Department of Orthodontics, Université Paris Cité, Paris, France.
Department of Orthodontics, Saint Louis University, St Louis, MO, United States.
Eur J Orthod. 2024 Oct 1;46(5). doi: 10.1093/ejo/cjae031.
The aim of this investigation was to evaluate whether Class II malocclusion in adult patients can be successfully corrected using a completely customized lingual appliance (CCLA) in combination with Class II elastics.
In order to detect differences in the final treatment outcome, two groups were matched for age and gender. Treatment results of 40 adult orthodontic patients with a Class I malocclusion (Group 1) were compared to 40 adults with a Class II malocclusion (Group 2). All patients had completed treatment with a CCLA (WIN, DW Lingual Systems, Bad Essen, Germany) without known centric occlusion-centric relation discrepancies, issues of compliance, or overcorrection in the individual treatment plan which was defined by a target set-up. In order to compare the treatment results of the two groups, 7 measurements using the American Board of Orthodontics Model Grading System (ABO MGS) and linear measurements for anterior-posterior (AP) and vertical dimensions were assessed at the start of lingual treatment (T1), after debonding (T2B) and compared to the individual target set-up (T2A).
A statistically significant AP correction was achieved in Group 2 which represented 95% of the planned amount. The planned overbite correction was fully achieved in the Class I and Class II group. In both groups, there was a statistically significant improvement in the ABO scores, with no significant difference between the two groups at T2. 100% of the patients in Group 2 and 92.5% in Group 1 would meet the ABO standards after CCLA treatment.
The main limitation of this study is that only patients who were wearing the elastics as prescribed were retrospectively included. Therefore, the results of this study may have limited generalizability.
Completely customized lingual appliances in combination with Class II elastics can correct a Class II malocclusion successfully in adult patients. The final treatment outcome can be of a similar high quality in Class I and Class II patients.
本研究旨在评估在成人患者中，使用完全定制舌侧矫治器（CCLA）结合Ⅱ类牵引能否成功矫正Ⅱ类错颌。
为了检测最终治疗结果的差异，将两组患者按年龄和性别相匹配。将 40 名具有Ⅰ类错颌的成人正畸患者（第 1 组）的治疗结果与 40 名具有Ⅱ类错颌的成人（第 2 组）进行比较。所有患者均完成了 CCLA（WIN，DW Lingual Systems，Bad Essen，德国）治疗，无正中关系-正中关系不调、顺应性问题或个别治疗计划的过度矫正，该计划由目标设定定义。为了比较两组的治疗结果，使用美国正畸医师协会模型分级系统（ABO MGS）的 7 项测量值和前-后（AP）和垂直距离的线性测量值，在舌侧治疗开始时（T1）、拆除托槽时（T2B）和与个别目标设定（T2A）进行比较。
第 2 组的 AP 矫正有统计学意义，达到了计划矫正量的 95%。Ⅰ类和Ⅱ类组的计划覆盖矫正均完全实现。在两组中，ABO 评分均有统计学意义的改善，T2 时两组间无显著差异。第 2 组 100%的患者和第 1 组 92.5%的患者在 CCLA 治疗后将符合 ABO 标准。
本研究的主要局限性在于仅回顾性纳入了按规定佩戴橡皮圈的患者。因此，本研究的结果可能具有一定的局限性。
完全定制的舌侧矫治器结合Ⅱ类牵引可成功矫正成人Ⅱ类错颌。Ⅰ类和Ⅱ类患者的最终治疗结果质量相似。
