两种不同功能矫治器（Activator 或 Bionator）联合固定矫治器治疗安氏Ⅱ类错[牙合]的对比评估：一项回顾性的自身对照研究。

Comparative assessment of two-phase class II treatment with Activator or Bionator followed by fixed appliances: A retrospective controlled before-and-after study.

机构信息

Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.

Children's and Youth Dental Clinic of the City of St. Gallen, St. Gallen, Switzerland.

出版信息

Int Orthod. 2024 Jun;22(2):100863. doi: 10.1016/j.ortho.2024.100863. Epub 2024 Feb 29.

DOI:10.1016/j.ortho.2024.100863

Abstract

AIM

Two-phase treatment for children with Class II malocclusion with several functional appliances is still performed by many orthodontists, while the Activator and the Bionator appliances are two of the most popular ones. Aim of this study was to compare the skeletal and dentoalveolar effects of treatment with these two appliances.

METHODS

Class II children treated with Activator or Bionator in the first phase, followed by a phase of fixed appliances were included. Skeletal and dentoalveolar parameters were assessed from lateral cephalograms and analysed with linear regressions at 5%.

RESULTS

A total of 89 patients (mean age 10.0 years; 47% female) were included. During the first phase, Bionator increased less the SNB (difference in mean treatment-induced changes [MD] -0.7°; 95% confidence interval [CI] -1.3 to -0.2°; P=0.01) and decreased less the ANB angle (MD 0.6°; 95% CI 0 to 1.1°; P=0.03) compared to Activator. Activator slightly increased the facial axis and Bionator reduced it (MD -1.6°; 95% CI -2.3 to -0.8°; P<0.001). Compared to Activator, the Bionator retroclined more the upper incisors (MD -2.4°; 95% CI -4.6 to -0.2°; P=0.03) and increased more the interincisal angle (MD 2.9°; 95% CI 0.5 to 5.4°; P=0.02). After the second phase (6.2 years after baseline), the only differences were a reduced facial axis (MD -1.3°; 95% CI -2.2 to -0.3°; P=0.008) and an increased maxillary rotation (MD 0.9°; 95% CI 0 to 1.8°; P=0.04) with Bionator compared to Activator.

CONCLUSION

Similar dentoalveolar effects were seen overall with two-phase treatment with either appliance, with Bionator being associated with more vertical increase compared to Activator.

摘要

目的

对于伴有多种功能矫治器的 II 类错颌儿童，许多正畸医生采用双期治疗，而其中 Activator 和 Bionator 是最常用的两种矫治器。本研究旨在比较这两种矫治器治疗的骨骼和牙颌效果。

方法

纳入接受 Activator 或 Bionator 一期治疗，随后接受固定矫治器二期治疗的 II 类错颌儿童。从侧位头颅侧位片上评估骨骼和牙颌参数，并采用线性回归在 5%水平上进行分析。

结果

共纳入 89 例患者（平均年龄 10.0 岁，女性占 47%）。在第一阶段，Bionator 使 SNB 增加的幅度较小（平均治疗诱导变化的差值[MD]为-0.7°；95%置信区间[CI]为-1.3 至-0.2°；P=0.01），使 ANB 角减小的幅度也较小（MD 为 0.6°；95% CI 为 0 至 1.1°；P=0.03）。与 Activator 相比，Activator 略微增加了面轴，而 Bionator 则减小了面轴（MD-1.6°；95% CI-2.3 至-0.8°；P<0.001）。与 Activator 相比，Bionator 使上颌切牙后倾更多（MD-2.4°；95% CI-4.6 至-0.2°；P=0.03），并使切牙交角增加更多（MD 2.9°；95% CI 0.5 至 5.4°；P=0.02）。在第二阶段（基线后 6.2 年）后，仅观察到 Bionator 与 Activator 相比，面轴减小（MD-1.3°；95% CI-2.2 至-0.3°；P=0.008）和上颌旋转增加（MD 0.9°；95% CI 0 至 1.8°；P=0.04）。