中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (25): 6489-6495.doi: 10.12307/2026.385

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

间接模型重叠法分析无托槽隐形矫治深覆𬌗病例前牙压低的效率

王诗语1，黄钖钖2，刘  浩1，3，胥加斌3，王鹏来3，杨  丽1   

  1. 徐州医科大学附属口腔医院，1口腔正畸科，2儿童口腔科，江苏省徐州市   221000；3徐州医科大学口腔医学院，江苏省徐州市   221000
  • 收稿日期:2025-06-30 修回日期:2025-10-15 出版日期:2026-09-08 发布日期:2026-04-20
  • 通讯作者: 杨丽，硕士，副主任医师，徐州医科大学附属口腔医院口腔正畸科，江苏省徐州市 221000
  • 作者简介:王诗语，男，1997年生，江苏省淮安市人，汉族，2024年徐州医科大学毕业，硕士，医师，主要从事口腔正畸研究。
  • 基金资助:
    江苏省自然科学基金项目(BK20241040)，项目负责人：胥加斌；徐州市卫生健康委科技项目(XWKYHT20220133)，项目负责人：杨丽；徐州市卫生健康委青年医学科技创新项目(XWKYSL20210200)，项目负责人：刘浩

Efficiency of anterior tooth intrusion in deep overbite cases with clear aligners: analysis via the indirect model superimposition method

Wang Shiyu1, Huang Yangyang2, Liu Hao1, 3, Xu Jiabin3, Wang Penglai3, Yang Li1   

  1. 1Department of Orthodontics, 2Department of Pediatric Dentistry, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China; 3School of Stomatology, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
  • Received:2025-06-30 Revised:2025-10-15 Online:2026-09-08 Published:2026-04-20
  • Contact: Yang Li, MS, Associate chief physician, Department of Orthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
  • About author:Wang Shiyu, MS, Physician, Department of Orthodontics, Affiliated Stomatological Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
  • Supported by:
    Jiangsu Natural Science Foundation, No. BK20241040 (to XJB); Xuzhou Municipal Health Commission Science and Technology Project, No. XWKYHT20220133 (to YL); Youth Medical Science and Technology Innovation Project of Xuzhou Municipal Health Commission, No. XWKYSL20210200 (to LH)

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摘要：



文题释义：
深覆𬌗：是一种垂直向错牙合畸形，表现为上前牙唇面覆盖下前牙超过切1/3。深覆牙合根据严重程度，可分为Ⅰ度(超过切1/3，但不超过切1/2)、Ⅱ度(超过切1/2，但不超过切2/3)和Ⅲ度(超过切2/3)。深覆牙合对牙周、咬合、关节等均会造成不利影响，应积极矫正，促进口颌系统健康。
前牙压低：深覆牙合的矫正思路为前牙压低和后牙伸长，前牙压低适用于上前牙暴露量大、露龈笑、下颌Spee曲线较陡等情况。由于伸长移动属于无托槽隐形矫治器较难实现的牙齿移动之一，因此前牙压低是无托槽隐形矫治深覆牙合病例的主要手段，但压低效率因牙位、矫治方案、拔牙模式不同而异。

背景：前牙压低是无托槽隐形矫治技术矫正深覆牙合的常用方法，但压低效率在不同病例间存在较大差异。
目的：采用基于咬合记录的间接模型重叠法，分析比较无托槽隐形矫治器的前牙压低效率。
方法：纳入43例前牙深覆牙合患者，分为不拔牙组和拔牙组。不拔牙组再分为简单排齐组和上颌磨牙远移组；拔牙组再分为拔除第一前磨牙组和拔除第二前磨牙组。在Geomagic 2014软件中，基于眶耳平面-牙合平面角校准矫治前、后模型的牙合平面倾斜度，基于上颌腭皱襞和咬合记录完成上、下模型重叠，基于眶耳平面建立测量坐标系，测量实际压低量，将ClinCheck方案中的相对压低量记为压低设计量，进行前牙压低设计量与实际压低量的相关与线性回归分析。
结果与结论：①不拔牙组和拔牙组前牙的实际压低量均显著小于压低设计量(P < 0.01)，使用无托槽隐形矫治器压低前牙应设计过矫治；②不拔牙组的前牙压低效率(50.69%)显著高于拔牙组(39.73%)(P < 0.01)，拔牙矫治病例应设计更多的过矫治；③下前牙的压低效率显著高于上前牙(P < 0.01)，上前牙压低应设计更多的过矫治；④上颌磨牙远移组的前牙压低效率与简单排齐组之间无显著差异(P > 0.05)；⑤拔除第二前磨牙组的前牙压低效率显著高于拔除第一前磨牙组(P < 0.01)，拔除第二前磨牙比拔除第一前磨牙更有利于前牙的垂直向控制；⑥各组前牙的压低设计量与实际压低量之间均存在线性关系，回归方程可为医生根据不同牙位和不同方案设计个性化的过矫治量提供参考。
https://orcid.org/0009-0009-4805-6031 (王诗语)


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 无托槽隐形矫治, 深覆牙合, 前牙压低, 拔牙矫治, 磨牙远移, 过矫治

Abstract: BACKGROUND: Anterior tooth intrusion is commonly used in the deep overbite cases with clear aligners. However, the intrusion efficiency varies significantly among different cases.
OBJECTIVE: To analyze and compare the intrusion efficiency of the anterior teeth with clear aligners by the indirect model superimposition method based on the occlusal records. 
METHODS: Forty-three patients with anterior deep overbite were selected as the subjects of this study and divided into the non-extraction and extraction groups. The non-extraction group was then divided into the alignment and maxillary molar distalization subgroups. The extraction group was subdivided into the first premolar extraction and second premolar extraction subgroups. In the Geomagic 2014 software, the occlusal plane inclinations of the pre- and post-treatment models were calibrated based on the angle between the Frankfort plane and occlusal plane. The maxillary and mandibular models were superimposed by the maxillary palatine folds and occlusal records. Based on the Frankfort plane, the measurement coordinate system was established to measure the actual intrusion amount. The relative intrusion amount in the ClinCheck protocol was recorded as the designed intrusion amount.  
RESULTS AND CONCLUSION: (1) The actual intrusion amount of the anterior teeth was significantly less than the designed intrusion amount in the non-extraction and extraction groups (P < 0.01). Overcorrection should be designed in the anterior intrusion using clear aligners. (2) The intrusion efficiency in the non-extraction group (50.69%) was significantly higher than that in the extraction group (39.73%) (P < 0.01). More overcorrection was required in the extraction cases. (3) The intrusion efficiency of the mandibular anterior teeth was significantly higher than that of the maxillary anterior teeth (P < 0.01). More overcorrection was required in the intrusion of maxillary anterior teeth. (4) There was no significant difference in the intrusion efficiency between the alignment subgroup and maxillary molar distalization subgroup (P > 0.05). (5) The intrusion efficiency of the second premolar extraction subgroup was significantly higher than that of the first premolar extraction subgroup (P < 0.01). Extracting the second premolars was more beneficial for the vertical control of the anterior teeth than extracting the first premolars. (6) There was a linear relationship between the designed and actual intrusion amount between the groups. The regression equation could provide reference for the clinicians to design personalized overcorrection amount based on different teeth and treatment protocols.

Key words: clear aligner, deep overbite, anterior intrusion, extraction treatment, molar distalization, overcorrection

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