Barthélemi Stéphane, Desoutter Alban, Souaré Fatoumata, Cuisinier Frédéric
Department of Orthodontics, University of Montpellier, Montpellier, France.
Korean J Orthod. 2019 Sep;49(5):279-285. doi: 10.4041/kjod.2019.49.5.279. Epub 2019 Sep 24.
This study evaluated the efficiency of anchorage provided by temporary anchorage devices (TADs) in maxillary bicuspid extraction cases during retraction of the anterior teeth using a fixed appliance.
Patients aged 12 to 50 years with malocclusion for which bilateral first or second maxillary bicuspid extractions were indicated were included in the study and randomly allocated to the TAD or control groups. Retraction of the anterior teeth was achieved using skeletal anchorage in the TAD group and conventional dental anchorage in the control group. A computed tomography (CT) scan was performed after alignment of teeth, and a second CT scan was performed at the end of extraction space closure in both groups. A three-dimensional superimposition was performed to visualize and quantify the maxillary first molar movement during the retraction phase, which was the primary outcome, and the stability of TAD movement, which served as the secondary outcome.
Thirty-four patients (17 in each group) underwent the final analysis. The two groups showed a significant difference in the movement of the first maxillary molars, with less significant anchorage loss in the TAD group than that in the control group. In addition, TAD movement showed only a slight mesial movement on the labial side. On the palatal side, the mesial TAD movement was greater.
In comparison with conventional dental anchorage, TADs can be considered an efficient source of anchorage during retraction of maxillary anterior teeth. TADs remain stable when correctly placed in the bone during the anterior tooth retraction phase.
本研究评估了在使用固定矫治器内收前牙过程中,临时锚固装置(TADs)在上颌双尖牙拔除病例中提供锚固的效率。
纳入年龄在12至50岁、因错牙合畸形需拔除双侧上颌第一或第二双尖牙的患者,并随机分为TAD组和对照组。TAD组使用骨锚固内收前牙,对照组使用传统牙锚固。在牙齿排齐后进行计算机断层扫描(CT),两组在拔牙间隙关闭结束时均进行第二次CT扫描。进行三维叠加以可视化和量化内收阶段上颌第一磨牙的移动情况(这是主要结果)以及TAD移动的稳定性(作为次要结果)。
34例患者(每组17例)进行了最终分析。两组在上颌第一磨牙的移动方面存在显著差异,TAD组的锚固丧失比对照组更不明显。此外,TAD在唇侧仅表现出轻微的近中移动。在腭侧,TAD的近中移动更大。
与传统牙锚固相比,TADs可被视为上颌前牙内收过程中一种有效的锚固来源。在前牙内收阶段,TAD正确植入骨内时保持稳定。