Chenin David A, Trosien Andrew H, Fong Patricia F, Miller Robert A, Lee Rodney S
Restorative Department, University of the Pacific School of Dentistry, San Francisco, USA.
J Am Dent Assoc. 2003 Sep;134(9):1232-9. doi: 10.14219/jada.archive.2003.0358.
In the United States, the demand for straight white teeth has never been more important to patients. Crowded, poorly aligned teeth are not esthetically pleasing and are difficult to keep clean. However, until recently, the process of straightening the teeth typically has involved appliances involving bands, brackets and wires that also can be difficult to clean. The desire for a cosmetic solution to misaligned teeth has led to an increase in the number of patients seeking veneers, crowns and other laboratory-fabricated cosmetic restorations. Some clinicians are not aware that there are other ways to align teeth without either significant enamel reduction or conspicuous fixed orthodontic appliances.
An alternative method of treatment, involving a series of clear removable appliances, circumvents this shortcoming and enables tooth alignment while avoiding deterioration in the cosmetics of the smile during treatment. This article describes a method of treatment, Invisalign (Align Technology, Santa Clara, Calif.), that clinicians can use in conjunction with 3-D computer models to accomplish the esthetic and oral hygiene objectives during and after treatment.
The authors present three case reports, all involving a chief concern of crowding. The first case involved treatment of both arches by interproximal reduction, alignment of teeth and leveling the curve of Spee. The second case involved treatment of both arches by proclination, expansion and minor interproximal reduction. The final case shows relief of lower-arch crowding via lower-incisor extraction.
In addition to satisfying the patient's chief concern of desiring straight teeth, this method of treatment satisfies additional objectives of esthetic treatment and esthetic results with significant oral hygiene benefits. Clinicians can address a patient's chief concern effectively without requiring an inventory of appliances (such as bands, brackets, wires and instruments). Furthermore, the use of 3-D computer models can give clinicians additional information to make more complete decisions regarding treatment.
在美国，患者对整齐洁白牙齿的需求从未像现在这样重要。牙齿拥挤、排列不齐不仅不美观，而且难以保持清洁。然而，直到最近，矫正牙齿的过程通常需要使用带有牙箍、托槽和钢丝的矫治器，这些矫治器同样难以清洁。对牙齿排列不齐的美容解决方案的需求导致寻求贴面、牙冠和其他实验室制作的美容修复体的患者数量增加。一些临床医生没有意识到，还有其他方法可以在不大量减少牙釉质或不使用明显的固定正畸矫治器的情况下使牙齿排列整齐。
一种替代治疗方法，涉及一系列透明可摘矫治器，克服了这一缺点，能够在治疗期间实现牙齿排列整齐，同时避免微笑美观度下降。本文介绍了一种名为Invisalign（Align Technology公司，加利福尼亚州圣克拉拉）的治疗方法，临床医生可以结合三维计算机模型使用该方法，以实现治疗期间及治疗后的美观和口腔卫生目标。
作者展示了三个病例报告，所有病例主要问题均为牙齿拥挤。第一个病例通过邻面减径、牙齿排齐和整平Spee曲线对上下牙弓进行治疗。第二个病例通过牙前倾、扩弓和轻微邻面减径对上下牙弓进行治疗。最后一个病例通过拔除下前牙缓解下牙弓拥挤。
除了满足患者对整齐牙齿的主要需求外，这种治疗方法还满足了美容治疗的其他目标，并带来显著的口腔卫生益处，实现了美观效果。临床医生可以有效解决患者的主要问题，而无需储备大量矫治器（如牙箍、托槽、钢丝和器械）。此外，使用三维计算机模型可以为临床医生提供更多信息，以便做出更全面的治疗决策。
