Wang Zhizun, Mei Li, Tang Zhenxing, Wu Dong, Zhou Yue, Abdulghani Ehab A, Li Yuan, Zheng Wei, Li Yu
State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Discipline of Orthodontics, Department of Oral Sciences, University of Otago, Dunedin, New Zealand.
Korean J Orthod. 2025 Jan 25;55(1):26-36. doi: 10.4041/kjod24.136. Epub 2024 Oct 11.
Miniscrews are commonly utilized as temporary anchorage devices (TADs) in cases of maxillary protrusion and premolar extraction. This study aimed to investigate the effects and potential side effects of two conventional miniscrew configurations on the maxillary incisors.
Eighty-two adult patients with maxillary dentoalveolar protrusion who had undergone bilateral first premolar extraction were retrospectively divided into three groups: non-TAD, two posterior miniscrews only (P-TADs), and two anterior and two posterior miniscrews combined (AP-TADs). Cone-beam computed tomography was used to evaluate the maxillary central incisors (U1).
The AP-TADs group had significantly greater U1 intrusion (1.99 ± 2.37 mm, n = 50) and less retroclination (1.70° ± 8.80°) compared to the P-TADs (-0.07 ± 1.65 mm and 9.45° ± 10.68°, n = 60) and non-TAD group (0.30 ± 1.61 mm and 1.91° ± 9.39°, n = 54). However, the AP-TADs group suffered from significantly greater apical root resorption (ARR) of U1 (2.69 ± 1.38 mm) than the P-TADs (1.63 ± 1.46 mm) and non-TAD group (0.89 ± 0.97 mm). Notably, the incidence of grade IV ARR was 16.6% in the AP-TADs group, significantly higher than the rates observed in the P-TADs (6.7%) and non-TAD (1.9%) groups. Multiple regression analysis revealed that after excluding tooth movement factors, the AP-TADs configuration resulted in an additional 0.5 mm of ARR compared with the P-TADs group.
In cases of maxillary protrusion and premolar extraction, the use of combined anterior and posterior miniscrews enhances incisor intrusion and minimizes torque loss of the maxillary incisors. However, this approach results in more severe ARR, likely due to the increased apical movement and composite force exerted.
在治疗上颌前突和拔除前磨牙的病例中，微型螺钉通常用作临时支抗装置（TAD）。本研究旨在探讨两种传统微型螺钉配置对上颌切牙的影响及潜在副作用。
回顾性分析82例接受双侧第一前磨牙拔除的成年上颌牙槽突前突患者，将其分为三组：非TAD组、仅使用两颗后牙微型螺钉（P-TAD组）和使用两颗前牙及两颗后牙微型螺钉联合（AP-TAD组）。采用锥形束计算机断层扫描评估上颌中切牙（U1）。
与P-TAD组（-0.07±1.65mm，倾斜度9.45°±10.68°，n=60）和非TAD组（0.30±1.61mm，倾斜度1.91°±9.39°，n=54）相比，AP-TAD组U1的压低量显著更大（1.99±2.37mm，n=50），且牙轴后倾度更小（1.70°±8.80°）。然而，AP-TAD组U1的根尖牙根吸收（ARR）明显比P-TAD组（1.63±1.46mm）和非TAD组（0.89±0.97mm）更严重。值得注意的是，AP-TAD组IV级ARR的发生率为16.6%，显著高于P-TAD组（6.7%）和非TAD组（1.9%）。多元回归分析显示，排除牙齿移动因素后，与P-TAD组相比，AP-TAD配置导致额外0.5mm的ARR。
在上颌前突和拔除前磨牙的病例中，联合使用前牙和后牙微型螺钉可增强切牙压低，并使上颌切牙的扭矩损失最小化。然而，这种方法会导致更严重的ARR，可能是由于根尖移动增加和复合力作用所致。
