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使用三维数字模型评估微型螺钉和Nance腭弓在安氏I类拥挤青少年上颌节段性尖牙后移中控制支抗的有效性:一项随机临床试验

Effectiveness of Mini-screw and Nance palatal arch for anchorage control following segmental maxillary canine retraction in adolescents with angle Class I crowding using 3D digital models: A randomized clinical trial.

作者信息

Verma Sanjeev, Kumar Vinay, Verma Raj Kumar, Singh Satinder Pal, Sharma Shagun

机构信息

Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

J World Fed Orthod. 2025 Jun 17. doi: 10.1016/j.ejwf.2025.04.003.

Abstract

OBJECTIVES

To compare anchorage control and treatment duration between Mini-screws and the Nance palatal arch during segmental canine retraction in adolescents.

TRIAL DESIGN

Two-arm, parallel-group randomized controlled trial.

METHODOLOGY

Fifty patients (11-18 years) requiring first premolar extraction were randomly assigned to Group 1 (Nance palatal arch) or Group 2 (Mini-screw) in the ratio of 1:1. Eligibility criteria included Angle's Class I molar relation, tooth material arch length discrepancy more than 10 mm, requiring first premolar extraction. Allocation was concealed using sequentially numbered, opaque, sealed envelopes. Pretreatment and postretraction digital models were analyzed after individual canine retraction with Burstone's T-loop using 3-matic software. t tests were used to assess tooth movement, and the Mann-Whitney test was employed to evaluate treatment duration (P < 0.05).

RESULTS

All 25 patients in the Nance group completed the trial. Two patients in the Mini-screw group were excluded due to screw loosening (n = 23 analyzed). The mean distal canine movement was similar in both groups, but molar mesial movement was significantly lower in Group 2 (0.68 and 0.41 mm) than in Group 1 (1.68 and 1.61 mm). The treatment duration was significantly less Group 2 (173.2 days) compared to Group 1 (186.0 days).

HARMS

No harms were reported in the trail.

CONCLUSION

Although the mesial movement of molars was significantly less for the Mini-screws, the Nance palatal appliance was clinically equally effective in reinforcing the distal movement of canines. The differences in anchorage loss between the two modalities were small, and clinical judgment is thus imperative for decision-making and planning for absolute anchorage with a Mini-screw.

摘要

目的

比较青少年节段性尖牙后移过程中微型螺钉与Nance腭弓在支抗控制和治疗时间方面的差异。

试验设计

双臂、平行组随机对照试验。

方法

50例(11 - 18岁)需要拔除第一前磨牙的患者按1:1比例随机分为1组(Nance腭弓组)或2组(微型螺钉组)。纳入标准包括安氏I类磨牙关系、牙弓长度差异超过10mm且需要拔除第一前磨牙。采用连续编号、不透明、密封的信封进行随机分组隐匿。在使用Burstone T形曲完成个体尖牙后移后,使用3-matic软件对治疗前和后移后的数字化模型进行分析。采用t检验评估牙齿移动情况,采用Mann-Whitney检验评估治疗时间(P < 0.05)。

结果

Nance组的25例患者均完成试验。微型螺钉组有2例患者因螺钉松动被排除(最终分析23例)。两组尖牙远中移动的平均值相似,但2组磨牙近中移动(分别为0.68和0.41mm)明显低于1组(分别为1.68和1.61mm)。2组的治疗时间(173.2天)明显短于1组(186.0天)。

不良事件

试验中未报告不良事件。

结论

虽然微型螺钉组磨牙的近中移动明显较少,但Nance腭弓矫治器在增强尖牙远中移动方面临床效果相当。两种方式在支抗丧失方面的差异较小,因此在决定是否使用微型螺钉进行绝对支抗时,临床判断至关重要。

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