隐形矫治联合种植修复在错(牙合)畸形伴牙列缺损患者中的临床应用效果

The clinical performance of invisible orthodontics combined with the implant in treating malocclusion patients with dentition defect

目的:探讨数字化无托槽隐形矫治(invisible bracketless technique,IBT)联合口腔种植修复技术对错(牙合)畸形伴牙列缺损患者临床疗效的影响。方法:选取2018年1月~2020年2月本院收治的136例错(牙合)畸形伴牙列缺损患者,随机分为对照组和观察组,各68例,对照组采用传统固定正畸+种植修复治疗,观察组采用IBT+种植修复治疗。比较两组患者的头影测量指标、上下颌牙弓大小、牙齿功能、菌斑指数(plaque index,PLI)、软垢指数(debris index,DI)、红白美学指数和不良结局的差异。结果:矫治完成后两组患者PLI、DI均降低,且观察组低于对照组(P<0.05);与治疗前比,观察组矫治完成1年后牙齿功能各项评分均升高,且高于对照组(P<0.05);观察组矫治完成1年后,SNA、SNB及牙弓大小改善程度优于对照组(P<0.05)。观察组修复后即刻红色美学指数(近远中龈乳头、唇侧龈缘曲线)、白色美学指数(牙冠形态、牙冠外形轮廓)等指标分值明显高于对照组(P<0.05)。修复后2年随访观察,观察组不良结局发生率明显低于对照组(P<0.05)。结论:IBT联合种植修复可使错(牙合)畸形伴牙列缺损患者获得更加理想的咬合功能,利于牙周健康,且美观度较高,不良结局发生率低,值得临床推广。

Objective:To investigate the clinical performance of invisible bracketless technique(IBT)combined with the implant in treating malocclusion patients with dentition defects.Methods:Totally 136 malocclusion patients with dentition defects admitted to our hospital from January 2018 to February 2020 were selected and randomly divided into the control and observation groups with 68 cases each.The control group was treated with traditional fixed orthodontics+implant restoration,and the observation group was treated with IBT+implant restoration.The differences in imaging indexes,tooth function,plaque index(PLI),debris index(DI),red and white aesthetic scores,and adverse outcomes between the two groups were compared.Results:After the completion of correction,the PLI and DI of both groups of patients decreased,and the observation group was lower(P<0.05).Compared with before treatment,the observation group showed an increase in various scores of tooth function one year after the completion of orthodontic treatment,which was higher than that of the control group(P<0.05).After one year of orthodontic treatment,the improvement in SNA,SNB,and arch size in the observation group were better than that in the control group(P<0.05).The observation group showed significantly higher scores of indicators such as the red aesthetic index(near and far gingival papilla,labial gingival margin curve)and white aesthetic index(crown shape,crown contour)immediately after repair compared to the control group(P<0.05).After 2 years of follow-up observation after repair,the incidence of adverse outcomes in the observation group was significantly lower(P<0.05).Conclusion:IBT combined with implant restoration can achieve more ideal occlusal function for patients with malocclusion and dentition defects,which is beneficial for periodontal health and has a higher aesthetic value.The incidence of adverse outcomes is low,and it is worthy of clinical promotion.