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粘结式和真空成型保持器的有效性:一项前瞻性随机对照临床试验。

Effectiveness of bonded and vacuum-formed retainers: A prospective randomized controlled clinical trial.

作者信息

O'Rourke Niamh, Albeedh Hussein, Sharma Pratik, Johal Ama

机构信息

Specialty registrar in orthodontics, Centre for Oral Growth and Development, Barts and the London School of Medicine and Dentistry, London, United Kingdom; postgraduate student in orthodontics, Institute of Dentistry, Queen Mary University, London, United Kingdom.

Senior clinical lecturer and consultant orthodontist, Centre for Oral Growth and Development, Barts and the London School of Medicine and Dentistry, London, United Kingdom.

出版信息

Am J Orthod Dentofacial Orthop. 2016 Sep;150(3):406-15. doi: 10.1016/j.ajodo.2016.03.020.

Abstract

INTRODUCTION

The objective of this prospective trial was to compare the clinical effectiveness of bonded retainers with vacuum-formed retainers, in terms of maintaining the results of orthodontic treatment in the lower arch up to 18 months post debond.

METHODS

This was a hospital-based, prospective randomized controlled clinical trial in which a total of 82 subjects were randomly allocated using a computer-generated number sequence to 1 of 2 groups, receiving either a vacuum-formed retainer (Essix Ace plastic (120 mm; DENTSPLY Raintree Essix, Sarasota, Fla) or a bonded retainer (0.0175 coaxial archwire (Ortho-Care, UK, Shipley, United Kingdom) bonded in place with Transbond LR (3M United Kingdom, Brachnell, United Kingdom) for the mandibular arch. Each number was placed in an opaque, concealed envelope and chosen randomly by the study subject; this determined the allocation group. Eligibility criteria included patients nearing debond after treatment with 0.022 × 0.028-in slot size preadjusted edgewise fixed orthodontic appliances whose pretreatment records and study models were available to confirm pretreatment labial segment crowding or spacing and who had clinically acceptable alignment at the end of treatment. The main outcome was to investigate the clinical effectiveness of the 2 types of retainers in terms of changes in incisor irregularity at 6 months of retention. The following measurements were recorded at each time point (6, 12, and 18 months) with a digital caliper: Little's irregularity index, intercanine width, intermolar width, arch length, and extraction site opening. Blinding was applicable only at debond because of the permanence of 1 intervention.

RESULTS

The 2 groups were well matched with respect to age, sex, clinical characteristics, and treatment plans. There was a statistically significant difference between the groups for changes in Little's irregularity index at 6 months, with the vacuum-formed retainer group showing greater changes than the bonded retainer group (P = 0.008). There was no statistically significant difference between the groups for changes in Little's irregularity index at 12 and 18 months.There were also no statistically significant changes at any time for intercanine width, intermolar width, arch length, or extraction site opening.

CONCLUSIONS

Some relapse is likely after fixed appliance therapy irrespective of retainer choice, and this is minimal in most patients at 6 months after debond. Bonded retainers have a better ability to hold the mandibular incisor alignment in the first 6 months after treatment than do vacuum-formed retainers.

REGISTRATION

Not applicable.

PROTOCOL

The protocol was not published before trial commencement.

FUNDING

There is no funding or conflict of interest to be declared.

摘要

引言

这项前瞻性试验的目的是比较粘结式保持器和压膜式保持器在保持正畸治疗效果方面的临床有效性,观察时间为下牙弓去粘结后长达18个月。

方法

这是一项基于医院的前瞻性随机对照临床试验,共有82名受试者通过计算机生成的数字序列随机分配到2组中的1组,分别接受压膜式保持器(Essix Ace塑料材质,120毫米;登士柏雨树公司,佛罗里达州萨拉索塔市)或粘结式保持器(0.0175同轴弓丝,英国奥索护理公司,希普利市,英国),粘结在下颌牙弓上使用Transbond LR(3M英国公司,布拉内尔市,英国)。每个数字被放入一个不透明的密封信封中,由研究对象随机选择;这决定了分配组。纳入标准包括使用0.022×0.028英寸槽沟尺寸的预调直丝弓固定正畸矫治器治疗后即将去粘结的患者,其治疗前记录和研究模型可用于确认治疗前唇侧段拥挤或间隙情况,且治疗结束时临床排列可接受。主要观察指标是研究两种类型保持器在保持6个月时切牙不齐变化方面的临床有效性。在每个时间点(6、12和18个月)使用数字卡尺记录以下测量值:利特尔不齐指数、尖牙间宽度、磨牙间宽度、牙弓长度和拔牙部位开口度。由于一种干预措施的永久性,仅在去粘结时采用盲法。

结果

两组在年龄、性别、临床特征和治疗计划方面匹配良好。在6个月时,两组在利特尔不齐指数变化方面存在统计学显著差异,压膜式保持器组的变化大于粘结式保持器组(P = 0.008)。在12个月和18个月时,两组在利特尔不齐指数变化方面无统计学显著差异。在任何时间点,尖牙间宽度、磨牙间宽度、牙弓长度或拔牙部位开口度也无统计学显著变化。

结论

无论选择何种保持器,固定矫治器治疗后都可能出现一定程度的复发,在大多数患者去粘结后6个月时复发程度最小。在治疗后的前6个月,粘结式保持器比压膜式保持器在保持下颌切牙排列方面具有更好的能力。

注册情况

不适用。

方案

方案在试验开始前未发表。

资金

无需声明资金来源或利益冲突。

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