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CBCT与口内扫描在评估使用隐形矫治器牵引埋伏尖牙的正畸牵引中的三维比较

Three-Dimensional Comparison of CBCT and Intraoral Scans for Assessing Orthodontic Traction of Impacted Canines with Clear Aligners.

作者信息

Pinho Teresa, Carvalho João Pedro

机构信息

UNIPRO-Oral Pathology and Rehabilitation Research Unit, University Institute of Health Science (IUCS), CESPU, 4585-116 Gandra, Portugal.

UMIB-Multidisciplinary Biomedical Research Unit, Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, 4050-313 Porto, Portugal.

出版信息

Dent J (Basel). 2025 Jun 24;13(7):286. doi: 10.3390/dj13070286.

Abstract

: Canine impaction complicates treatment and prolongs duration, requiring precise localization. CBCT is the gold standard for diagnosis and assessment. However, it involves high radiation exposure and cost. This study aimed to evaluate the effectiveness of a combined biomechanical approach for orthodontic traction of impacted maxillary canines (IMCs) and to determine whether intraoral scans (STL files) could replace a final CBCT in assessing canine repositioning. : The sample included 10 patients (7 males and 3 females) with 13 severely displaced IMCs, treated with a protocol combining Invisalign aligners, elastics, mini-implants, and sectional wires. In all, 9 IMC were palatally impacted, while 4 were buccally impacted. A representative clinical case is presented to illustrate the biomechanics used in one of the complex cases. Canine movement was evaluated at the cusp and apex through two methods: overlay of pre- and post-treatment CBCTs, and overlay of initial and final STL scans onto the initial CBCT. : A Class I canine relationship was successfully achieved in all patients. No statistically significant differences were found between the two measurement methods ( > 0.05). : Orthodontic traction of IMC, especially in complex cases, can be achieved using aligners, elastics, mini-implants, and sectional wires. Once the canine crown has erupted and is clinically visible, STL scans overlaid with the initial CBCT can accurately assess the final position of the crown and root. This allows clinicians to avoid a second CBCT in selected cases, reducing patient radiation exposure while maintaining diagnostic accuracy.

摘要

犬牙阻生使治疗复杂化并延长疗程,需要精确的定位。锥形束计算机断层扫描(CBCT)是诊断和评估的金标准。然而,它涉及高辐射暴露和高成本。本研究旨在评估一种联合生物力学方法对上颌阻生犬牙(IMCs)进行正畸牵引的有效性,并确定口腔内扫描(STL文件)在评估犬牙重新定位时是否可以替代最终的CBCT。:样本包括10例患者(7例男性和3例女性),有13颗严重移位的IMCs,采用隐适美矫治器、弹力牵引、微型种植体和片段弓丝联合方案进行治疗。总共有9颗IMCs腭侧阻生,4颗颊侧阻生。展示了一个具有代表性的临床病例来说明其中一个复杂病例所采用的生物力学方法。通过两种方法在牙尖和根尖评估犬牙移动情况:治疗前和治疗后的CBCT叠加,以及初始和最终的STL扫描叠加到初始CBCT上。:所有患者均成功实现了I类犬牙关系。两种测量方法之间未发现统计学显著差异(>0.05)。:IMCs的正畸牵引,尤其是在复杂病例中,可以使用矫治器、弹力牵引、微型种植体和片段弓丝来实现。一旦犬牙冠萌出并在临床上可见,将STL扫描与初始CBCT叠加可以准确评估牙冠和牙根的最终位置。这使得临床医生在某些选定病例中可以避免进行第二次CBCT,在保持诊断准确性的同时减少患者的辐射暴露。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ff5/12293305/a92c99702f35/dentistry-13-00286-g001.jpg

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