目的：观察骨皮质切开术联合加速器辅助正畸牙移动的临床效果,以评估该方式作为加速正畸牙移动辅助手段的临床价值。方法：选取2022—2023年就诊于我院正畸科采用隐形拔牙矫治的双颌前突患者15例,分别测量上颌左右两象限,共计30个样本。将其平均分为三组,在隐形矫治过程中A组采用骨皮质切开术联合加速器,B组采用骨皮质切开术,C组作为对照,在整个矫治过程中采用单纯隐形矫治。采集前牙内收3个月前后的口腔数字模型及CBCT影像,评估三组上颌尖牙移动量、移动速率以及上前牙牙根吸收量。结果：隐形拔牙矫治内收前牙后,A组与B组上颌尖牙移动量均明显大于C组,差异有统计学意义,但A组和B组间没有统计学差异;内收第一个月上颌尖牙移动速率A组与B组均明显大于C组,但A组和B组之间差异不显著;内收第二到三个月上颌尖牙移动速率三组均无显著差异;前牙内收后牙根均有一定吸收,且中切牙和尖牙牙根吸收量均大于侧切牙,但三组间无统计学差异。结论：正畸加速器对骨皮质切开术在加快正畸牙移动速率、降低牙根吸收率的方面无明显协同作用;骨皮质切开术能有效加快正畸牙移动速率,但对降低牙根吸收率无明显作用。
Abstract
Objective To observe the clinical effect of corticotomy combined with accelerator assisted orthodontic tooth movement, and to evaluate the clinical value of this method as an auxiliary means to accelerate orthodontic tooth movement. Methods A total of 15 patients with bimaxillary protrusion treated with invisible extraction in the Department of Orthodontics of our hospital during 2022—2023 were selected. The left and right maxillary quadrants were measured, and a total of 30 samples were selected. Group A was treated with corticotomy combined with accelerator, group B was treated with corticotomy, and group C was treated with clear aligner. The digital model and CBCT images were collected before and after anterior teeth retraction for 3 months. The amount and rate of maxillary canine movement and the amount of maxillary anterior root resorption were evaluated. Results After anterior teeth retraction, the maxillary canine movement in group A and group B was significantly greater than that in group C, but there was no significant difference between group A and group B. In the first month of retraction, the maxillary canine movement rate in group A and group B was significantly higher than that in group C, but there was no significant difference between group A and group B. There was no significant difference in canine movement rate between the three groups from the second month to the third month. All the anterior teeth had some root resorption after retraction, and the central incisors and canines had more root resorption than the lateral incisors, but there was no statistically significant difference among the three groups. Conclusion The accelerators have no synergistic effect on the rate of orthodontic tooth movement and the rate of root resorption during corticotomy. Corticotomy can effectively accelerate the rate of orthodontic tooth movement, but has no significant effect on reducing the rate of root resorption.
关键词
骨皮质切开术 /
加速 /
牙移动 /
隐形矫治器 /
双颌前突
Key words
corticotomy /
speed up /
tooth movement /
clear aligner /
bimaxillary protrusion
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基金
湖南省自然科学基金“骨皮质切开术联合AcceleDent装置对双颌前突隐形矫治患者疗效及机制的研究”（2021JJ70061）
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