Mavropoulos Anestis, Karamouzos Andreas, Kiliaridis Stavros, Papadopoulos Moschos A
Department of Orthodontics, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
Angle Orthod. 2005 Jul;75(4):532-9. doi: 10.1043/0003-3219(2005)75[532:EONSFA]2.0.CO;2.
Objective of this prospective study was the three-dimensional (3D) analysis of tooth movements after the noncompliance simultaneous distalization of the first and second maxillary molars. Ten patients (five girls and five boys; mean age: 13.2 years) with bilateral Class II molar relationships were treated with a noncompliance, fixed intraoral appliance. Upper second molars had already erupted in all cases. Dental casts and lateral cephalometric radiographs were taken immediately before placement and after removal of the appliance. The casts were 3D digitized and superimposed on a predefined area in the palate. The resulting holograms, as well as the cephalometric radiographs, were digitized and analyzed by means of customized cephalometric software. The whole procedure was repeated after a two- to four-week interval to estimate the error of both methods. The cast assessment of 3D sagittal and vertical tooth movements was more reliable than the cephalometric record. The average maxillary first molar distal movement was 2.8 mm. Anchorage loss was expressed by a 1.9-mm proclination of the central incisors. A substantial variation among patients and among the right and left side in the same patient was observed. Noncompliance simultaneous distalization of the first and second maxillary molars can be an efficient treatment option for the correction of Class II molar relationship. However, anchorage loss and individual variation have to be seriously considered. Bilaterally symmetrical effectiveness should not be relied upon.
这项前瞻性研究的目的是对上颌第一和第二磨牙非依从性同时远中移动后的牙齿移动进行三维(3D)分析。10例双侧安氏II类磨牙关系的患者(5名女孩和5名男孩;平均年龄:13.2岁)采用非依从性固定口内矫治器进行治疗。所有病例中上颌第二磨牙均已萌出。在矫治器放置前和拆除后立即制取石膏模型和头颅侧位片。将石膏模型进行三维数字化,并叠加在腭部的预定义区域上。所得全息图以及头颅侧位片进行数字化处理,并通过定制的头影测量软件进行分析。在两到四周的间隔后重复整个过程,以评估两种方法的误差。石膏模型对三维矢状向和垂直向牙齿移动的评估比头影测量记录更可靠。上颌第一磨牙平均远中移动2.8mm。切牙唇倾1.9mm表示支抗丧失。观察到患者之间以及同一患者左右侧之间存在显著差异。上颌第一和第二磨牙非依从性同时远中移动可能是矫治安氏II类磨牙关系的一种有效治疗选择。然而,必须认真考虑支抗丧失和个体差异。不应依赖双侧对称的疗效。