El-Bialy Tarek
Division of Orthodontics, Katz Group Centre for Pharmacy and Health Research, School of Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada.
Dent J (Basel). 2020 Oct 1;8(4):110. doi: 10.3390/dj8040110.
This study presents a novel technique utilizing high-frequency vibration to shorten treatment time and preserve alveolar bone in challenging orthodontic cases that have been treated with Invisalign clear aligners. Four non-growing orthodontic patients (age range 14-47 years old) with Class II skeletal patterns (convex profiles with retrognathic mandibles) who sought correction of their crowded teeth and non-surgical correction of their convex profiles were included in this study. These patients were treated using Invisalign clear aligners together with high-frequency vibration (HFV) devices (120 Hz) (VPro5™) that were used by all patients for five minutes per day during active orthodontic treatment. Vertical control and forward rotation of the mandible for each patient was achieved through pre-programming the Invisalign to produce posterior teeth intrusion. Successful forward rotation of the mandibles achieved in all patients led to improvement of their facial convex profiles (apical base relationship (ANB) improved 2.1 ± 0.5 degrees; FMA (Frankfurt mandibular plane angle) improved 1.2 + 1.1 degrees). Dental decompensation was achieved by lingual tipping of the lower incisors and palatal root torque of upper incisors. The use of HFV together with Invisalign facilitated achieving these results within a 12 ± 6 months period. In addition, more bone labial to the lower incisors after their lingual movement was noted. In conclusion, the use of HFV concurrent with SmartTrack Invisalign aligners allowed complex tooth movement and forward mandibular projection without surgery in non-growing patients with skeletal Class II relationships. The clinical impact and implications of this case series are: (1) the use of HFV facilitates complex orthodontic tooth movement including posterior teeth intrusion and incisor decompensation; (2) forward mandibular projection of the mandible and increased bone formation labial to lower incisors can be achieved in non-growing patients that may minimize the need for surgical intervention in similar cases or gum recession due to lower incisors labial inclination.
本研究提出了一种新技术，该技术利用高频振动来缩短治疗时间，并在使用隐适美透明矫治器治疗的具有挑战性的正畸病例中保留牙槽骨。本研究纳入了4名非生长发育期的正畸患者（年龄范围为14 - 47岁），他们均为II类骨骼型（面部凸型，下颌后缩），寻求矫治牙齿拥挤并进行非手术矫正凸面型。这些患者使用隐适美透明矫治器并配合高频振动（HFV）设备（120 Hz）（VPro5™）进行治疗，所有患者在正畸治疗活跃期每天使用该设备5分钟。通过对隐适美进行预编程以实现后牙压低，从而实现每位患者下颌的垂直控制和向前旋转。所有患者均成功实现下颌向前旋转，面部凸面型得到改善（尖牙基底关系（ANB）改善2.1±0.5度；FMA（法兰克福下颌平面角）改善1.2 + 1.1度）。通过下切牙舌倾和上切牙腭根转矩实现牙齿去代偿。HFV与隐适美联合使用有助于在12±6个月的时间内取得这些效果。此外，在下切牙舌向移动后，发现下切牙唇侧的骨量更多。总之，在非生长发育期的骨骼II类关系患者中，HFV与SmartTrack隐适美矫治器同时使用可实现复杂的牙齿移动和下颌向前突出，而无需手术。本病例系列的临床影响和意义在于：（1）HFV的使用有助于复杂的正畸牙齿移动，包括后牙压低和切牙去代偿；（2）在非生长发育期的患者中可实现下颌向前突出以及下切牙唇侧骨形成增加，这可能会减少类似病例中手术干预的需求或因下切牙唇倾导致的牙龈退缩。
