Supanich Puttaporn, Thongudomporn Udom, Viteporn Smorntree
Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Orthodontic Section, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, 90112, Thailand.
Clin Oral Investig. 2025 Jan 6;29(1):46. doi: 10.1007/s00784-024-06145-9.
This randomized clinical trial compared arch dimensional changes, dentoskeletal changes, and the rate of overbite correction in deep bite adults treated with fixed appliances and either maxillary incisor bite turbos (IBT) or canine bite turbos (CBT).
Forty-six deep bite subjects treated with fixed appliances were randomized into IBT (n = 23) and CBT (n = 23) groups. Changes in intercanine width (ICW), arch height (AH), and Little's Irregularity Index (LII) were analyzed from before treatment (T) to 3 months after aligning with 0.012" NiTi archwires in both arches (T). Cephalometric changes between T and the visit when normal overbite was achieved (T) were assessed. Within-group and between-group comparisons were analyzed at a significance level of 0.05.
In both groups, mandibular ICW, and maxillary and mandibular AH significantly increased while maxillary and mandibular LII decreased. Maxillary and mandibular incisor proclination and molar extrusion were observed. The IBT group showed significantly greater changes in mandibular ICW, maxillary and mandibular AH, and mandibular incisor proclination than the CBT group. However, the overbite correction rate and the LII reduction were not significantly different between the groups.
The IBT and CBT produced similar effects on arch dimensions and dentoskeletal changes. However, the IBT group demonstrated greater arch dimensional changes.
Clinicians may consider IBT if flaring incisors is desired. Alternatively, CBT is better for cases with limited incisor proclination and where minimizing arch dimension change is needed, such as in narrow ridge situations.
The trial was registered at Thai Clinical Trial Registry on https://www.thaiclinicaltrials.org , under the identifier TCTR20230811013.
本随机临床试验比较了使用固定矫治器并配合上颌切牙咬涡轮(IBT)或尖牙咬涡轮(CBT)治疗的深覆合成年患者的牙弓尺寸变化、牙颌面变化以及覆合矫正率。
46名接受固定矫治器治疗的深覆合患者被随机分为IBT组(n = 23)和CBT组(n = 23)。分析从治疗前(T0)到上下颌均使用0.012英寸镍钛弓丝排齐后3个月(T1)期间的尖牙间宽度(ICW)、牙弓高度(AH)和Little不规则指数(LII)的变化。评估T0到达到正常覆合时(T2)的头影测量变化。组内和组间比较的显著性水平为0.05。
两组患者下颌ICW、上颌和下颌AH均显著增加,而上颌和下颌LII均降低。观察到上颌和下颌切牙前倾以及磨牙伸长。IBT组在下颌ICW、上颌和下颌AH以及下颌切牙前倾方面的变化显著大于CBT组。然而,两组之间的覆合矫正率和LII降低情况并无显著差异。
IBT和CBT在牙弓尺寸和牙颌面变化方面产生了相似的效果。然而,IBT组显示出更大的牙弓尺寸变化。
如果希望切牙唇倾,临床医生可考虑使用IBT。或者,CBT更适用于切牙前倾受限且需要最小化牙弓尺寸变化的病例,例如窄牙槽嵴情况。
该试验在泰国临床试验注册中心(https://www.thaiclinicaltrials.org )注册,标识符为TCTR20230811013。