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前、后牙区微型种植体辅助上颌切牙压低的比较:牙根吸收与治疗效率

Comparison of anterior and posterior mini-implant-assisted maxillary incisor intrusion: Root resorption and treatment efficiency.

作者信息

Aras Isil, Tuncer Ali V

机构信息

a  Assistant Professor, Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey.

b  Professor, Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey.

出版信息

Angle Orthod. 2016 Sep;86(5):746-52. doi: 10.2319/085015-571.1. Epub 2016 Jan 7.

Abstract

OBJECTIVE

To compare, through cone-beam computed tomography (CBCT), the root resorption and treatment efficiency of two different mini-implant-assisted modalities in intruding the maxillary incisors.

MATERIALS AND METHODS

Thirty-two adults who had deep bite and elongated maxillary incisors were randomly allocated to two groups: anterior mini-implant group (AMG) and posterior mini-implant group (PMG). In the AMG, approximately 40 g of force was applied per side with elastic chains from mini-implants placed between the lateral incisors and canines and in the PMG, with beta-titanium wires from mini-implants placed between the second premolars and first molars. This study was conducted on CBCT scans taken before intrusion and after 4 months of intrusion. Data were analyzed by means of a paired t-test, independent t-test, and Pearson's correlation test.

RESULTS

One patient was excluded from the AMG due to mini-implant loosening. While the incisors showed a significant reduction in length and volume, this amount was greater in the AMG, especially in the central incisors (P < .05). Together with the mean intrusion rates of 0.62 and 0.39 mm/mo in the AMG and PMG respectively, the center of resistance of the incisors showed distal movement with labial tipping; these changes were greater in the PMG (P < .001). Volumetric root resorption was correlated with the amount of intrusion (P < .05).

CONCLUSIONS

Intrusion anchoring from posterior mini-implants is preferred in cases of upright incisors, as the use of such mechanics directs the roots into the spongiosa where they undergo less root resorption and more labial tipping.

摘要

目的

通过锥形束计算机断层扫描(CBCT)比较两种不同的微型种植体辅助方式在上颌切牙内收中的牙根吸收情况和治疗效果。

材料与方法

32名患有深覆合和上颌切牙过长的成年人被随机分为两组:前牙微型种植体组(AMG)和后牙微型种植体组(PMG)。在AMG组中,通过弹性链从位于侧切牙和尖牙之间的微型种植体每侧施加约40g的力,而在PMG组中,通过β-钛丝从位于第二前磨牙和第一磨牙之间的微型种植体施加力。本研究基于内收前和内收4个月后的CBCT扫描进行。数据采用配对t检验、独立t检验和Pearson相关检验进行分析。

结果

一名患者因微型种植体松动被排除在AMG组之外。虽然切牙的长度和体积显著减小,但AMG组的减小量更大,尤其是中切牙(P < .05)。AMG组和PMG组切牙的平均内收速率分别为0.62和0.39mm/月,切牙的抗力中心向远中移动并伴有唇倾;这些变化在PMG组中更大(P < .001)。体积性牙根吸收与内收量相关(P < .05)。

结论

在直立切牙的情况下,后牙微型种植体的内收锚固是首选,因为这种力学方式可将牙根引导至松质骨,在那里牙根吸收较少且唇倾更多。

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