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微小骨穿孔对微型种植体支抗上颌前牙整体后移空间关闭速率的影响:一项随机临床试验。

Effect of micro-osteoperforations on rate of space closure by mini-implant supported maxillary anterior en-masse retraction: A randomized clinical trial.

作者信息

Raghav Pradeep, Khera Amit Kumar, Bhasin Pranav

机构信息

Department of Orthodontics, Subharti Dental College, Meerut, UP, India.

出版信息

J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):185-191. doi: 10.1016/j.jobcr.2021.01.010. Epub 2021 Jan 22.

Abstract

BACKGROUND

Micro-osteoperforations is one of the non-invasive surgical techniques used in attempt to accelerate OTM. Conflicting reports on its effectiveness has been reported in the literature.

OBJECTIVES

The objectives of this trial were to investigate the effect of micro-osteoperforations on the rate of space closure and on molar anchorage loss during mini-implant supported maxillary anterior en-masse retraction.

TRIAL DESIGN

A single center, parallel arm, randomized controlled trial was conducted.

METHOD

Sixty, male and female subjects (age range 16-25 years) having Class I bimaxillary protrusion or Class II div 1 malocclusion, who required fixed mechanotherapy with either upper 1st premolar or all four 1st premolar extractions were allocated into two groups using 1:1 allocation ratio. The allocation was done by block randomization method with a block size of 6. In the experimental group, 5 MOPs per side were performed only once just before the en-masse anterior retraction. Mini-screws were placed in order to obtain maximum anchorage. Impressions were taken every month till 4 months and rate of space closure was measured on 3D study models.

RESULTS

Data of 27 subjects in control (attrition ​= ​3) and 28 subjects in experimental group (attrition ​= ​2) were analyzed at the end of this trial. There was a statistically significant increase in the rate of en-masse retraction for the 1st month(p ​= ​0.001,95%CI, 0.17, 0.37 ​mm) but there was no statistically significant difference for the subsequent 2nd (p ​= ​0.450,95%CI,0.13,0.43 ​mm), 3rd(p ​= ​0.204,95%CI,0.23,0.47 ​mm) and 4th month (p ​= ​0.680,95%CI,0.21,0.41 ​mm) between experimental and control groups. There was also no difference (p ​> ​0.05) in molar anchorage loss between both groups at all time intervals.

CONCLUSION

Micro-osteoperforations (MOPs) did not accelerate the rate of anterior en-masse retraction over a period of 4 months; however, it temporarily increases the rate of retraction only for first month and no affect on molar anchorage.

TRIAL REGISTRATION

The trial was registered at www.ctri.nic.in with CTRI No- CTRI/2019/03/018140).

摘要

背景

微骨穿孔术是用于尝试加速牙齿移动的非侵入性外科技术之一。文献中关于其有效性的报道相互矛盾。

目的

本试验的目的是研究微骨穿孔术对微型种植体支抗上颌前牙整体后移期间间隙关闭速率和磨牙支抗丧失的影响。

试验设计

进行了一项单中心、平行组、随机对照试验。

方法

60名年龄在16 - 25岁之间、患有I类双颌前突或II类1分类错牙合、需要拔除上颌第一前磨牙或全部四颗第一前磨牙进行固定机械治疗的男性和女性受试者,按照1:1的分配比例分为两组。采用区组随机化方法进行分配,区组大小为6。在试验组中,仅在整体前牙后移前一侧进行5次微骨穿孔,仅一次。放置微型螺钉以获得最大支抗。每月取模直至4个月,并在三维研究模型上测量间隙关闭速率。

结果

本试验结束时分析了对照组27名受试者(失访 = 3)和试验组28名受试者(失访 = 2)的数据。第一个月整体后移速率有统计学显著增加(p = 0.001,95%CI,0.17,0.37mm),但在随后的第二个月(p = 0.450,95%CI,0.13,0.43mm)、第三个月(p = 0.204,95%CI,0.23,0.47mm)和第四个月(p = 0.680,95%CI,0.21,0.41mm)试验组和对照组之间无统计学显著差异。两组在所有时间间隔的磨牙支抗丧失也无差异(p > 0.05)。

结论

微骨穿孔术在4个月期间并未加速前牙整体后移速率;然而,它仅在第一个月暂时增加后移速率,且对磨牙支抗无影响。

试验注册

该试验在www.ctri.nic.in注册,注册号为CTRI/2019/03/018140。

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