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3D 引导正畸超声骨刀辅助精准性和疗效的随机对照研究。

The efficacy and accuracy of 3D-guided orthodontic piezocision: a randomized controlled trial.

机构信息

Oral and Maxillofacial Surgery Department, University of Damascus Dental School, Damascus, Syria.

Department of Oral and Maxillofacial Surgery, University of Damascus Dental School, Damascus, Syria.

出版信息

BMC Oral Health. 2023 Mar 28;23(1):181. doi: 10.1186/s12903-023-02902-6.

DOI:10.1186/s12903-023-02902-6
PMID:36978052
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10053659/
Abstract

BACKGROUND

No randomized controlled trial (RCT) has studied the accuracy of surgical guides used in terms of orthodontic treatment acceleration. Therefore the aim of this trial was to assess computer-guided piezocision-based orthodontic.

MATERIALS AND METHODS

Thirty-two patients with severely crowded upper anterior teeth were enrolled and randomly allocated to either the experimental group (ExpG) or the control one. Subjects of the ExpG received three-dimensional (3D) guided piezoelectric corticotomies on the buccal alveolar bone of the anterior region. Five piezocision cuts were properly performed between each anterior teeth and the adjacent in virtual models. Surgical guides were designed and 3D-printed with preplanned slots that guide gingival and then piezoelectric incisions. The patients underwent Cone-Beam Computed Tomography CBCT before and immediately after surgery. Thus, Predesigned piezocisions were compared to the actual ones in attempt to measure three dimensional deviations of the applied peizocisions.

RESULTS

Ninety-six severe maxillary dental crowding were assigned for eligibility, 40 of them met the inclusion criteria. Thirty-two participants were randomly allocated to the trial`s groups. No patient was lost to follow-up neither from the control nor the experimental group. Overall alignment time (OAT) was reduced by 53% in the experimental group compared to the control group. The mean of the 3D deviation of the surgical guide was 0.23 mm (standard deviation 0.19 mm).

CONCLUSION

The values of the surgical guide deviation was nearly null, which confirms that this innovative technique is clinically applicable. Furthermore, this technique was impressively effective in accelerating orthodontic tooth movement.

TRIAL REGISTRATION

This trial was registered at The ISRCTN registry (ID: ISRCTN65498676 Registration date: 07/04/2021).

摘要

背景

尚未有随机对照试验(RCT)研究过用于加速正畸治疗的外科导板的准确性。因此,本试验旨在评估计算机引导的基于压电的正畸。

材料和方法

招募了 32 名上前牙严重拥挤的患者,并将其随机分为实验组(ExpG)或对照组。ExpG 组的受试者在前牙区颊侧牙槽骨上接受了三维(3D)引导的压电皮质切开术。在虚拟模型中,每颗前牙与相邻牙之间适当进行了 5 次压电切割。设计并 3D 打印了带有预规划槽的外科导板,以引导牙龈和随后的压电切口。患者在手术前后进行了锥形束 CT(CBCT)检查。因此,尝试比较预设计的压电切割与实际的压电切割,以测量施加的压电切割的三维偏差。

结果

共有 96 例严重的上颌牙齿拥挤符合入选条件,其中 40 例符合纳入标准。32 名参与者被随机分配到试验组。对照组和实验组均无失访病例。实验组的总体对齐时间(OAT)比对照组缩短了 53%。手术导板的平均三维偏差为 0.23 毫米(标准偏差 0.19 毫米)。

结论

手术导板偏差值几乎为零,这证实了这项创新技术具有临床应用价值。此外,这项技术在加速正畸牙齿移动方面效果显著。

试验注册

本试验在国际临床试验注册平台(ISRCTN)注册(注册号:ISRCTN65498676,注册日期:2021 年 7 月 4 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/3073140b447c/12903_2023_2902_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/dba96ac386ee/12903_2023_2902_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/e03d6a67c8eb/12903_2023_2902_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/af20788e251d/12903_2023_2902_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/5a505588ec7d/12903_2023_2902_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/c84618b2a328/12903_2023_2902_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/3073140b447c/12903_2023_2902_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/dba96ac386ee/12903_2023_2902_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/e03d6a67c8eb/12903_2023_2902_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/af20788e251d/12903_2023_2902_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/5a505588ec7d/12903_2023_2902_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/c84618b2a328/12903_2023_2902_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d06/10053659/3073140b447c/12903_2023_2902_Fig6_HTML.jpg

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