Tabellion Maike, Simgen Julia, Lisson Jörg Alexander
Department of Orthodontics (G56), Saarland University, Kirrberger Strasse 100, 66424, Homburg, Saar, Germany.
Clin Oral Investig. 2025 May 10;29(6):294. doi: 10.1007/s00784-025-06368-4.
Since relapse after orthodontic treatment and stability and failure of CAD/CAM fabricated and Conventional fixed retainers are widely discussed, this study investigated and compared two-year post-treatment stability after insertion of a CAD/CAM fabricated or Conventional fixed retainer in the lower jaw.
Digitized dental casts or intraoral scans of n = 60 patients were used for data acquisition. The patients were divided into two groups according to the retention protocol: CAD/CAM fabricated fixed retainer (n = 30, mean age 16.97 ± 5.74 years) and Conventional fixed retainer (n = 30, mean age 15.70 ± 4.19 years). The evaluation included established procedures for dental measurements of the mandible (Intercanine Distance and Little´s Irregularity Index) before orthodontic treatment, at the end of orthodontic treatment, when the fixed retainer was inserted and two years after the insertion of the fixed retainer. All retainers were inserted by the same practitioner. Complications were recorded. Statistics included Shapiro-Wilk-, T- and Friedman-Tests. The level of significance was set at p < 0.05.
In patients with Conventional fixed retainers the change of the Intercanine Distance between insertion of the fixed retainer and two years afterwards was significantly more pronounced than in patients with CAD/CAM fabricated fixed retainers (ICD: Δ CAD/CAM: -0.03 ± 0.22 mm; Δ Conventional: 0.12 ± 0.29 mm). Stability of Intercanine Distance was less in patients with Conventional fixed retainers. The change of Little´s Irregularity Index was not significant between the groups. In two patients with a Conventional fixed retainer a bonding surface was renewed within the first three months.
Within two years, CAD/CAM fabricated fixed retainers showed less relapse of Intercanine Distance and fewer complications than Conventional fixed retainers.
Considering the amount of relapse and the differences in complications, CAD/CAM fabricated fixed retainers and Conventional fixed retainers are useful appliances for stabilization of treatment results with favorable stability. Fabrication of CAD/CAM based fixed retainers is aside from that timesaving compared to Conventional fixed retainers.
由于正畸治疗后的复发以及计算机辅助设计/制造(CAD/CAM)制作的固定保持器和传统固定保持器的稳定性及失败情况已被广泛讨论,本研究调查并比较了在下颌植入CAD/CAM制作的或传统固定保持器后两年的治疗后稳定性。
使用n = 60例患者的数字化牙模或口内扫描数据进行采集。根据保持方案将患者分为两组:CAD/CAM制作的固定保持器组(n = 30,平均年龄16.97±5.74岁)和传统固定保持器组(n = 30,平均年龄15.70±4.19岁)。评估包括在正畸治疗前、正畸治疗结束时、植入固定保持器时以及植入固定保持器两年后对下颌进行牙齿测量的既定程序(尖牙间距离和利特尔不规则指数)。所有保持器均由同一位医生植入。记录并发症情况。统计学分析包括 Shapiro-Wilk 检验、T 检验和 Friedman 检验。显著性水平设定为p < 0.05。
在植入传统固定保持器的患者中,从植入固定保持器到两年后的尖牙间距离变化比植入CAD/CAM制作的固定保持器的患者更明显(尖牙间距离:CAD/CAM组变化量Δ:-0.03±0.22 mm;传统组变化量Δ:0.12±0.29 mm)。传统固定保持器患者的尖牙间距离稳定性较差。两组间利特尔不规则指数的变化无显著性差异。在两名佩戴传统固定保持器的患者中,在头三个月内更换了粘结面。
在两年内,CAD/CAM制作的固定保持器相比传统固定保持器,尖牙间距离的复发更少,并发症也更少。
考虑到复发量和并发症差异,CAD/CAM制作的固定保持器和传统固定保持器都是用于稳定治疗效果且稳定性良好的有用矫治器。除此之外,与传统固定保持器相比,基于CAD/CAM制作的固定保持器制作更节省时间。