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后牙反颌矫治的新概念:初步结果

Novel concept for posterior crossbite correction : Preliminary results.

作者信息

Wiechmann Dirk

机构信息

Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany.

Private Practice, Lindenstr. 44, 49152, Bad Essen, Germany.

出版信息

J Orofac Orthop. 2025 Jan;86(1):1-10. doi: 10.1007/s00056-023-00468-0. Epub 2023 May 4.

Abstract

PURPOSE

The efficiency of dentoalveolar compensation involving both jaws for posterior crossbite correction using computer-aided design/computer-aided manufacturing (CAD/CAM) expansion and compression archwires was evaluated. Treatment outcome was tested against the null hypothesis that the transverse correction achieved would be significantly smaller than planned.

METHODS

This retrospective study included 64 patients (mean age 23.5 years, median 17.0, minimum/maximum: 9.0/63.0, standard deviation 13.7) with uni- or bilateral posterior crossbite. In all consecutively debonded patients, expansion and/or compression archwires were used for dentoalveolar correction involving both jaws. Plaster casts prior to (T1) and following treatment (T2) with completely customized lingual appliances (CCLA) were compared with the treatment plan represented by an individual target set-up. The statistical analysis was carried out using the Schuirmann TOST (two one-sided t‑tests) equivalence test on the basis of a one-sample t‑test with α = 0.025 to one side. The non-inferiority margin was set at δ = 0.5 mm.

RESULTS

All posterior crossbites could be corrected by dentoalveolar compensation involving both jaws. The mean total correction achieved was 6.9 mm (mean maxillary expansion: 4.3 mm/mean mandibular compression: 2.6 mm) with a maximum of 12.8 mm. The transverse corrections achieved in both arches at T2 were equivalent to the planned corrections in the set-up (p < 0.001).

CONCLUSION

The results of this study indicate that CAD/CAM expansion and compression archwires can be an efficient tool to achieve the desired correction in patients with a posterior crossbite even in more severe cases.

摘要

目的

评估使用计算机辅助设计/计算机辅助制造(CAD/CAM)扩弓和缩弓丝进行双颌牙槽代偿以矫正后牙反牙合的效率。针对横向矫正效果显著小于计划值这一零假设对治疗结果进行检验。

方法

这项回顾性研究纳入了64例单侧或双侧后牙反牙合患者(平均年龄23.5岁,中位数17.0岁,最小/最大年龄:9.0/63.0岁,标准差13.7)。在所有连续拆除矫治器的患者中,使用扩弓和/或缩弓丝进行双颌牙槽代偿。将使用完全定制舌侧矫治器(CCLA)治疗前(T1)和治疗后(T2)的石膏模型与由个体目标定位代表的治疗计划进行比较。基于单侧α = 0.025的单样本t检验,使用舒尔曼TOST(双侧单样本t检验)等效性检验进行统计分析。非劣效性界值设定为δ = 0.5毫米。

结果

所有后牙反牙合均可通过双颌牙槽代偿得以矫正。实现的平均总矫正量为6.9毫米(平均上颌扩弓:4.3毫米/平均下颌缩弓:2.6毫米),最大矫正量为12.8毫米。T2时两牙弓实现的横向矫正与定位中的计划矫正等效(p < 0.001)。

结论

本研究结果表明,即使在更严重的病例中,CAD/CAM扩弓和缩弓丝也可以成为实现后牙反牙合患者所需矫正的有效工具。

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