Chen Ying-Chen, Chen Carol Yi-Hsuan, Chen Min-Chi, Ko Ellen Wen-Ching, Lin Cheng-Hui
Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan 333, Taiwan.
Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
J Clin Med. 2023 Sep 18;12(18):6029. doi: 10.3390/jcm12186029.
The surgery-first approach (SFA) is conducted to decrease the difficulty and duration of orthodontic treatment by correcting the skeletal discrepancy at the initial stage of treatment. However, the indication of the SFA has not been well defined yet. This study explored the dental occlusion characteristics for treatment decision-making regarding the SFA. A total of 200 skeletal Class III patients were consecutively collected and divided into two groups: the orthodontic-first approach (OFA) group and the SFA group. The pretreatment digital dental models and lateral cephalograms were measured. Logistic regression was completed and receiver operating characteristic (ROC) curves were obtained to predict the probability of the SFA. Results showed that the ROC model with L1-MP, upper and lower arch length discrepancy, overbite, and asymmetric tooth number as influencing factors revealed that the sensitivity and specificity for determining SFA were 83.0% and 65.0%, respectively; the accuracy of prediction was 75.0%. In conclusion, our findings indicate that the six measurements from digital dental models and lateral cephalograms can be effectively applied in treatment decision-making for the SFA with satisfactory accuracy.
手术优先方法（SFA）旨在通过在治疗初始阶段纠正骨骼差异来降低正畸治疗的难度和时长。然而，SFA的适应症尚未得到明确界定。本研究探讨了用于SFA治疗决策的牙合特征。连续收集了200例骨性III类患者并将其分为两组：正畸优先方法（OFA）组和SFA组。对治疗前的数字化牙模和头颅侧位片进行测量。完成逻辑回归并获得受试者工作特征（ROC）曲线以预测SFA的概率。结果显示，以L1-MP、上下牙弓长度差异、覆牙合和不对称牙数作为影响因素的ROC模型表明，确定SFA的敏感性和特异性分别为83.0%和65.0%；预测准确率为75.0%。总之，我们的研究结果表明，来自数字化牙模和头颅侧位片的六项测量可有效应用于SFA的治疗决策，准确率令人满意。
