Upadhyay Madhur, Yadav Sumit, Nagaraj K, Patil Sameer
Department of Craniofacial Sciences, Division of Orthodontics, School of Dental Medicine, University of Connecticut, Farmington, CT 06030, USA.
Am J Orthod Dentofacial Orthop. 2008 Jul;134(1):18-29.e1. doi: 10.1016/j.ajodo.2007.03.025.
The purpose of this randomized controlled trial was to quantify the treatment effects of en-masse retraction of anterior teeth with mini-implants as anchor units in bialveolar dental protrusion patients undergoing extraction of all 4 first premolars.
A total of 40 patients (mean age, 17.5 years; SD, 3.2 years) were randomly assigned either to group 1 (G1), anterior space closure with mini-implants as anchor units, or group 2 (G2), anterior space closure with conventional methods of anchorage (without mini-implants). Skeletal, dental, and soft-tissue changes were analyzed in both groups on lateral cephalograms taken before retraction and after space closure.
Student paired and unpaired t tests were used to analyze the treatment changes in the 2 groups. For the skeletal parameters, a statistically significant decrease in the facial vertical dimensions was seen in G1, but the variables in G2 showed no significant differences (P >0.05). Anchorage loss, in both the horizontal and vertical directions, was noted in G2, whereas G1 showed distalization (anchorage gain) and intrusion of molars. Although the soft-tissue response was variable, facial convexity angle, nasolabial angle, and lower lip protrusion had greater changes in G1. No differences were found in the amount of upper lip retraction between the groups (P >0.05).
Mini-implants provided absolute anchorage to allow greater skeletal, dental, and esthetic changes in patients requiring maximum anterior retraction, when compared with other conventional methods of space closure. The treatment changes were favorable. However, no differences in the mean retraction time were noted between the 2 groups.
本随机对照试验的目的是量化在拔除全部4颗第一前磨牙的双牙弓前突患者中,使用微型种植体作为支抗单位整体内收前牙的治疗效果。
总共40例患者(平均年龄17.5岁;标准差3.2岁)被随机分为两组,第1组(G1)使用微型种植体作为支抗单位关闭前牙间隙,第2组(G2)使用传统支抗方法(不使用微型种植体)关闭前牙间隙。在两组患者内收前及间隙关闭后拍摄的头颅侧位片上分析骨骼、牙齿和软组织的变化。
采用学生配对和非配对t检验分析两组的治疗变化。对于骨骼参数,G1组面部垂直维度有统计学意义的降低,而G2组各变量无显著差异(P>0.05)。G2组在水平和垂直方向均出现支抗丧失,而G1组磨牙有远中移动(支抗增加)和压低。尽管软组织反应存在差异,但G1组面部凸度角向、鼻唇角和下唇突度变化更大。两组间上唇内收量无差异(P>0.05)。
与其他传统间隙关闭方法相比,微型种植体提供了绝对支抗,使需要最大程度前牙内收的患者在骨骼、牙齿和美观方面有更大改变。治疗变化是有利的。然而,两组间平均内收时间无差异。