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一项体内研究,比较在传统模型和数字制造模型上制作的透明保持器在脱粘结后六个月期间的临床效果。

An In Vivo Study to Compare the Clinical Effectiveness of Clear Retainer Made on a Conventional and a Digitally Fabricated Model Over a Six-Month Period After Debonding.

作者信息

Sharma Perthish, Kahlon Sukhdeep Singh, Boparai Chetan Dev Singh

机构信息

Orthodontics and Dentofacial Orthopedics, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, IND.

出版信息

Cureus. 2024 Feb 23;16(2):e54740. doi: 10.7759/cureus.54740. eCollection 2024 Feb.

Abstract

Background With the advent of 3D printing, many more possibilities have arisen for treatment planning. 3D rapid prototyping has enabled us to see a whole other dimension that has helped us to give the best possible care for our patients. With more and more advancements being made in this subject, it becomes necessary to check the reliability of the equipment and its effectiveness in the management of the problem at hand. This original study was conducted with the aim of checking the accuracy, dimensional stability, and reliability of orthodontic retainers made on a conventional and digitally fabricated model over a six-month period after debonding. Material and methods The patients were selected from those who have completed fixed orthodontic mechanotherapy from the Department of Orthodontics and Dentofacial Orthopaedics, Sri Guru Ram Das Institute of Dental Sciences and Research, Sri Amritsar. Fifty patients received a clear retainer, which was fabricated for the upper and lower arch after removing the brackets. Patients were included in this study irrespective of their age groups. The manual method used a vacuum-forming machine to fabricate six retainers on stone models. In the digital method, new impressions were taken after three months, and digital models were obtained through 3D scanning and printing, followed by clear retainer fabrication. The data were gathered through a systematic process involving manual and digital methods for clear retainer fabrication and subsequent evaluation. The data obtained was computed for statistical evaluation and comparison. Results Mean and standard deviations of conventional (manual) and digital variables in the two groups were calculated. An ANOVA test was used to evaluate statistically significant differences for mesiodistal width and buccolingual width, and a post hoc Tuckey test was applied for multiple comparisons. The results indicated that most mesiodistal and buccolingual width measurements showed non-significant variations and exhibited a good correlation. Extraction space opening, assessed through an independent t-test for both the maxilla and mandible, also yielded non-significant and comparable results. Additionally, intra-operator and inter-operator measurements using a digital caliper demonstrated high agreement. Intra-class correlation (ICC) values exceeded 0.75, and inter-operator ICC results reflected a high level of agreement ranging from 0.8 to 0.99. Conclusion The primary objective of this study was to establish a correlation between the accuracy, dependability, and clinical efficacy of orthodontic retainers produced using both conventional and digitally created models. This investigation spanned a duration of six months following the removal of orthodontic brackets. The results showed that most of the statistically significant values were due to the inherent potential of the 3D printer for polymerization shrinkage, which, being a stereolithographic 3D printer, had a potential for a slight dimensional shift in the transverse dimension. However, the mean difference between all the models printed was slight and clinically insignificant.

摘要

背景 随着3D打印技术的出现,治疗计划有了更多的可能性。3D快速成型技术使我们能够看到一个全新的维度,这有助于我们为患者提供尽可能最好的护理。随着该领域的进步越来越多,有必要检查设备的可靠性及其在解决手头问题方面的有效性。这项原创研究旨在检查在脱粘后六个月内,基于传统模型和数字制造模型制作的正畸保持器的准确性、尺寸稳定性和可靠性。

材料与方法 患者选自斯里阿姆利则市斯里古鲁·拉姆·达斯牙科学院和研究所正畸与牙颌面矫形科完成固定正畸机械治疗的患者。50名患者接受了透明保持器,在拆除托槽后为上下牙弓制作。无论年龄组如何,患者均纳入本研究。手工方法使用真空成型机在石膏模型上制作六个保持器。在数字方法中,三个月后取新的印模,通过3D扫描和打印获得数字模型,然后制作透明保持器。数据通过涉及透明保持器制作和后续评估的手工和数字方法的系统过程收集。对获得的数据进行计算以进行统计评估和比较。

结果 计算了两组中传统(手工)和数字变量的均值和标准差。使用方差分析测试评估近远中宽度和颊舌宽度的统计学显著差异,并应用事后Tuckey检验进行多重比较。结果表明,大多数近远中宽度和颊舌宽度测量显示无显著差异,且具有良好的相关性。通过对上颌和下颌进行独立t检验评估的拔牙间隙张开情况,也得出无显著差异且具有可比性的结果。此外,使用数字卡尺进行的操作者内和操作者间测量显示高度一致。组内相关系数(ICC)值超过0.75,操作者间ICC结果反映出0.8至0.99的高度一致性。

结论 本研究的主要目的是建立使用传统模型和数字创建模型制作的正畸保持器的准确性、可靠性和临床疗效之间的相关性。这项研究在拆除正畸托槽后的六个月内进行。结果表明,大多数具有统计学显著意义的值是由于3D打印机存在聚合收缩的内在可能性,作为一台立体光刻3D打印机,其在横向维度上有轻微尺寸偏移的可能性。然而,所有打印模型之间的平均差异很小,在临床上无显著意义。

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