上海口腔医学 ›› 2022, Vol. 31 ›› Issue (2): 193-197.doi: 10.19439/j.sjos.2022.02.015

• 论著 • 上一篇    下一篇

微种植钉辅助无托槽隐形矫治器控制“过山车”效应的疗效分析

马晓晴, 项飞, 樊明月, 宋怡, 王晓慧, 张玲, 钱文昊   

  1. 上海市徐汇区牙病防治所,上海 200032
  • 收稿日期:2020-12-04 修回日期:2021-01-18 出版日期:2022-04-25 发布日期:2022-05-16
  • 通讯作者: 钱文昊,E-mail: pingyanlaoto@163.com
  • 作者简介:马晓晴(1978-),男,硕士,副主任医师,E-mail: mxq780927@163.com
  • 基金资助:
    2017年徐汇区医学尖峰学科(SHXH201706); 上海市医学重点专科(ZK2019B12); 徐汇区医学科研项目(SHXH201915)

Clinical efficacy of the combination of miniscrew with clear aligner in controlling the roller coaster effect

MA Xiao-qing, XIANG Fei, FAN Ming-yue, SONG Yi, WANG Xiao-hui, ZHANG Ling, QIAN Wen-hao   

  1. Shanghai Xuhui District Dental Center. Shanghai 200032, China
  • Received:2020-12-04 Revised:2021-01-18 Online:2022-04-25 Published:2022-05-16

摘要: 目的: 探讨微种植钉辅助无托槽隐形矫治器长距离内收上前牙、关闭间隙过程中控制“过山车”效应的临床疗效。方法: 选择双颌前突成人患者16例,男5例,女11例,平均年龄(25.1±2)岁。所有患者均拔除4颗第一前磨牙且采用无托槽隐形矫治器矫治,所有病例均采用G6设计,其中实验组(8例)在治疗初始即采用微种植钉进行牙的三维控制,对照组(8例)采用常规G6方案,出现明显的“过山车”效应时植入微种植钉辅助解决。采用 Graphpad Prism 6.0 软件包对治疗前、后数据及组间数据进行配对 t 检验。结果: 所有拔牙间隙均顺利关闭,面型获得明显改善。治疗中,实验组前牙转矩控制良好,未出现“过山车”效应;对照组6例在治疗中前牙明显舌倾(P<0.05),后牙开,前牙区微种植钉施加压低力后,咬合关系改善。结论: 微种植钉能有效预防、消除无托槽隐形矫治器长距离关闭间隙过程中发生的“过山车”效应。

关键词: 无托槽隐形矫治器, 双颌前突, 间隙关闭, “过山车”效应, 微种植钉

Abstract: PURPOSE: To investigate the clinical efficacy of miniscrew in controlling the roller coaster effect in long-distance space closure with clear aligner. METHODS: Sixteen adult patients with bimaxillary protrusion were selected. All cases were treated with clear aligner and their four first premolars were extracted. G6 was designed in all cases. In the experimental group, four miniscrews were inserted at the beginning of treatment to control the teeth in three dimensions; while in the control group, the miniscrews were not applied until obvious roller coaster effect appeared. Paired t test was used to analyze the data with Graphpad Prism 6.0 software package. RESULTS: All the extraction space was closed successfully and the lateral profile was improved significantly. The torque of the upper incisor was under well control and no roller coaster effect happened in the experimental group; while in the control group, the lingual inclination of the upper incisors and open bite of the posterior teeth developed(P<0.05). After the miniscrews intrusion of the upper anterior teeth, the occlusion relationship improved significantly. CONCLUSIONS: Miniscrews effectively prevents and eliminates the roller coaster effect in the process of long-distance space closure with clear aligner.

Key words: Clear aligner, Bi-maxillary protrusion, Space closure, Roller coaster effect, Miniscrew

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