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微骨穿孔对正畸关闭间隙中上颌切牙内收速率的影响:一项随机对照临床试验。

The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled clinical trial.

机构信息

Graduate Program in Dentistry, School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil.

Graduate Program in Dentistry, Department of Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Prog Orthod. 2024 Feb 12;25(1):6. doi: 10.1186/s40510-023-00505-z.

Abstract

BACKGROUND

This single-centered randomized controlled clinical trial aimed to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating the orthodontic retraction of maxillary incisors.

METHODS

Forty-two patients aged 16-40 were recruited and randomly assigned into two groups, one which underwent MOPs (MOPG) in the buccal and palatal region of all maxillary incisors immediately before the start of retraction and one which did not (CG). Eligibility criteria included the orthodontic need for maxillary first premolars extraction and space closure in two phases. The primary outcome of the study consisted of measuring the rate of space closure and, consequently, the rate of incisors' retraction using digital model superimposition 14 days later and monthly thereafter for the next 4 months. The secondary outcomes included measuring anchorage loss, central incisors' inclination, and root length shortening, analyzed using cone beam computed tomography scans acquired before retraction and 4 months after retraction. Randomization was performed using QuickCalcs software. While clinical blinding was not possible, the image's examinator was blinded.

RESULTS

Twenty-one patients were randomly assigned to each group. However, due to various reasons, a total of 37 patients (17 male and 20 female) were analyzed (mean age: 24.3 ± 8.1 years in the MOPG; 22.2 ± 4.2 years in the CG) during the trial. No statistically significant difference was found between the MOPG and the CG regarding the incisors' retraction measured at different time points at the incisal border (14 days, 0.4 mm vs. 0.5 mm; 1 month, 0.79 mm vs. 0.77 mm; 2 months, 1.47 mm vs. 1.41 mm; 3 months, 2.09 mm vs. 1.88 mm; 4 months, 2.62 mm vs. 2.29 mm) and at the cervical level (14 days, 0.28 mm vs. 0.30 mm; 1 month, 0.41 mm vs. 0.32 mm; 2 months, 0.89 mm vs. 0.61 mm; 3 months, 1.36 mm vs. 1.10 mm; 4 months, 1.73 mm vs. 1.39 mm). Similarly, no statistically significant differences were detected in the space closure, anchorage loss, central incisors' inclination, and radicular length between groups. No adverse effect was observed during the trial.

CONCLUSIONS

MOPs did not accelerate the retraction of the maxillary incisors, nor were they associated with greater incisor inclination or root resorption. Trial registration ClinicalTrials.gov NCT03089996. Registered 24 March 2017- https://clinicaltrials.gov/ct2/show/NCT03089996 .

摘要

背景

本单中心随机对照临床试验旨在评估微骨切开术(MOPs)在加速上颌切牙正畸内收中的有效性。

方法

招募了 42 名年龄在 16-40 岁的患者,并将其随机分为两组,一组在开始内收前立即在所有上颌切牙的颊侧和腭侧进行 MOPs(MOPG),另一组不进行(CG)。入选标准包括上颌第一前磨牙拔牙和两期分阶段关闭间隙的正畸需求。研究的主要结果包括使用数字模型叠加测量 14 天后和随后每月测量 4 个月内的间隙关闭率,从而测量切牙的内收率。次要结果包括使用锥形束 CT 扫描测量支抗丢失、中切牙倾斜和根长缩短,在开始内收前和内收后 4 个月进行测量。随机化使用 QuickCalcs 软件进行。虽然无法进行临床盲法,但图像检查者是盲法的。

结果

21 名患者被随机分配到每组。然而,由于各种原因,共有 37 名患者(17 名男性和 20 名女性)在试验中进行了分析(平均年龄:MOPG 组为 24.3±8.1 岁;CG 组为 22.2±4.2 岁)。在不同时间点,MOPG 和 CG 组在切缘的切牙内收测量中未发现统计学差异(14 天,0.4 毫米对 0.5 毫米;1 个月,0.79 毫米对 0.77 毫米;2 个月,1.47 毫米对 1.41 毫米;3 个月,2.09 毫米对 1.88 毫米;4 个月,2.62 毫米对 2.29 毫米)和颈缘(14 天,0.28 毫米对 0.30 毫米;1 个月,0.41 毫米对 0.32 毫米;2 个月,0.89 毫米对 0.61 毫米;3 个月,1.36 毫米对 1.10 毫米;4 个月,1.73 毫米对 1.39 毫米)。同样,两组之间的间隙关闭、支抗丢失、中切牙倾斜和根长没有统计学差异。试验过程中未观察到不良影响。

结论

MOPs 并未加速上颌切牙的内收,也不会导致切牙倾斜或根吸收增加。试验注册 ClinicalTrials.gov NCT03089996。注册于 2017 年 3 月 24 日-https://clinicaltrials.gov/ct2/show/NCT03089996。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97db/10859353/25d60745e224/40510_2023_505_Fig1_HTML.jpg

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