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上颌前牙保持期间及去除保持器后 1 年的稳定性-两种不同粘结保持器和真空成型保持器对青少年保持的 RCT 研究

Stability of maxillary anterior teeth during retention and 1 year after removal of retention-an RCT on adolescents retained with two different bonded retainers and a vacuum-formed retainer.

机构信息

Orthodontic Clinic, Public Dental Health, Växjö, Sweden.

Division of Orthodontics and Paediatric Dentistry, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.

出版信息

Eur J Orthod. 2023 Nov 30;45(6):629-636. doi: 10.1093/ejo/cjad020.

Abstract

BACKGROUND

Maxillary bonded and removable retainers maintain teeth in correct positions following orthodontic treatment. There is insufficient evidence regarding the capacity of the retention methods to stabilize the maxillary teeth both during and after retention.

OBJECTIVE

To evaluate retention capacity and 1-year post-retention changes in the irregularity of maxillary anterior teeth and single anterior tooth contact point discrepancy (CPD) of two bonded and one removable retention method.

TRIAL DESIGN

Three-arm parallel group single-centre randomized controlled trial.

METHODS

Ninety adolescent patients treated with fixed orthodontic appliances were enrolled. After gaining informed consent, the patients were randomized in blocks of 30 by an independent person into one of three groups: A) bonded retainer 13-23; B) bonded retainer 12-22; and C) removable vacuum-formed retainer. The primary outcomes were changes in Little's irregularity index (LII) and single CPD measured on digitalized casts before retention (T1), after 2 years of retention (T2), and 1-year post-retention (T3).

BLINDING

The digital casts were blinded for the outcome assessor.

RESULTS

Data on all 90 patients were analysed according to intention-to-treat principles. Changes in LII during retention were 0.3 mm in group A, 0.6 mm in group B, and 1.0 mm in group C. No significant differences between the groups were seen (P > 0.05). Changes during post-retention were 1.1 mm in group A, 0.5 mm in group B, and 0.4 mm in group C. Group A showed more significant changes than groups B and C (P = 0.003). During the whole post-treatment period, no significant differences were shown between the groups (P > 0.05). CPD did not differ significantly between the groups at any point.

HARMS

Three patients showed changes of LII over 3 mm or CPD over 2 mm during the post-retention period, and two accepted to be realigned.

LIMITATIONS

The trial was a single-centre study evaluating 1-year post-retention changes.

CONCLUSIONS

The changes were clinically insignificant during and after the retention period. Thus, all three methods showed equal retention capacity.

TRIAL REGISTRATION

www.clinicaltrials.com (NCT04616755).

摘要

背景

上颌粘接式和可摘式保持器可在正畸治疗后保持牙齿在正确的位置。关于保持方法在保持期内和保持期后稳定上颌牙齿的能力,证据不足。

目的

评估两种粘接式和一种可摘式保持器的保持能力以及上颌前牙不整齐和单个前牙接触点差异(CPD)在 1 年保持后的变化。

试验设计

三臂平行组单中心随机对照试验。

方法

共纳入 90 名接受固定正畸治疗的青少年患者。在获得知情同意后,通过一名独立人员以 30 人为一组的方式将患者随机分为三组:A)13-23 粘接式保持器;B)12-22 粘接式保持器;和 C)可摘式真空成型保持器。主要结局为数字化模型上记录的 Little 不整齐指数(LII)和单个 CPD 在保持前(T1)、保持 2 年后(T2)和保持 1 年后(T3)的变化。

盲法

数字化模型对结果评估者设盲。

结果

根据意向治疗原则分析了所有 90 例患者的数据。保持期间 LII 的变化在 A 组为 0.3mm,B 组为 0.6mm,C 组为 1.0mm。组间无显著差异(P>0.05)。保持后期间的变化在 A 组为 1.1mm,B 组为 0.5mm,C 组为 0.4mm。A 组的变化明显大于 B 组和 C 组(P=0.003)。在整个治疗后期间,组间无显著差异(P>0.05)。各组在任何时间点的 CPD 均无显著差异。

危害

3 名患者在保持后期间 LII 变化超过 3mm 或 CPD 变化超过 2mm,其中 2 名接受重新排列。

局限性

该试验为单中心研究,评估了 1 年保持后的变化。

结论

在保持期内和保持期后,变化在临床上无显著意义。因此,三种方法均具有相同的保持能力。

试验注册

www.clinicaltrials.com(NCT04616755)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/376d/10687510/b20c8f91773c/cjad020_fig1.jpg

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