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正畸治疗及环龈上纤维切断术后前牙的旋转复发

Rotational relapse of anterior teeth following orthodontic treatment and circumferential supracrestal fiberotomy.

作者信息

Al-Jasser Reham, Al-Subaie Mai, Al-Jasser Nasser, Al-Rasheed Abdulaziz

机构信息

Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O. Box: 60169-37, Riyadh 11545, Saudi Arabia.

Department of Orthodontics, Prince Sultan Military Medical City, 40001, As Sulimaniyah, Riyadh 12233, Saudi Arabia.

出版信息

Saudi Dent J. 2020 Sep;32(6):293-299. doi: 10.1016/j.sdentj.2019.10.003. Epub 2019 Oct 24.

Abstract

BACKGROUND/PURPOSE: Several factors cause relapse of orthodontically de-rotated teeth after appliance removal. Circumferential supracrestal fiberotomy (CSF) may release the tension on the supra-alveolar fibers following tooth de-rotation, thereby reducing the relapse risk. However, careful identification of the amount and location of relapse enables proper clinical evaluation. We aimed to determine the amount of orthodontic relapse following CSF for de-rotated anterior teeth.

MATERIALS AND METHODS

Eleven patients with 90 orthodontically de-rotated anterior teeth were enrolled. CSF was performed after orthodontic treatment, during fixed retainer placement. Rotational correction and relapse were measured on three casts (preorthodontic treatment, cast 1; postorthodontic treatment + CSF, cast 2; and 12-month follow-up, cast 3). The Wilcoxon test was used to assess significant differences in the tooth rotation angles between casts 1 and 2 and casts 2 and 3. The relationship between the magnitude of relapse and pretreatment severity of rotation was assessed by the point biserial correlation test. The Mann-Whitney test helped in identifying significant differences in the amount of relapse between maxillary and mandibular teeth.

RESULTS

The mean amount of rotational correction was 14.05°, while the mean amount and percentage of relapse were 1.1° and 10.8%, respectively [0.81° (8%) and 1.44° (14%) for maxillary and mandibular teeth, respectively]. The relapse amount was proportional to the pretreatment rotation severity, and it was larger for the mandibular canines. There was no significant difference in the amount of relapse between the maxillary and mandibular teeth ( = 0.07).

CONCLUSION

Post-treatment rotational relapse of anterior teeth subjected to CSF was minimal and statistically insignificant after 1 year of follow-up. This validates the promising results of CSF when combined with appropriate mechanical retention for an adequate period.

摘要

背景/目的:多种因素可导致正畸旋转牙在矫治器拆除后复发。环周龈上纤维切断术(CSF)可能会在牙齿旋转后释放牙槽嵴上纤维的张力,从而降低复发风险。然而,仔细识别复发的程度和位置有助于进行恰当的临床评估。我们旨在确定CSF治疗后前牙正畸复发的程度。

材料与方法

纳入11例患者,共90颗正畸旋转的前牙。在正畸治疗后、固定保持器佩戴期间进行CSF。在三个模型上测量旋转矫正和复发情况(正畸治疗前,模型1;正畸治疗后+CSF,模型2;12个月随访,模型3)。采用Wilcoxon检验评估模型1与模型2以及模型2与模型3之间牙齿旋转角度的显著差异。采用点二列相关检验评估复发程度与治疗前旋转严重程度之间的关系。Mann-Whitney检验有助于识别上颌牙和下颌牙复发量的显著差异。

结果

平均旋转矫正量为14.05°,而平均复发量和复发百分比分别为1.1°和10.8%[上颌牙和下颌牙分别为0.81°(8%)和1.44°(14%)]。复发量与治疗前旋转严重程度成正比,下颌尖牙的复发量更大。上颌牙和下颌牙的复发量无显著差异(P=0.07)。

结论

接受CSF治疗的前牙在随访1年后治疗后旋转复发最小,且在统计学上无显著意义。这证实了CSF与适当的机械保持相结合并持续足够时间时的良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35d4/7452021/28c61459905f/gr1.jpg

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