中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (28): 4559-4564.doi: 10.12307/2024.458

• 口腔组织构建 oral tissue construction • 上一篇    下一篇

无托槽隐形矫治技术远移磨牙对不同垂直骨面型患者垂直向控制的效果

彭  怡1，李晓龙2   

  1. 1萍乡市人民医院口腔科，江西省萍乡市  337000；2四川大学华西口腔医院正畸科，四川省成都市  610041
  • 收稿日期:2023-05-13 接受日期:2023-07-27 出版日期:2024-10-08 发布日期:2023-11-27
  • 通讯作者: 李晓龙，博士，主治医师，四川大学华西口腔医院正畸科，四川省成都市 610041
  • 作者简介:彭怡，女，1989年生，江西省萍乡市人，汉族，2014年南昌大学毕业，硕士，主治医师，主要从事口腔正畸专业的研究。
  • 基金资助:
    爱齐科研专项基金(AQKY22-2-3)，项目负责人：李晓龙

Effect of molar distalization with clear aligners on occlusal vertical dimension in different vertical craniofacial patterns

Peng Yi1, Li Xiaolong2   

  1. 1Department of Stomatology, Pingxiang People’s Hospital, Pingxiang 337000, Jiangxi Province, China; 2Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China 
  • Received:2023-05-13 Accepted:2023-07-27 Online:2024-10-08 Published:2023-11-27
  • Contact: Li Xiaolong, MD, Attending physician, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan Province, China
  • About author:Peng Yi, Master, Attending physician, Department of Stomatology, Pingxiang People’s Hospital, Pingxiang 337000, Jiangxi Province, China
  • Supported by:
    Align Technology Special Research Fund, No. AQKY22-2-3 (to LXL)

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摘要：


文题释义：

无托槽隐形矫治技术：借助激光扫描技术、层析扫描技术、工业化CT技术将常规的口腔阴模或者石膏阳模进行三维扫描和重建，结合可视化三维图像处理及激光快速成形技术，模拟临床矫治设计和牙齿的移动方式和步骤，将每个矫治阶段的三维牙颌模型进行三维快速激光成形，在成形的母模上制作每个阶段的透明压膜隐形矫治器，让患者按序戴在牙齿上，从而达到模型上牙齿排列形态的一种矫治方法。
垂直骨面型：即面部生长型，是遗传的表现型，从垂直生长方向上可分为平均生长型、水平生长型、垂直生长型。平均生长型关节窝的下降及髁突的垂直生长与上颌体及上牙槽的垂直向下的生长移动和下牙槽的向上移动生长是均衡协调的，称之为均面型。水平生长型，前面高相对小而后面高相对大，表现为短面型，有深覆合的趋势。垂直生长型，前面高的生长相对大于后面高的生长，表现为长面型，有开合的趋势。


背景：已有研究证实，无托槽隐形矫治技术能够有效实现磨牙的远中移动，但是对于远移磨牙后不同垂直骨面型患者垂直向如何变化尚未明确。

目的：探讨无托槽隐形矫治技术推磨牙向远中对不同垂直骨面型患者在垂直向上的影响。
方法：选择40例(安氏Ⅰ类13例，安氏Ⅱ类20例，安氏Ⅲ类7例)错牙合畸形患者，其中高角组13例，均角组17例，低角组10例；年龄10-53岁，平均28.5岁。应用无托槽隐形矫治技术进行正畸治疗，均采取推磨牙向远中的方法，治疗前后拍摄头颅侧位片，由同一位专业正畸医师对牙齿和颌骨的矢状向及垂直向相关指标进行测量，每个数据测量3次取平均值。

结果与结论：①40例患者矫治后牙列拥挤解除，前牙建立正常覆合覆盖，面型得到一定改善；②高角组的下颌平面与前颅底平面的交角(GoGn-SN)减小0.4°，均角组、低角组的下颌平面与前颅底平面的交角(GoGn-SN)增加小于1°，3组中的前下面高(ANS-Me)增加小于1 mm，治疗前后差值均无统计学意义；③低角组上颌第一磨牙的近中颊尖点至上腭平面的距离(U6-PP)减小0.47 mm(P < 0.01)，均角组下颌中切牙切端至下颌平面的距离(L1-MP)减小0.83 mm(P < 0.05)，上中切牙长轴与前颅底平面相交的下内角(U1-SN)减小6.46°(P < 0.001)，差异有显著性意义；④提示无托槽隐形矫治技术推磨牙向远中能有效进行垂直向控制，防止下颌平面顺时针旋转，维持下面高，高角患者也能采用隐形矫治远移磨牙；隐形矫治器上下前牙压低实现率不足，临床设计方案时应该对前牙压低进行过矫治设计。

https://orcid.org/0009-0005-0889-0612(彭怡)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词:  , 错牙合畸形, 垂直骨面型, 无托槽隐形矫治技术, 磨牙远中移动, 垂直向

Abstract: BACKGROUND: Previous studies have shown that clear aligners can achieve molar distalization effectively, but it is not yet clear how the vertical dimensions change in patients with different vertical craniofacial patterns after molar distalization .
OBJECTIVE: To evaluate the effect of molar distalization with clear aligners on occlusal vertical dimension in different vertical craniofacial patterns. 
METHODS: Forty patients (13 cases of Class I malocclusion, 20 cases of Class II malocclusion, and 7 cases of Class III malocclusion) were selected, including 13 cases in the high angle group, 17 cases in the average angle group, and 10 cases in the low angle group. Among them, the age ranged from 10 to 53 years, with an average of 28.5 years. All patients were subjected to clear aligners for molar distalization. Lateral cephalometric films were taken before and after treatment. Cephalometric measurements, including the sagittal and vertical indicators of teeth and jaws, were measured by the same orthodontist, and each indicator was measured 3 times and averaged.
RESULTS AND CONCLUSION: After orthodontic treatment, the crowded dentition was corrected, the overbite and overjet were back to normal and the lateral profile was improved significantly in all 40 patients. The GoGn-SN in the high angle group decreased by 0.4°, while the GoGn-SN in the average and low angle groups increased by less than 1°, the ANS-Me in the three groups increased by less than 1 mm. There was no statistically significant difference before and after treatment. There was a statistically significant decrease in the U6-PP in the low angle group by 0.47 mm (P < 0.01). The L1-MP and the U1-SN in the average angle group significantly decreased by 0.83 mm (P < 0.05) and by 6.46° (P < 0.001), respectively. In conclusion, molar distalization with clear aligner treatment can control the vertical dimension effectively, prevent clockwise mandibular rotation, and maintain the lower face height. Patients with high angle can also undergo invisible orthodontics to distal molars. The realization rate of the anterior tooth intrusion movement by using clear aligners is insufficient, and the intrusion design should be increased to prevent the elongation phenomenon in anterior teeth.

Key words: malocclusion, vertical craniofacial pattern, clear aligner treatment, molar distalization, vertical

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