无托槽隐形矫治器远移上下磨牙矫治恒牙早期牙列拥挤的疗效分析

Efficacy of clear aligners in treating crowded dentition in early permanent teeth by moving the upper and lower molars far

目的评价无托槽隐形矫治器远移上下颌磨牙矫治恒牙早期牙列拥挤的临床效果。方法选择恒牙早期安氏Ⅰ类中度拥挤病例36例,其中男性17例,女性19例,年龄(13.20±0.53)岁。采取无托槽隐形矫治器推上下颌磨牙向后获取间隙排齐整平牙列。测量治疗前后头颅侧位X线片,采用配对t检验比较治疗前后各项头影测量数值。结果36例患者平均疗程为21.2个月。治疗后均获得良好的覆(牙合)、覆盖及中性磨牙(牙合)关系,上下颌牙列整齐,软组织侧貌得到维持。相关头影测量项目分析显示:治疗后Ptm-U6距减小(2.89±1.22)mm、Go-L6距减小(2.61±1.07)mm,差异均有统计学意义(P<0.01),而UL-EP、LL-EP、NLA、FCA矫治前后差异均无统计学意义。结论在治疗目标位设置合理以及良好的牙齿移动设计的情况下,无托槽隐形矫治器能有效远移上下磨牙获取间隙矫治恒牙早期中度拥挤病例,并维持了患者侧貌形态。

Objective To evaluate the clinical efficacy of clear aligner for crowded dentition in early permanent teeth by moving the upper and lower molars far.Methods A total of 36 adolescent patients with ClassⅠAngle malocclusion admitted in our department from March 2017 to August 2023 were enrolled,and they were 17 males and 19 females,and at a mean age of 13.20±0.53 years.Clear aligner was applied to push the upper and lower molars backward to obtain a neat dentition.Lateral cephalometric X-ray film before and after treatment was measured,and paired t-test was used to compare the cephalometric measurements before and after treatment.Results The average course of treatment was 21.2 months.Overbite,overjet and molar relationship were turned to normal after treatment,and the soft tissue profile was maintained.Analysis of relevant cephalometric items showed that the Ptm-U6 distance was decreased by 2.89±1.22 mm,and the Go-L6 distance was decreased by 2.61±1.07 mm after treatment,with significant differences(P<0.01).While,there were no statistically differences in UL-EP,LL-EP,NLA and FCA before and after treatment.Conclusion With reasonable treatment target and good tooth movement design,clear aligner can effectively move the upper and lower molar distally to correct moderate dentition congestion in early permanent teeth,and meanwhile the patients’profile is maintained.