the 165 implants,152 were successful and 13 were lost,with a success rate of 92.12%.The implantation success rate of patients over 18 years old was higher than that of patients under 18 years old(P<0.05);different vertical bone surface types had an impact on the implantation success rate;patients with equal-angle type had a higher implantation success rate(P<0.05).The implantation success rate of patients with good oral hygiene was higher than that of poor oral hygiene(P<0.05);the implantation success rate of patients without swelling was higher than that of patients with swelling(P<0.05).There was no significant difference in the effects of gender,implantation site,implant length,implantation method,implantation angle,and augmentation method on the success rate(P>0.05).Age,vertical skeletal shape,health condition,and swelling were the influencing factors of implant placement success rate(P<0.05).Logistic regression analysis showed that age,oral hygiene status and implant success rate were positively correlated.The planting success rate was negatively correlated.Conclusion In the process of clinical application,it is necessary to take effective countermeasures according to different risk factors to ensure the stability of the micro-implant anchorage during orthodontics and achieve the expected therapeutic effect.