青少年前牙开（牙合）患者使用透明矫治器与临时骨锚固装置辅助后牙压低的牙-骨骼效应的三维比较评估：一项单中心、回顾性队列研究。

A 3-dimensional comparative assessment of the dentoskeletal effects of clear aligners vs temporary skeletal anchorage device-assisted posterior intrusion in adolescents with anterior open bite: A single-center, retrospective, cohort study.

作者信息

Lo-Cao Daniel, Pandis Nikolaos, Darendeliler M Ali, Papadopoulou Alexandra K

机构信息

Discipline of Orthodontics, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Sydney, Australia.

Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland.

出版信息

Am J Orthod Dentofacial Orthop. 2025 Mar;167(3):345-361. doi: 10.1016/j.ajodo.2024.10.017. Epub 2024 Dec 30.

DOI:10.1016/j.ajodo.2024.10.017

PMID:39736048

Abstract

INTRODUCTION

The dentoskeletal effects of clear aligner treatment (CAT) with Invisalign vs temporary skeletal anchorage device-anchored Sydney intrusion spring (SIS) were compared in consecutively treated growing patients with anterior open bite using cone-beam computed tomography scans.

METHODS

Fifteen adolescents treated exclusively with Invisalign, and 14 with SIS (first-phase treatment) were assessed retrospectively. Rigid-wise, voxel-based registration of pretreatment and posttreatment cone-beam computed tomography scans were performed using the anterior cranial base, maxillary plane, and mandibular body as reference regions. Treatment outcomes were compared between groups using median regression modeling.

RESULTS

Molar intrusion and incisor extrusion (millimeters), as well as buccolingual inclination changes (°), were not expressed as prescribed in the ClinChecks for Invisalign. Both treatment modalities resulted in similar improvement of anterior open bite; however, via different mechanics. Compared with CAT, SIS demonstrated significantly greater intrusion of the maxillary first molars when measured from the mesiobuccal (16: 2.09 mm [95% confidence interval {CI}, 1.05-3.12]; 26: 2.98 mm [95% CI, 2.00-3.96]) and palatal cusps (16: 2.08 mm [95% CI, 1.15-3.01], 26: 2.83 mm [95% CI, 1.92-3.74]) and less extrusion of the maxillary incisors (12: -1.30 mm [95% CI, -2.13 to -0.47], 11: -1.30 mm [95% CI, -2.40 to -0.20], 21: -0.92 mm [95% CI, -1.73 to -0.12], 22: -0.85 mm [95% CI, -1.71 to -0.00]). There was weak evidence of association with less extrusion of the mandibular incisors using SIS. Maxillary and mandibular incisors tipped lingually in both groups with no statistical difference across groups.

CONCLUSIONS

SIS demonstrated greater maxillary molar intrusion, whereas CAT was associated with incisor extrusion.

摘要

引言

使用锥形束计算机断层扫描，比较了连续治疗的前牙开颌生长发育期患者中，隐适美隐形矫治器（CAT）与临时骨支抗装置固定的悉尼推磨牙向后弹簧（SIS）的牙-骨骼效应。

方法

回顾性评估了15例仅接受隐适美治疗的青少年和14例接受SIS治疗（第一阶段治疗）的青少年。在刚性方面，以前颅底、上颌平面和下颌体为参考区域，对治疗前和治疗后的锥形束计算机断层扫描进行基于体素的配准。使用中位数回归模型比较两组的治疗结果。

结果

隐适美ClinChecks中规定的磨牙压低和切牙伸长（毫米）以及颊舌向倾斜度变化（°）均未出现。两种治疗方式均使前牙开颌得到了类似改善；然而，力学原理不同。与CAT相比，从近中颊尖测量时，SIS使上颌第一磨牙的压低更为显著（16号牙：2.09毫米[95%置信区间{CI}，1.05 - 3.12]；26号牙：2.98毫米[95% CI，2.00 - 3.96]），腭尖也是如此（16号牙：2.08毫米[95% CI，1.15 - 3.01]，26号牙：2.83毫米[95% CI，1.92 - 3.74]），而上颌切牙伸长较少（12号牙：-1.30毫米[95% CI，-2.13至-0.47]，11号牙：-1.30毫米[95% CI，-2.40至-0.20]，21号牙：-0.92毫米[95% CI，-1.73至-0.12]，22号牙：-0.85毫米[95% CI，-1.71至-0.00]）。有微弱证据表明使用SIS时下颌切牙伸长较少。两组上颌和下颌切牙均舌倾，组间无统计学差异。