Angle Orthod. 2023 Nov 1;93(6):644-651. doi: 10.2319/020923-94.1.
To compare the efficacy and efficiency of treatment with clear aligners (CAT) vs fixed appliances (FAT) in adolescents with Class I and II moderate to severe malocclusions.
One operator's (Garfinkle) cases from 2014 to 2019, started at age 12-18 years, with pre- and posttreatment records were identified and used according to an institutional review board-approved protocol. Records were measured by two calibrated, blinded investigators, aided by software (OrthoCAD [Cadent, Fairview, N.J.], Dolphin Imaging & Management Solutions [Chatsworth, Calif]). Discrepancy index (DI) and cast radiograph evaluation (CRE) scores, treatment duration, number of scheduled and emergency visits, and reported appliance and interarch elastic wear compliance were compared between groups using Wilcoxon rank sum and Fisher's exact tests. Cephalometric superimpositions were completed to evaluate craniofacial growth and dental changes.
Records from 72 cases met the criteria and were included. For the 47 CAT and 25 FAT cases, mean DI (21 ± 5 and 24 ± 8, respectively; P = .20) and CRE (35 ± 10 and 34 ± 9, respectively; P = .90) scores were not significantly different. Other case attributes and reported appliance and interarch elastic wear compliance were also not significantly different. CAT vs FAT cases had significantly smaller treatment durations (24 ± 6 vs 27 ± 5 months; P = .01) and visit numbers (16 ± 5 vs 24 ± 4; P < .01), but emergency visit numbers were not significantly different (2 ± 2 vs 3 ± 2; P = .08).
In adolescents with Class I and II malocclusions and moderate to severe DI scores, on average, CAT vs FAT cases were completed 3 months faster with eight fewer visits, but treatment efficacy was not significantly different.
比较使用透明牙套（CAT）和固定矫治器（FAT）治疗 I 类和 II 类中度至重度错颌畸形青少年的疗效和效率。
根据机构审查委员会批准的方案，确定并使用了一位医生（Garfinkle） 2014 年至 2019 年的病例，这些病例的起始年龄为 12-18 岁，治疗前后均有记录。由两名经过校准的、盲法的调查员使用软件（OrthoCAD [Cadent，Fairview，NJ]，Dolphin Imaging & Management Solutions [Chatsworth，CA]）进行测量。使用 Wilcoxon 秩和检验和 Fisher 确切检验比较两组间的差异指数（DI）和模型记录评估（CRE）评分、治疗持续时间、预约和急诊就诊次数，以及报告的矫治器和上下颌间弹性的顺应性。完成头颅侧位片重叠以评估颅面生长和牙齿变化。
符合标准并纳入 72 例病例。47 例 CAT 组和 25 例 FAT 组的平均 DI（分别为 21 ± 5 和 24 ± 8；P =.20）和 CRE（分别为 35 ± 10 和 34 ± 9；P =.90）评分无显著差异。其他病例特征以及报告的矫治器和上下颌间弹性的顺应性也无显著差异。CAT 组与 FAT 组的治疗持续时间（分别为 24 ± 6 个月和 27 ± 5 个月；P =.01）和就诊次数（分别为 16 ± 5 次和 24 ± 4 次；P <.01）明显较小，但急诊就诊次数无显著差异（分别为 2 ± 2 次和 3 ± 2 次；P =.08）。
在 I 类和 II 类错颌畸形且 DI 评分中度至重度的青少年中，平均而言，CAT 组比 FAT 组完成治疗快 3 个月，就诊次数少 8 次，但治疗效果无显著差异。
