无托槽隐形矫治下前牙压低过矫治的回归分析研究

doi:10.13591/j.cnki.kqyx.2024.05.002

摘要/Abstract

摘要：

目的通过分析下前牙压低的最终实现值与方案预设值之间的关系,探究一种过矫治计算方法以及相关影响因素。方法纳入20例采用隐适美隐形矫治器压低下前牙的患者。将ClinCheck方案中的相对压低值记为压低预设值,经数字化模型重叠技术测得压低实现值。评估实现值与预设值的差异和关系,分析压低量等因素对压低效率的影响。结果下前牙压低的平均效率约为62.2%,中切牙效率最高,尖牙最低。压低量、下切牙唇倾度和下尖牙区附件类型均影响压低效率。压低预设值与实现值之间差异显著,存在线性关系。下前牙压低过矫治量计算公式为Z=(W-0.110)/0.533-W(Z为过矫治量,W为期望压低量)。结论矫治方案中的下前牙预设压低量不能完全实现,对于设计下尖牙压低,或压低量大,或初始位下切牙舌倾的病例应设计更多过矫治。与优化附件相比,下尖牙设计垂直矩形附件更有利于提高压低效率。

关键词: 无托槽隐形矫治, 前牙压低, 效率, 线性回归, 过矫治

Abstract:

Objective To explore an overcorrection quantization method and related influencing factors through analyzing relationships between the achieved and preset intrusion values of mandibular anterior teeth with clear aligners. Methods Twenty patients receiving Invisalign were recruited. The relative intrusion values in the ClinCheck software were recorded as the preset intrusion. The achieved intrusion values were measured through the digital model superimposition. Statistical analysis was conducted to assess the differences and linear relationships between the preset and achieved intrusion values, and investigate the effect of related factors such as intrusion amounts on the intrusion efficiency. Results For the mandibular anterior teeth, the mean intrusion efficiency was 62.2%, with the highest in the central incisors and the lowest in the canines. The intrusion amounts, incisors labial inclinations, and canine attachment types affected the intrusion efficiency. The differences between the preset and achieved values were significant, and the linear relationship existed. The formula of the intrusion overcorrection for the mandibular anterior teeth is “Z=(W-0.110)/0.533-W”. Z represents the overcorrection and W represents the ideal intrusion. Conclusion The preset intrusion values in the treatment protocol could not be fully achieved. Moreover, correction should be designed in cases of mandibular canine intrusion, large amountsof intrusion, orlingually inclined incisors. Compared to the optimized attachments, the vertical rectangular attachments on the mandibular canines could improve the efficiency.

Key words: clear aligners, anterior teeth intrusion, efficiency, linear regression, overcorrection

中图分类号:

R783.5

黄钖钖, 王诗语, 刘浩, 杨丽, 王鹏来, 袁长永. 无托槽隐形矫治下前牙压低过矫治的回归分析研究[J]. 口腔医学, 2024, 44(5): 329-333.

HUANG Yangyang, WANG Shiyu, LIU Hao, YANG Li, WANG Penglai, YUAN Changyong. A regression analysis of the overcorrection for the mandibular anterior teeth in trusion with clear aligners[J]. Stomatology, 2024, 44(5): 329-333.

图/表 9

图1

图2

图3

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表1

表2

压低实现值与预设值的相关与线性回归分析"

牙位	$r$	P₂	R²	F	P₃	过矫治量
下前牙	0.921	<0.01^**	0.849	661.178	<0.01^**	Z=(W-0.110)/0.533-W
下中切牙	0.930	<0.01^**	0.865	243.042	<0.01^**	Z=(W-0.108)/0.561-W
下侧切牙	0.909	<0.01^**	0.826	180.532	<0.01^**	Z=(W-0.165)/0.512-W
下尖牙	0.940	<0.01^**	0.884	290.148	<0.01^**	Z=(W-0.063)/0.525-W

表2

图6

表3

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牙位	n	预设值/mm	实现值/mm	差值/mm	t	P₁	效率/%
下前牙	120	1.602±0.728	0.965±0.422	0.637±0.377	18.494	<0.01^**	62.2±11.6
下中切牙	40	1.578±0.726	0.994±0.438	0.584±0.357	10.343	<0.01^**	64.9±11.3
下侧切牙	40	1.650±0.731	1.010±0.412	0.641±0.396	10.229	<0.01^**	64.0±12.2
下尖牙	40	1.578±0.743	0.891±0.415	0.687±0.380	11.423	<0.01^**	57.7±10.2

指标	n	β	SE	95%CI	P
压低量		-0.059	0.013	(-0.086,-0.032)	<0.010^**
下颌平面角		0.002	0.003	(-0.003,0.007)	0.480
下切牙唇倾度		0.005	0.002	(0.001,0.009)	0.019^*
尖牙区附件类型
优化旋转	13	Ref.
优化控根	13	-0.007	0.023	(-0.054,0.039)	0.761
垂直矩形	14	0.049	0.023	(0.004,0.094)	0.034^*