Graduate Orthodontic Program, Department of Orthodontics and Pediatric Dentistry, University of Michigan, Ann Arbor, MI 48109-1078, USA.
Am J Orthod Dentofacial Orthop. 2011 Nov;140(5):688-95. doi: 10.1016/j.ajodo.2011.02.026.
The objectives of this prospective clinical study were to evaluate the quality of treatment outcomes achieved with a complex orthodontic finishing protocol involving serpentine wires and a tooth positioner, and to compare it with the outcomes of a standard finishing protocol involving archwire bends used to detail the occlusion near the end of active treatment.
The complex finishing protocol sample consisted of 34 consecutively treated patients; 1 week before debonding, their molar bands were removed, and serpentine wires were placed; this was followed by active wear of a tooth positioner for up to 1 month after debonding. The standard finishing protocol group consisted of 34 patients; their dental arches were detailed with archwire bends and vertical elastics. The objective grading system of the American Board of Orthodontics was used to quantify the quality of the finish at each time point. The Wilcoxon signed rank test was used to compare changes in the complex finishing protocol; the Mann-Whitney U test was used to compare changes between groups.
The complex finishing protocol group experienced a clinically significant improvement in objective grading system scores after treatment with the positioner. Mild improvement in posterior space closure was noted after molar band removal, but no improvement in the occlusion was observed after placement of the serpentine wires. Patients managed with the complex finishing protocol also had a lower objective grading system score (14.7) at the end of active treatment than did patients undergoing the standard finishing protocol (23.0).
Tooth positioners caused a clinically significant improvement in interocclusal contacts, interproximal contacts, and net objective grading system score; mild improvement in posterior band space was noted after molar band removal 1 week before debond.
本前瞻性临床研究的目的是评估涉及蛇形弓丝和牙齿定位器的复杂正畸后处理方案的治疗效果质量，并与在主动治疗结束时使用弓丝弯制精细后牙段牙合关系的标准后处理方案的结果进行比较。
复杂后处理方案组由 34 名连续治疗的患者组成；在离带前 1 周，拆除磨牙带环，放置蛇形弓丝；随后在离带后 1 个月内持续佩戴牙齿定位器。标准后处理方案组由 34 名患者组成；使用弓丝弯制和垂直弹性橡皮圈精细后牙段牙合关系。采用美国正畸医师协会的客观分级系统来量化每个时间点的后处理质量。使用 Wilcoxon 符号秩检验比较复杂后处理方案的变化；使用 Mann-Whitney U 检验比较组间变化。
佩戴定位器后，复杂后处理方案组的客观分级系统评分有显著的临床改善。拆除磨牙带环后，后牙段牙弓间隙有轻度改善，但放置蛇形弓丝后牙合关系没有改善。采用复杂后处理方案的患者在主动治疗结束时的客观分级系统评分（14.7）也低于采用标准后处理方案的患者（23.0）。
牙齿定位器显著改善了牙合接触关系、邻接关系和总体客观分级系统评分；拆除磨牙带环 1 周后，后牙段牙弓间隙有轻度改善。
