Department of Orthodontics, Uningá University Center, Maringá, Paraná, Brazil; Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
Am J Orthod Dentofacial Orthop. 2021 Nov;160(5):671-685. doi: 10.1016/j.ajodo.2020.05.027. Epub 2021 Sep 4.
The objective of this study was to compare the aging changes of the dental arches in orthodontically treated and untreated subjects after a 4-decade follow-up period.
This retrospective study analyzed 2 groups. The treated group comprised 29 patients (11 male, 18 female) presenting with Class I or Class II malocclusions orthodontically treated with extractions of 4 first premolars. Dental models taken at pretreatment (12.84 years), posttreatment (14.95 years), and long-term posttreatment (51.37 years) were evaluated. The untreated (control) group consisted of 22 untreated patients with dental models taken at 13.32, 17.82, and 60.95 years of age. The dental models were digitized, and the following variables were evaluated: Little irregularity index, intercanine, interpremolar and intermolar widths, arch length, arch perimeter, overjet, and overbite. Interphase comparison of the treated group was performed with repeated measures analysis of variance and Tukey tests. Intergroup comparisons were performed using t tests (P <0.05).
Crowding was corrected with treatment but relapsed significantly in the long term. Intercanine width increased with treatment and decreased in the long term. Interpremolar and intermolar widths, arch perimeter, and length decreased with treatment and continued to decrease long-term posttreatment. Overjet and overbite were corrected with treatment and remained stable in the long term. From posttreatment to long-term posttreatment, a greater crowding increase was observed in the treated group than in the untreated group. The treated group demonstrated a greater decrease in mandibular intercanine and maxillary and mandibular interpremolar widths than the untreated sample. Overbite increased in the treated group and decreased in the untreated group. The multiple regression analysis showed that previous 4-premolar extractions orthodontic treatment is significantly associated with anterior crowding in the long term.
In the long-term, the treated patients showed relapse of crowding and a decrease in arch form. Long-term changes of treated patients were different from untreated subjects. Relapse might have contributed to greater changes in incisor crowding and arch widths observed in the treated patients.
本研究的目的是比较正畸治疗和未治疗患者在 40 年随访后的牙弓老化变化。
本回顾性研究分析了 2 组患者。治疗组包括 29 名患者(男 11 名,女 18 名),存在 I 类或 II 类错牙合畸形,经 4 颗第一前磨牙拔牙矫正。治疗前(12.84 岁)、治疗后(14.95 岁)和长期治疗后(51.37 岁)拍摄的牙模进行了评估。未治疗(对照组)组由 22 名未经治疗的患者组成,他们在 13.32 岁、17.82 岁和 60.95 岁时拍摄了牙模。对牙模进行数字化处理,评估以下变量:小不调指数、尖牙间宽度、前磨牙间宽度、磨牙间宽度、牙弓长度、牙弓周长、覆牙合和覆盖。采用重复测量方差分析和 Tukey 检验对治疗组进行组内比较。采用 t 检验进行组间比较(P<0.05)。
治疗后牙列拥挤得到了纠正,但在长期随访中明显复发。尖牙间宽度随着治疗而增加,而在长期随访中则减少。前磨牙间宽度、磨牙间宽度、牙弓周长和长度随着治疗而减少,并在长期治疗后继续减少。覆牙合和覆盖通过治疗得到纠正,并在长期随访中保持稳定。从治疗后到长期治疗后,治疗组的牙列拥挤增加量大于未治疗组。与未治疗组相比,治疗组下颌尖牙间宽度和上颌及下颌前磨牙间宽度减少更多。治疗组的覆盖增加,未治疗组的覆盖减少。多元回归分析显示,四前磨牙拔牙正畸治疗与长期前牙拥挤显著相关。
在长期随访中,治疗患者表现出拥挤的复发和牙弓形态的减少。治疗患者的长期变化与未治疗患者不同。复发可能导致治疗组观察到的切牙拥挤和牙弓宽度变化更大。