Wang Xiao-Ming, Meng Wen-Yu, Wang Wei-Ning, Huo Yi-Fei, Xue Hui
Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing (NO: 20JR10RA653 - ZDKF20210401), School of Stomatology, Lanzhou University, No. 199, Donggang West Road, Gansu Province, Lanzhou, 730000, People's Republic of China.
Department of Orthodontics, School of Stomatology, Lanzhou University, No. 199, Donggang West Road, Gansu Province, Lanzhou, 730000, People's Republic of China.
Clin Oral Investig. 2023 Jul;27(7):3961-3972. doi: 10.1007/s00784-023-05020-3. Epub 2023 Apr 18.
The purpose of this study was to develop a novel Bonwill⁃Hawley method (Bonwill⁃Hawley arch form based on CBCT image) for the assessment of dental crowding, and to investigate and compare the accuracy and eligibility with the conventional brass wire and caliper methods under different crowding conditions.
Sixty patients with the pair of plaster casts and CBCT data were collected. All the casts were marked and transformed into digital models using iTero scanner, and imported into OrthoCAD software to measure the required space. Using the conventional brass wire (M1) and caliper methods (M2), the available space and dental crowding were measured and calculated basing on digital models, respectively. Correspondingly, the axial planes in the level of dental arches were oriented and captured from the CBCT images to draw the Bonwill⁃Hawley arch forms (M3), which were used to measure and calculate the available space and dental crowding. For each method, intra and inter-examiner reliabilities were evaluated with intra-class correlation coefficients (ICCs). Wilcoxon test and Kruskal-Wallis test were performed for statistically analyzing the discrepancy among different groups.
Both intra- and inter-examiner reliability were generally excellent for all parameters obtained by the three methods, except for the dental crowding measured using M1(ICC: 0.473/0.261). The dental crowding measured using M2 were significantly increased in mild, moderate and severe-crowding groups compared with M1. However, no significant difference was detected between M1 and M3 in severe-crowding group (maxilla, p = 0.108 > 0.05; mandible, p = 0.074 > 0.05). With the deterioration of crowding condition, the discrepancy of dental crowding between M1 and M2, or M1 and M3 were significantly decreased (maxilla, M2-M1, mild VS serve, p = 0.003 < 0.05; maxilla, M3-M1, mild VS serve, p = 0.003 < 0.05; mandible, M2-M1, mild VS serve, p = 0.000 < 0.001; mandible, M3-M1, mild VS serve, p = 0.043 < 0.05).
Dental crowding measured using the novel Bonwill⁃Hawley method was relatively greater than the caliper method, but not exceeding the brass wire method, which wound gradually come close to the brass wire method with the deterioration of crowding condition.
The Bonwill⁃Hawley method basing on CBCT image proved to be a reliable and acceptable choice for orthodontists to analyze the dental crowding.
本研究旨在开发一种用于评估牙列拥挤的新型邦威尔-霍利方法（基于CBCT图像的邦威尔-霍利牙弓形态），并在不同拥挤条件下研究和比较其与传统铜丝法和卡尺法的准确性及适用性。
收集60例患者的石膏模型及CBCT数据。所有模型均进行标记，并使用iTero扫描仪转换为数字模型，然后导入OrthoCAD软件测量所需空间。分别采用传统铜丝法（M1）和卡尺法（M2），基于数字模型测量并计算可用空间和牙列拥挤情况。相应地，从CBCT图像中确定并获取牙弓水平的轴向平面，绘制邦威尔-霍利牙弓形态（M3），用于测量和计算可用空间及牙列拥挤情况。对于每种方法，采用组内相关系数（ICC）评估检查者内和检查者间的可靠性。进行Wilcoxon检验和Kruskal-Wallis检验，以统计分析不同组间的差异。
除使用M1测量的牙列拥挤情况外（ICC：0.473/0.261），三种方法获得的所有参数的检查者内和检查者间可靠性总体均良好。与M1相比，使用M2测量的轻度、中度和重度拥挤组的牙列拥挤情况显著增加。然而，在重度拥挤组中，M1和M3之间未检测到显著差异（上颌，p = 0.108＞0.05；下颌，p = 0.074＞0.05）。随着拥挤情况的恶化，M1与M2或M1与M3之间牙列拥挤情况的差异显著减小（上颌，M2 - M1，轻度与重度，p = 0.003＜0.05；上颌，M3 - M1，轻度与重度，p = 0.003＜0.05；下颌，M2 - M1，轻度与重度，p = 0.000＜0.001；下颌，M3 - M1，轻度与重度，p = 0.043＜0.05）。
使用新型邦威尔-霍利方法测量的牙列拥挤情况相对大于卡尺法，但不超过铜丝法，且随着拥挤情况的恶化，该方法将逐渐接近铜丝法。
基于CBCT图像的邦威尔-霍利方法被证明是正畸医生分析牙列拥挤的一种可靠且可接受的选择。
