Al-Ibrahim Heba M, Hajeer Mohammad Y, Burhan Ahmad S, Haj Hamed Yaser, Alkhouri Issam, Zinah Eiad
Department of Orthodontics, University of Damascus Faculty of Dentistry, Damascus, SYR.
Department of Orthodontics, Appolonia Pediatric Dentistry Center, Dubai, ARE.
Cureus. 2023 Mar 3;15(3):e35733. doi: 10.7759/cureus.35733. eCollection 2023 Mar.
Introduction Dental crowding is one of the most common types of malocclusions. It can be treated with or without extraction, depending on the severity of the crowding. Extraction-based orthodontic treatments are the preferred treatment option in cases of severe crowding, but they take longer than non-extraction cases. Objective This study aimed to evaluate the dentoalveolar changes following the orthodontic treatment of severely crowded maxillary anterior teeth in adults using self-ligating brackets alone or combined with flapless piezocision. Materials and methods The participants in this study were 63 patients (46 females and 17 males; mean age SD: 19.71 ± 2.74 years) who attended the Department of Orthodontics at the University of Damascus from January 2020 to December 2021. The participants were divided into three groups at random: Group (1): traditional brackets group, Group (2): self-ligating brackets group; and Group (3): self-ligating brackets with flapless piezocision group. Little's Irregularity Index (LII) was measured at five assessment times: before the onset of orthodontic treatment (T0), after one month (T1), after two months (T2), after three months (T3), and at the end of the leveling and alignment phase (T4). The intercanine width (lingual), the intercanine width (cusp), and the canine rotation angle were measured at two assessment times: before the onset of orthodontic treatment (T0) and at the end of the leveling and alignment phase (T4). Results The three studied groups had statistically significant differences in terms of LII during the first three months, and the most significant improvement of LII was in the self-ligating brackets with the piezocision group (P < 0.001). In addition, the intercanine width (cusp) at the end of the leveling and aligning phase revealed greater mean values in both self-ligating brackets groups compared to the traditional brackets group, and the differences were statistically significant (P < 0.001). Otherwise, no statistically significant differences were found at the end of the leveling and aligning phase in the intercanine width (lingual) or the canine rotation angle between the three studied groups (P > 0.05). Conclusion Using self-ligating brackets with flapless piezocision revealed more significant results concerning LII as compared to other groups. Thus, combining these two acceleration methods could get more effective results in aligning severely crowded teeth. Self-ligating brackets, whether used alone or with flapless piezocision, resulted in greater intercanine width at the cusp level. The type of brackets (traditional or self-ligating) did not affect the canine rotation angle.
引言
牙列拥挤是最常见的错牙合畸形类型之一。根据拥挤程度，可采用拔牙或不拔牙的方式进行治疗。对于严重拥挤的病例，基于拔牙的正畸治疗是首选的治疗方案，但所需时间比不拔牙的病例更长。
目的
本研究旨在评估单独使用自锁托槽或联合无瓣压电切开术对成人严重拥挤的上颌前牙进行正畸治疗后的牙槽骨变化。
材料和方法
本研究的参与者为63例患者（46例女性和17例男性；平均年龄±标准差：19.71±2.74岁），他们于2020年1月至2021年12月在大马士革大学正畸科就诊。参与者被随机分为三组：第（1）组：传统托槽组；第（2）组：自锁托槽组；第（3）组：自锁托槽联合无瓣压电切开术组。在五个评估时间点测量Little不规则指数（LII）：正畸治疗开始前（T0）、1个月后（T1）、2个月后（T2）、3个月后（T3）以及整平排齐阶段结束时（T4）。在两个评估时间点测量尖牙间宽度（舌侧）、尖牙间宽度（牙尖）和尖牙旋转角度：正畸治疗开始前（T0）和整平排齐阶段结束时（T4）。
结果
在最初的三个月中，三个研究组在LII方面存在统计学显著差异，LII改善最显著的是自锁托槽联合压电切开术组（P<0.001）。此外，与传统托槽组相比，整平排齐阶段结束时，两个自锁托槽组的尖牙间宽度（牙尖）平均值更大，差异具有统计学意义（P<0.001）。否则，在整平排齐阶段结束时，三个研究组在尖牙间宽度（舌侧）或尖牙旋转角度方面未发现统计学显著差异（P>0.05）。
结论
与其他组相比，使用自锁托槽联合无瓣压电切开术在LII方面显示出更显著的效果。因此，将这两种加速方法结合起来在排齐严重拥挤的牙齿方面可能会获得更有效的结果。自锁托槽，无论是单独使用还是与无瓣压电切开术联合使用，在牙尖水平都能使尖牙间宽度更大。托槽类型（传统或自锁）不影响尖牙旋转角度。
