正畸医生对正畸透明矫正器应用情况的调查。

A survey of orthodontic clear aligner practices among orthodontists.

机构信息

Orthodontic Unit, Adelaide Dental School, the University of Adelaide, Adelaide, South Australia, Australia.

出版信息

Am J Orthod Dentofacial Orthop. 2022 Dec;162(6):e302-e311. doi: 10.1016/j.ajodo.2022.08.018. Epub 2022 Oct 3.

DOI:10.1016/j.ajodo.2022.08.018

PMID:36202697

Abstract

INTRODUCTION

The purpose of this cross-sectional study was to survey orthodontic clear aligner therapy (CAT) practices among orthodontists in Australia.

METHODS

A pilot-tested electronic questionnaire was distributed to 434 full members of the Australian Society of Orthodontists. Questions were related to demographics, use and choice of aligners, digital treatment planning, patient selection, treatment protocols, refinements/finishing, retention, and patient-reported aligner issues. Factors regarding the decision not to provide CAT were also surveyed.

RESULTS

The response rate was 54.6%. Most orthodontists (93.13%) provided CAT, which made up 24.17% of their annual orthodontic caseload. The median percentage of initial digital treatment plans (DTP) approved without changes was 0, with 4-6 changes reported by 24.14%. Orthodontists reported a mean of 2.02 ± 1.76 refinements per patient. Orthodontists were least comfortable treating patients with bilateral crossbite (71.28%) and deep overbite (62.56%). DTP challenges regarding tooth attachments and tooth positions and issues regarding patient compliance with CAT wear protocols were commonly reported. More than 1 CAT system was used by most (63.92%), with in-house systems used by 21.63%. Orthodontists rarely or never (63.68%) performed premolar extraction treatment with CAT. Adjunctive interproximal reduction was reportedly mostly carried out to relieve crowding and reduce open gingival embrasures. The view that fixed appliances provide better outcomes was a major influence (71.43%) on the decision for those who did not provide any CAT.

CONCLUSIONS

CAT practices among orthodontists varied. Further research is required to investigate the challenges in effective CAT provision highlighted in this survey.

摘要

简介

本横断面研究旨在调查澳大利亚正畸医生的正畸透明矫正器治疗（CAT）实践情况。

方法

对澳大利亚正畸学会的 434 名全职会员进行了试点测试的电子问卷调查。问题涉及人口统计学、矫正器的使用和选择、数字化治疗计划、患者选择、治疗方案、调整/完成、保持和患者报告的矫正器问题。还调查了不提供 CAT 的决定的相关因素。

结果

回复率为 54.6%。大多数正畸医生（93.13%）提供 CAT，占其年度正畸病例的 24.17%。未经修改即批准的初始数字治疗计划（DTP）的中位数百分比为 0，报告有 4-6 处更改的占 24.14%。正畸医生报告每位患者平均有 2.02 ± 1.76 次调整。正畸医生最不擅长治疗双侧反颌（71.28%）和深覆颌（62.56%）的患者。牙齿附件和牙齿位置的 DTP 挑战以及患者对 CAT 佩戴方案的依从性问题经常被报道。大多数正畸医生（63.92%）使用了不止一种 CAT 系统，其中 21.63%使用了内部系统。正畸医生很少或从未（63.68%）使用 CAT 进行前磨牙拔牙治疗。据报道，附加的邻面去釉主要用于缓解拥挤和减少开唇龈间隙。认为固定矫治器能提供更好的效果是不提供任何 CAT 的主要影响因素（71.43%）。