Krieger Elena, Seiferth Jörg, Marinello Ivana, Jung Britta A, Wriedt Susanne, Jacobs Collin, Wehrbein Heinrich
Department of Orthodontics, Medical Centre of Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
J Orofac Orthop. 2012 Sep;73(5):365-76. doi: 10.1007/s00056-012-0097-9. Epub 2012 Aug 11.
Based on our previous pilot study, the objective of this extended study was to compare (a) casts to their corresponding digital ClinCheck® models at baseline and (b) the tooth movement achieved at the end of aligner therapy (Invisalign®) to the predicted movement in the anterior region.
Pre- and post-treatment casts as well as initial and final ClinChecks® models of 50 patients (15-63 years of age) were analyzed. All patients were treated with Invisalign® (Align Technology, Santa Clara, CA, USA). Evaluated parameters were: upper/lower anterior arch length and intercanine distance, overjet, overbite, dental midline shift, and the irregularity index according to Little. The comparison achieved/predicted tooth movement was tested for equivalence [adjusted 98.57% confidence interval (- 1.00; + 1.00)].
Before treatment the anterior crowding, according to Little, was on average 5.39 mm (minimum 1.50 mm, maximum 14.50 mm) in the upper dentition and 5.96 mm (minimum 2.00 mm, maximum 11.50 mm) in the lower dentition. After treatment the values were reduced to 1.57 mm (minimum 0 mm, maximum 4.5 mm) in the maxilla and 0.82 mm (minimum 0 mm, maximum 2.50 mm) in the mandible. We found slight deviations between pretreatment casts and initialClinCheck® ranging on average from -0.08 mm (SD ± 0.29) for the overjet and up to -0.28 mm (SD ± 0.46) for the upper anterior arch length. The difference between achieved/predicted tooth movements ranged on average from 0.01 mm (SD ± 0.48) for the lower anterior arch length, up to 0.7 mm (SD ± 0.87) for the overbite. All parameters were significantly equivalent except for the overbite (-1.02; -0.39).
Performed with aligners (Invisalign®), the resolvement of the partly severe anterior crowding was successfully accomplished. Resolving lower anterior crowding by protrusion of the anterior teeth (i.e., enlargement of the anterior arch length) seems well predictable. The initial ClinCheck® models provided high accuracy compared to the initial casts. The achieved tooth movement was in concordance with the predicted movement for all parameters, except for the overbite.
基于我们之前的初步研究，本扩展研究的目的是比较（a）基线时石膏模型与其对应的数字化ClinCheck®模型，以及（b）隐形矫治器治疗（隐适美®）结束时实现的牙齿移动与前部区域的预测移动。
分析了50例患者（年龄15 - 63岁）治疗前和治疗后的石膏模型以及初始和最终的ClinCheck®模型。所有患者均接受隐适美®（美国加利福尼亚州圣克拉拉市Align Technology公司）治疗。评估参数包括：上下前牙弓长度、尖牙间距离、覆盖、覆合、牙中线偏移以及根据利特尔法计算的不整齐指数。对实现的/预测的牙齿移动进行等效性检验[调整后的98.57%置信区间（-1.00；+1.00）]。
治疗前，根据利特尔法，上颌牙列的前牙拥挤平均为5.39 mm（最小值1.50 mm，最大值14.50 mm），下颌牙列为5.96 mm（最小值2.00 mm，最大值11.50 mm）。治疗后，上颌的值降至1.57 mm（最小值0 mm，最大值4.5 mm），下颌降至0.82 mm（最小值0 mm，最大值2.50 mm）。我们发现治疗前石膏模型与初始ClinCheck®模型之间存在轻微偏差，覆盖平均偏差为-0.08 mm（标准差±0.29），上前牙弓长度偏差高达-0.28 mm（标准差±0.46）。实现的/预测的牙齿移动差异范围为，下前牙弓长度平均偏差0.01 mm（标准差±0.48），覆合偏差高达0.7 mm（标准差±0.87）。除覆合外（-1.02；-0.39），所有参数均具有显著等效性。
使用隐形矫治器（隐适美®）成功解决了部分严重的前牙拥挤问题。通过前牙前突（即增加前牙弓长度）解决下前牙拥挤似乎具有良好的可预测性。与初始石膏模型相比，初始ClinCheck®模型具有较高的准确性。除覆合外，所有参数实现的牙齿移动与预测移动一致。
