Department of Biomedical Surgical and Dental Sciences, University of Milan, 20142 Milan, Italy - Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy.
Department of Sciences Integrated Surgical and Diagnostic, University of Genova, Genova, Italy.
Eur J Paediatr Dent. 2023 Sep 1;24(3):180 - 187. doi: 10.23804/ejpd.2023.1727. Epub 2023 Jun 1.
The aim of this study was to assess the skeletal and dento-alveolar changes produced by a customised eruption guidance appliance (EGA) and a preformed EGA in subjects presenting a skeletal class II pattern during early mixed dentition and to evaluate the differences between the two devices.
All subjects included in the study were randomly selected from the record's archive according to the following inclusion criteria: (1) patients presenting upper central incisor and first permanent molars fully erupted; (2) early mixed dentition with age between 7 to 9 years old; (3) Angle class I or class II malocclusion; (4) increased overjet > 4 mm;(5) deep bite with at least 2/3 overlapping of the incisors; (6) no previous orthodontic treatment apart from maxillary expansion treatment. All children belonging to the case group received treatment with a 3D printed EGA whereas the other patients belonging to the control group were treated with preformed EGA. Records consisted in digital dental models and lateral cephalogram at the beginning (T0) and after 1 year of treatment (T1). Data collected on the digital models included the dentoalveolar changes in overbite, overjet, sagittal molar relationship, and dental crowding. Cephalometric tracings were computed by a single blinded observer using Dolphin Imaging software. Statistical analysis was performed with SPSS (version 25.00; IBM Corp, Armonk, NY). Comparison regarding the cephalometric changes between T1-T2 was carried out with paired t-test. Difference in distribution regarding sagittal molar and canine relationship and anterior crowding between groups at T1 and T2 has been computed with chi-square test. The independent sample t-test was used to perform the between group comparison.
In the short time, both the appliances showed to be effective in correcting class II malocclusion, anterior crowding, overjet and overbite. Custom-made appliance demonstrated to be significantly more effective in correcting anterior crowding, the dento-skeletal vertical relation and position of permanent incisor compared to the preformed appliance. Adopting a customised device, effects due to an average prescription appliance used to a specific patient can be reduced, resulting in more predictable results.
本研究旨在评估在混合牙列早期呈现骨骼 II 类模式的患者中使用定制式萌出引导装置（EGA）和预成型 EGA 引起的骨骼和牙牙槽变化，并评估两种设备之间的差异。
根据以下纳入标准，从档案记录中随机选择所有纳入研究的受试者：（1）上中切牙和第一恒磨牙完全萌出；（2）年龄在 7 至 9 岁之间的早期混合牙列；（3）Angle 类 I 或类 II 错颌；（4）超过 4mm 的前牙深覆盖；（5）至少有 2/3 的前牙重叠的深覆颌；（6）除上颌扩弓治疗外，无先前的正畸治疗。所有属于病例组的儿童均接受 3D 打印 EGA 治疗，而属于对照组的其他患者则接受预成型 EGA 治疗。记录包括治疗前（T0）和治疗 1 年后（T1）的数字牙科模型和侧位头颅侧位片。从数字模型中收集的资料包括覆盖、覆盖、矢状磨牙关系和牙齿拥挤的牙牙槽变化。使用 Dolphin Imaging 软件由一位单盲观察者进行头影测量描记。使用 SPSS（版本 25.00；IBM 公司，纽约州阿蒙克）进行统计分析。使用配对 t 检验比较 T1-T2 时的头影测量变化。使用卡方检验比较 T1 和 T2 时组间矢状磨牙和尖牙关系以及前牙拥挤的分布差异。使用独立样本 t 检验进行组间比较。
在短时间内，两种装置均有效纠正 II 类错颌、前牙拥挤、覆盖和覆颌。与预成型装置相比，定制装置在矫正前牙拥挤、牙颌矢状垂直关系和恒牙切牙位置方面的效果明显更显著。采用定制设备，可以减少由于特定患者使用普通处方设备而产生的影响，从而获得更可预测的结果。
