双牙合板式透明矫治器作用力值的测量及其影响因素分析

doi:10.13591/j.cnki.kqyx.2023.10.006

摘要/Abstract

摘要：

目的建立一种用于双牙合板式矫治器作用力值测量的新方法,测量双牙合板式透明矫治器产生的作用力值,并探究其影响因素。方法初期纳入使用双牙合板式透明矫治器进行矫治的骨性Ⅱ类患者,利用薄膜压力测试仪分别测量左右两侧的作用力值。通过Pearson相关性分析确定作用力值的影响因素,利用多重线性回归模型建立作用力值的回归方程。后期纳入新样本,验证回归模型的准确性。结果基于初期纳入的15例样本,前导量2.6~7.4 mm范围内,双牙合板式透明矫治器单侧作用力值为(2.51±0.51)N,与前导量呈正相关,与咬合打开量呈负相关。生成作用力值的多重线性回归模型Y= 0.963+0.319X(X为前导量)。经后期新纳入8例样本检验,预测力值与实测力值间一致性较好(ICC=0.79)。结论本研究首次建立了一种双牙合板式矫治器作用力值的测量方法,为其生物力学研究提供了新的手段,也为临床工作中记录该力值提供了工具;初步报道了双牙合板式透明矫治器的作用力值、影响因素,并建立了作用力值预测模型,为后续研究奠定了基础。

关键词: 生物力学, 无托槽隐形矫治, A6矫治器, 双牙合板矫治器, 下颌前导

Abstract:

Objective To report a novel approach to measuring the working force of twin-block like mandibular advancement appliance, measure the working force exerted by twin-block like clear aligner (A6, Angelalign) and explore its influencing factors. Methods Bilateral working force was measured by a portable pressure test system in patients with skeletal Class Ⅱ malocclusion treated with A6 appliance. Pearson correlation analysis was used to explore the influencing factors. Multiple linear regression was used to establish the prediction model of A6 working force. The prediction model was tested on a new sample of 8 patients who met the inclusion criteria. Results The working force exerted by the A6 appliance was (2.51±0.51)N unilaterally of 15 patients involved in this study, with sagittal advancement range from 2.6 to 7.4 mm. Pearson correlation analysis showed it was positively correlated with sagittal advancement (SA) and negatively correlated with vertical opening (VO). Multiple linear regression model for A6 working force was Y= 0.963+0.319X (X represents SA). The predicted working force was consistent with the real working force in 8 new participants (ICC=0.79). Conclusion This study for the first time established a novel method to measure the working force of twin-block like appliances, providing a tool for further research on the mechanobiology of twin-block like appliances and for orthodontists to record the force value in clinical work. The working force of A6 appliance and its influencing factors are preliminarily reported, and a prediction model is established, which paves the way for further research.

Key words: biomechanics, clear aligner therapy, A6 appliance, twin-block, mandibular advancement

中图分类号:

R783.5

周佳琦, 吴栋, 吴樱仪, 周力, 李宇. 双牙合板式透明矫治器作用力值的测量及其影响因素分析[J]. 口腔医学, 2023, 43(10): 894-898.

ZHOU Jiaqi, WU Dong, WU Yingyi, ZHOU Li, LI Yu. Measurement of the working force exerted by twin-block like clear aligners and analyses of its influencing factors[J]. Stomatology, 2023, 43(10): 894-898.

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参考文献 21

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患者序号	性别	年龄/岁	∠SN-MP/(°)	SA/mm	VO/mm	作用力值 /N	左侧作用力值 /N	右侧作用力值 /N
1	女	10	35.5	5.40	6.20	2.68	2.57	2.80
2	男	11	39.7	5.40	6.20	2.86	2.51	3.20
3	女	9	43.8	5.80	7.10	2.78	2.87	2.70
4	男	12	30.9	4.40	5.30	2.37	2.47	2.27
5	女	24	32.5	2.60	8.30	1.98	2.07	1.90
6	女	14	41.4	6.70	5.90	3.17	2.93	3.40
7	男	12	25.9	7.40	6.00	3.10	3.10	3.10
8	男	12	37.6	2.70	7.10	1.68	1.74	1.61
9	男	11	25.9	5.80	5.80	2.70	2.80	2.60
10	女	9	37.1	4.80	5.50	2.18	2.03	2.33
11	女	14	35.0	3.90	4.90	2.61	2.63	2.58
12	女	8	36.6	4.20	5.00	2.33	2.67	2.00
13	女	8	31.9	5.90	2.80	3.35	3.27	3.43
14	女	23	26.7	3.60	7.60	2.08	2.30	1.87
15	男	10	29.9	4.10	6.30	1.73	1.97	1.50

性别	例数	作用力值/N
男	6	2.40±0.59
女	9	2.57±0.48
t		-0.602
P		0.557

因素	测量值	r	P
SA/mm	4.85±1.38	0.859	<0.001
VO/mm	6.07±1.14	-0.521	0.046
∠SN-MP/(°)	34.03±5.56	0.122	0.664
年龄/岁	12.47±4.86	-0.325	0.237

模型	未标准化系数		标准化系数	t	P
模型	B	标准误	β	t	P
常数	0.963	0.265		3.635	0.003^*
SA	0.319	0.053	0.859	6.050	<0.001^*
VO				-1.315	0.213

患者序号	实测作用力值/N	预测作用力值/N
1	3.15	2.95
2	2.43	2.60
3	2.93	2.82
4	2.65	2.76
5	2.41	2.60
6	2.65	2.38
7	2.10	2.25
8	2.42	2.13
ICC	0.79