Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, Mich; Private practice, Novi, Mich.
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Mich.
Am J Orthod Dentofacial Orthop. 2023 Dec;164(6):824-836. doi: 10.1016/j.ajodo.2023.05.031. Epub 2023 Aug 18.
This study aimed to quantify the outcomes of adolescent patients with Class II malocclusion treated with the Carriere Motion 3D Appliance (CMA) combined with full fixed appliances.
Cone-beam computed tomography scans of 22 patients were available before orthodontic treatment (T1), at removal of the CMA (T2), and posttreatment (T3). The average age of the patients was 13.5 ± 1.6 years at T1, 14.1 ± 0.2 years at T2, and 15.6 ± 0.5 years at T3. The 3-dimensional image analysis procedures were performed using ITK-SNAP (version 3.6.0; www.itksnap.org, Hatfield, Pa) and SlicerCMF (version 4.11.0; http://www.slicer.org, Cambridge, Mass); skeletal and dentoalveolar changes relative to cranial base, maxillary, and mandibular regional superimpositions were evaluated.
Changes were analyzed with 1 sample t tests using the mean differences during the CMA phase (T1 to T2) and total treatment time (T1 to T3). Significant skeletal changes included a slight reduction of ANB from T1 to T3, mandibular growth (Co-Gn increment of 1.2 mm and 3.3 mm from T1 to T2 and T1 to T3, respectively), inferior displacement of point A, and anterior and inferior displacement of point B. The mandibular plane did not change significantly during treatment. During the CMA treatment, posterior tipping and distal rotation of the maxillary molars, tip back and inferior displacement of the maxillary canines, significant mesial rotation, and superior displacement of the mandibular molars were observed. These movements rebounded during the full fixed appliance phase except for the molar and canine vertical displacements. Clinically significant dental changes during treatment included a reduction in overjet and overbite, Class II correction of the molar and canine relationship, and proclination of the mandibular incisors.
The CMA is an effective treatment modality for Class II correction in growing patients because of a combination of mesial movement of the mandibular molar, distal rotation of the maxillary molar, and anterior displacement of the mandible.
本研究旨在量化使用 Carriere Motion 3D Appliance（CMA）联合全固定矫治器治疗 II 类错[牙合]青少年患者的治疗结果。
22 名患者在正畸治疗前（T1）、CMA 拆除时（T2）和治疗后（T3）均接受了锥形束 CT 扫描。患者的平均年龄为 T1 时 13.5 ± 1.6 岁，T2 时 14.1 ± 0.2 岁，T3 时 15.6 ± 0.5 岁。使用 ITK-SNAP（版本 3.6.0；www.itksnap.org，Hatfield，Pa）和 SlicerCMF（版本 4.11.0；http://www.slicer.org，马萨诸塞州剑桥）进行三维图像分析程序；评估了相对于颅底、上颌和下颌区域叠加的骨骼和牙颌变化。
使用 T1 至 T2 期间的平均差异（CMA 阶段）和总治疗时间（T1 至 T3），采用单样本 t 检验分析了变化。明显的骨骼变化包括 ANB 从 T1 到 T3 略有减小，下颌生长（Co-Gn 增量分别为 1.2mm 和 3.3mm，从 T1 到 T2 和 T1 到 T3），点 A 向下位移，点 B 向前和向下位移。治疗过程中下颌平面无明显变化。在 CMA 治疗期间，观察到上颌磨牙后倾和远移、上颌尖牙后倾和向下位移、显著的近中旋转和下颌磨牙向上位移。这些运动在全固定矫治器阶段反弹，除了磨牙和尖牙的垂直位移。治疗过程中明显的牙齿变化包括减少覆[牙合]和覆盖，磨牙和尖牙关系的 II 类矫正，以及下颌切牙的前倾。
CMA 是一种有效的治疗方法，适用于生长中的 II 类错[牙合]患者，因为它结合了下颌磨牙的近中移动、上颌磨牙的远移和下颌的前移位。
