Little R M
Department of Orthodontics, University of Washington, Seattle 98195-7446, USA.
Semin Orthod. 1999 Sep;5(3):191-204. doi: 10.1016/s1073-8746(99)80010-3.
For more than 40 years, research in the Department of Orthodontics, University of Washington (Seattle, WA) has focused on a growing collection of more than 800 sets of patient records to assess stability and relapse of orthodontic treatment. All patients had completed treatment a decade or more before the last set of data. Evaluation of treated premolar extraction patients, treated lower incisor extraction patients, treated non-extraction cases with generalized spacing, patients treated with arch enlargement strategies, and untreated normals showed similar physiologic changes: (1) Arch length decreases after orthodontic treatment. (2) Arch width measured across the mandibular canine teeth typically reduces posttreatment, whether or not the case was expanded during treatment. (3) Mandibular anterior crowding during the posttreatment phase is a continuing phenomenon well into the 20-to-40 years age bracket and likely beyond. (4) Third molar absence or presence, impacted or fully erupted, seems to have little effect on the occurrence or degree of relapse. (5) The degree of post-retention anterior crowding is both unpredictable and variable and no pretreatment variables either from clinical findings, casts, or cephalometric radiographs before or after treatment seem to be useful predictors.
40多年来,华盛顿大学(西雅图,华盛顿州)正畸科的研究一直聚焦于收集越来越多的800多套患者记录,以评估正畸治疗的稳定性和复发情况。所有患者在最后一组数据收集之前十年或更久就已完成治疗。对接受过治疗的拔除前磨牙患者、拔除下切牙患者、接受过治疗的有广泛性牙间隙的非拔牙病例、采用牙弓扩展策略治疗的患者以及未经治疗的正常对照者的评估显示出相似的生理变化:(1)正畸治疗后牙弓长度减小。(2)无论治疗期间是否进行过牙弓扩展,在下颌尖牙处测量的牙弓宽度通常在治疗后会减小。(3)治疗后阶段下颌前部拥挤是一种持续到20至40岁年龄段甚至更久的现象。(4)第三磨牙的缺失或存在、阻生或完全萌出,似乎对复发的发生或程度影响不大。(5)保持后前部拥挤的程度既不可预测又具有变异性,治疗前的临床检查、模型或治疗前后的头影测量X线片等预处理变量似乎都不是有用的预测指标。