无托槽隐形矫治器掩饰治疗成人骨性Ⅲ类错𬌗的牙根吸收研究

doi:10.13591/j.cnki.kqyx.2024.11.009

摘要/Abstract

摘要：

目的通过CBCT图像的测量分析,比较固定矫治器与无托槽隐形矫治器在掩饰性治疗成人骨性Ⅲ类错𬌗后牙根的吸收状况。方法回顾性选取了32例曾接受掩饰性治疗的骨性Ⅲ类错𬌗患者,根据其所使用的矫治器类型,分为固定矫治器组和无托槽隐形矫治器组,每组各16例。收集患者治疗前后的全牙列CBCT影像,并使用Mimics软件对下颌中切牙、第一前磨牙及第一磨牙进行三维重建,测量并比较两组患者治疗前后下颌牙根体积和长度的变化。结果正畸治疗后2组患者所测牙位牙根体积均显著减少(P<0.05),隐形矫治组下颌中切牙牙根长度平均减小(0.52±0.60)mm,固定矫治组下颌中切牙及第一前磨牙牙根长度分别减小(0.47±0.38)mm与(0.38±0.25)mm,差异均具有统计学意义(P<0.05)。2组间比较,除隐形矫治器组下颌中切牙体积减小量明显低于固定矫治器组外(P<0.05),其余牙根吸收相关指标2组差异均无统计学差异(P>0.05)。结论成人骨性Ⅲ类患者掩饰性治疗中,隐形矫治器较固定矫治器能在一定程度上减少下切牙的牙根吸收量,但在后牙区两者无明显差异。

关键词: 无托槽隐形矫治器, 固定矫治器, 牙根吸收, CBCT

Abstract:

Objective To compare the root resorption of posterior teeth between fixed orthodontic appliances and clear aligners in adult patients with skeletal Class Ⅲ malocclusion undergoing camouflage treatment by using cone-beam computed tomography(CBCT) measurements. Methods Thirty-two cases of skeletal Class Ⅲ malocclusion patients who had previously undergone camouflage treatment were retrospectively selected. Based on the type of orthodontic appliance used, they were divided into two groups (the fixed appliance group and the clear aligner group), each comprising 16 cases. CBCT images of the entire dental arch before and after treatment were collected for these patients, and three-dimensional reconstructions of the mandibular central incisors, first premolars, and first molars were generated using Mimics software. Changes in root volume and length of mandibular teeth before and after treatment were measured and compared between the two groups. Results Both groups showed significant reductions in measured root volume of the teeth after orthodontic treatment(P<0.05). In the clear aligner group, the mean reduction in root length of mandibular central incisors was (0.52±0.60)mm, while in the fixed appliance group, the reduction in root length of mandibular central incisors and first premolars was (0.47±0.38)mm and (0.38±0.25)mm, respectively. These differences were statistically significant(P<0.05). Except for the significantly lower reduction in root volume of mandibular central incisors in the clear aligner group compared to the fixed appliance group(P<0.05), there were no statistically significant differences in other root resorption-related parameters between the two groups(P>0.05). Conclusion In camouflage treatment of adult skeletal Class Ⅲ malocclusion patients, clear aligners can reduce the amount of root resorption in mandibular anterior teeth to a certain extent compared to fixed orthodontic appliances. However, there is no significant difference between the two appliances in the posterior teeth region.

Key words: clear aligner, fixed bracket, root resorption, CBCT

中图分类号:

R783.5

熊再道, 张燕萍, 顾永春, 周志浩. 无托槽隐形矫治器掩饰治疗成人骨性Ⅲ类错𬌗的牙根吸收研究[J]. 口腔医学, 2024, 44(11): 847-580.

XIONG Zaidao, ZHANG Yanping, GU Yongchun, ZHOU Zhihao. Study on root resorption after camouflage treatment of adult skeletal Class Ⅲ malocclusion with clear aligner[J]. Stomatology, 2024, 44(11): 847-580.

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测量指标	隐形组(n=16)		t	P	固定组(n=16)		t	P
测量指标	T0	T1	t	P	T0	T1	t	P
体积/mm³
L1	147.98±9.04	132.74±7.42	7.795	<0.001^***	149.16±6.85	129.99±12.77	8.257	<0.001^***
L4	192.29±20.35	180.30±13.22	3.048	0.014^*	183.46±17.75	167.82±15.14	3.376	0.008^**
L6	368.52±11.85	347.45±18.59	4.071	0.003^**	384.41±11.78	363.79±15.16	3.344	0.009^**
长度/mm
L1	21.81±0.86	21.28±1.18	2.728	0.023^*	20.77±0.78	20.30±1.12	3.937	0.003^**
L4	19.88±1.01	19.70±0.91	1.516	0.164	20.13±0.24	19.75±0.33	2.945	0.004^**
L6M	19.56±0.54	19.25±0.54	1.805	0.104	19.22±0.82	19.11±0.74	0.974	0.356
L6D	19.54±1.11	19.36±0.80	0.522	0.615	19.63±0.93	19.44±1.19	1.212	0.256

测量指标	隐形组(n=16)	固定组(n=16)	t	P
体积/mm³
L1	15.24±4.34	19.16±5.18	-1.834	0.042^*
L4	11.98±8.44	16.63±7.70	-1.564	0.068
L6	21.08±16.37	20.63±19.50	0.045	0.965
F	1.117	0.746
P	0.342	0.484
长度/mm
L1	0.52±0.60	0.47±0.38	0.349	0.735
L4	0.17±0.31	0.38±0.25	-1.667	0.056
L6M	0.31±0.44	0.19±0.30	0.517	0.618
L6D	0.18±0.23	0.11±0.18	0.883	0.400
F	1.182	2.162
P	0.322	0.135