Jung Min-Ho
Department of Orthodontics, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea.
Private Practice, Seoul, Korea.
Korean J Orthod. 2021 Nov 25;51(6):397-406. doi: 10.4041/kjod.2021.51.6.397.
The purpose of this study was to evaluate the effects of self-ligating brackets (SBs) and other factors that influence orthodontic treatment outcomes.
This two-armed cohort study included consecutively treated patients in a private practice. The patients were asked to choose between SBs and conventional brackets (CBs); if any patient did not have a preference, he or she was randomly allocated to the CB or SB group. All patients were treated using an identical archwire sequence. Evaluated parameters were as follows: treatment duration, number of bracket failures, poor oral hygiene, poor elastic wear, extraction, use of orthodontic mini-implants (OMI), OMI failure, American Board of Orthodontics (ABO) Discrepancy Index (DI), arch length discrepancy, and ABO Cast-Radiograph Evaluation (CRE) score. Stepwise regression analysis was performed to generate the equation for prediction of the CRE.
The final sample comprised 134 patients with an average age of 22.73 years. The average DI, CRE, and treatment duration were 21.81, 14.25, and 28.63 months, respectively. Analysis of covariance showed a significant difference in CRE between the CB and SB groups after adjusting for the effects of confounding variables. Stepwise regression analysis using four variables, namely extraction, SB use, poor elastic wear, and additional appliance use, could explain only 25.2% of the variance in the CRE.
Although the CRE was significantly better for CBs than for SBs, the clinical significance of this result seems to be limited. Extraction, SB use, poor elastic wear, and additional appliance use may have significant effects on treatment outcomes.
本研究旨在评估自锁托槽（SBs）及其他影响正畸治疗效果的因素。
这项双臂队列研究纳入了在一家私人诊所接受连续治疗的患者。患者被要求在自锁托槽和传统托槽（CBs）之间进行选择；若有患者无偏好，则将其随机分配至传统托槽组或自锁托槽组。所有患者均采用相同的弓丝序列进行治疗。评估参数如下：治疗持续时间、托槽脱落数量、口腔卫生差、弹性体磨损不佳、拔牙、正畸微种植体（OMI）的使用、OMI失败、美国正畸委员会（ABO）差异指数（DI）、牙弓长度差异以及ABO模型-放射片评估（CRE）评分。进行逐步回归分析以生成预测CRE的方程。
最终样本包括134例患者，平均年龄22.73岁。平均DI、CRE和治疗持续时间分别为21.81、14.25和28.63个月。协方差分析显示，在调整混杂变量的影响后，传统托槽组和自锁托槽组之间的CRE存在显著差异。使用拔牙、自锁托槽使用、弹性体磨损不佳和额外装置使用这四个变量进行的逐步回归分析仅能解释CRE中25.2%的方差。
尽管传统托槽的CRE明显优于自锁托槽，但该结果的临床意义似乎有限。拔牙、自锁托槽使用、弹性体磨损不佳和额外装置使用可能对治疗效果有显著影响。
