Formerly, Department of Orthodontics, Marquette University School of Dentistry, Milwaukee, Wis; currently, Private practice, Chicago, Ill.
Marquette University School of Dentistry, Milwaukee, Wis.
Am J Orthod Dentofacial Orthop. 2021 Aug;160(2):250-258. doi: 10.1016/j.ajodo.2020.04.028. Epub 2021 Jul 1.
The purpose of this study was to compare the efficacy of Invisalign's (Align Technology, Santa Clara, Calif) optimized and conventional attachments on rotational and extrusive tooth movements.
Initial, predicted, and achieved digital dental models from 100 orthodontic patients were exported from Invisalign's ClinCheck software as stereolithography files and subsequently imported into the Slicer CMF program (version 4.7.0; http://www.slicer.org) for superimpositions on posterior teeth with no planned movement. Rotational and extrusive measurements for both optimized and conventional attachments were made on 382 teeth from the superimposition of the initial and predicted models (predicted movement) and from the superimposed initial and achieved models (achieved movement). Predicted and achieved movements were compared along with movements of teeth with optimized and conventional attachments.
Differences between accuracies of tooth movements using optimized vs conventional attachments for both rotation and extrusion were neither statistically nor clinically significant. Mean predicted values were larger than mean achieved values for all attachment types and movements (P < 0.0001). For extrusion, the mean difference between predicted and achieved movements was clinically significant (0.40 mm and 0.62 mm for optimized and conventional attachments, respectively). Overall, the mean accuracy was 57.2%. Mean accuracy was 63.2% for rotation and 47.6% for extrusion. Interproximal reduction or spacing did not significantly affect accuracy.
Conventional attachment types may be just as effective as Invisalign's proprietary optimized attachments for rotations of canines and premolars and extrusion of incisors and canines. Clinicians should consider overcorrecting tooth movements, especially anterior tooth extrusion.
本研究旨在比较 Invisalign（加利福尼亚州圣克拉拉的Align Technology）的优化附件和传统附件在牙齿旋转和外展运动中的疗效。
从 100 名正畸患者的初始、预测和实际数字牙科模型中，从 Invisalign 的 ClinCheck 软件导出立体光刻文件，并随后将其导入 Slicer CMF 程序（版本 4.7.0；http://www.slicer.org），以便在后牙上进行无计划移动的重叠。在初始和预测模型的叠加（预测运动）以及初始和实际模型的叠加（实际运动）上，对 382 颗牙齿进行了优化和传统附件的旋转和外展测量。对优化和传统附件的预测和实际运动进行了比较，并与牙齿的运动进行了比较。
旋转和外展两种运动中，优化附件与传统附件的运动精度差异既无统计学意义，也无临床意义。所有附件类型和运动的平均预测值均大于平均实际值（P<0.0001）。对于外展，预测和实际运动之间的平均差异具有临床意义（优化和传统附件分别为 0.40mm 和 0.62mm）。总体而言，平均精度为 57.2%。旋转的平均精度为 63.2%，外展的平均精度为 47.6%。邻面减少或间隙并不显著影响精度。
传统附件类型可能与 Invisalign 的专有的优化附件一样有效，可用于尖牙和前磨牙的旋转以及切牙和尖牙的外展。临床医生应考虑过度矫正牙齿运动，尤其是前牙外展。
