国际口腔医学杂志

国际口腔医学杂志 ›› 2022, Vol. 49 ›› Issue (1): 109-115.doi: 10.7518/gjkq.2022009

• 综述 • 上一篇    下一篇

隐形矫治技术推磨牙远移机制与疗效的研究进展

李俊霖(),肖立伟()   

  1. 中南大学湘雅二医院口腔医学中心 长沙 410011
  • 收稿日期:2021-03-02 修回日期:2021-09-20 出版日期:2022-01-01 发布日期:2022-01-07
  • 通讯作者: 肖立伟
  • 作者简介:李俊霖,硕士,Email： 3055571066@qq.com

Research progress on the mechanism and efficacy of molar distalization with clear aligner technique

Li Junlin(),Xiao Liwei()   

  1. Center of Stomatology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
  • Received:2021-03-02 Revised:2021-09-20 Online:2022-01-01 Published:2022-01-07
  • Contact: Liwei Xiao

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摘要：

隐形矫治技术作为新型的正畸矫治技术,其美观、舒适、方便等特点受到患者与医生的青睐,经过十几年的技术改进、材料更新,隐形矫治的效果逐渐优化。通过其特殊的矫治力施加方式,配合附件、辅助装置对转矩和支抗的精细控制,在推磨牙远移时,磨牙接近整体移动,同时能避免下颌旋转,减小前牙支抗丢失。本文对隐形矫治技术推磨牙远中的机制与疗效作一综述,提出现阶段研究的不足和临床应用中的限制,为临床应用和技术改进提供参考依据。

关键词: 隐形矫治技术, 磨牙远移, 作用机制, 临床疗效, 正畸

Abstract:

As a novel orthodontic treatment technology, the clear aligner technique is favored by patients and dentists for its aesthetic, comfort and convenient features. After more than ten years of technical improvement and material update, the efficacy of clear aligner technique is gradually optimized. Through its special way of applying orthodontic force, in addition to the torque and the anchorage control of attachment and auxiliary devices,the molars distally move with nearly bodily movement, meanwhile avoiding the mandibular rotation and reducing anchorage loss of the anterior teeth. This article reviews the mechanism and efficacy of clear aligner technique in molar distalization treatment, and points out the deficiencies in current research and the limitations in clinical application, providing a reference for clinical application and technical improvement.

Key words: clear aligner technique, molar distalization, mechanism, clinical efficacy, orthodontic

表1

对隐形矫治推磨牙远移疗效研究的分析"

参考文献 年代 研究类型 研究对象
数量与年龄		 对照设计 测量方式 矫治方式
[21] 2011 回顾性研究 5例,平均21.5岁 — 三维模型分析磨牙远移阶段前后位置变化 国产隐形矫治器移动上颌2颗磨牙
[8] 2014 随机对照实验 30例,13~72岁 有/无附件磨牙远移/
尖牙转矩/前磨牙扭转		 三维模型分析磨牙远移阶段前后位置变化 Invisalign隐形矫治器移动1颗上磨牙
[23] 2016 回顾性研究 15例,平均27岁8个月 — CBCT三维测量磨牙远移阶段前后位置变化 Invisalign隐形矫治器移动上颌2颗磨牙/采用Ⅱ类牵引或微种植钉
[16] 2016 回顾性研究 20例,（29.73±6.89）岁 — 头颅侧位片测量整个治疗前后位置变化 Invisalign隐形矫治器移动上颌2颗磨牙
[19] 2016 随机对照实验 30例,平均30.5岁 上颌3—7添加附件/
上颌4—6添加附件		 头颅侧位片测量整个治疗前后位置变化 Invisalign隐形矫治器移动上颌2颗磨牙
[22] 2017 回顾性研究 7例,11~20岁 — 三维模型分析磨牙远移阶段前后位置变化 时代天使隐形矫治器移动上颌2颗磨牙或移动第一磨牙
[28] 2019 回顾性研究 19例,平均24岁 — 头颅侧位片测量磨牙远移阶段前后位置变化 Invisalign隐形矫治器移动上下磨牙
[26] 2019 回顾性研究 10例,（22.7±5.3）岁 — 头颅侧位片测量整个治疗前后位置变化 Invisalign隐形矫治器移动上颌2颗磨牙
[24] 2020 回顾性研究 58例,12~34岁 — 头颅侧位片与曲面体层片测量整个治疗前后位置变化 隐形矫治器移动上磨牙45例,下磨牙13例
[1] Kesling HD. The philosophy of the tooth positio-ning appliance[J]. Am J Orthod Oral Surg, 1945,31(6):297-304.
[2] Djeu G, Shelton C, Maganzini A. Outcome assessment of Invisalign and traditional orthodontic treatment compared with the American Board of Orthodontics objective grading system[J]. Am J Orthod Dentofacial Orthop, 2005,128(3):292-298.
[3] Kassas W, Al-Jewair T, Preston CB, et al. Assessment of Invisalign treatment outcomes using the ABO Model Grading System[J]. J World Fed Orthod, 2013,2(2):e61-e64.
[4] Haouili N, Kravitz ND, Vaid NR, et al. Has Invisa-lign improved? A prospective follow-up study on the efficacy of tooth movement with Invisalign[J]. Am J Orthod Dentofacial Orthop, 2020,158(3):420-425.
[5] Phulari B. History of molar distalization in orthodontics[M] //History of orthodontics. New Delhi: Jay-pee Brothers Medical Publishers (P) Ltd., 2013: 232-233.
[6] Boyd RL. Esthetic orthodontic treatment using the invisalign appliance for moderate to complex malocclusions[J]. J Dent Educ, 2008,72(8):948-967.
[7] Iliadi A, Koletsi D, Eliades T. Forces and moments generated by aligner-type appliances for orthodontic tooth movement: a systematic review and meta-ana-lysis[J]. Orthod Craniofac Res, 2019,22(4):248-258.
[8] Simon M, Keilig L, Schwarze J, et al. Forces and moments generated by removable thermoplastic alig-ners: incisor torque, premolar derotation, and molar distalization[J]. Am J Orthod Dentofacial Orthop, 2014,145(6):728-736.
[9] Drake CT, McGorray SP, Dolce C, et al. Orthodontic tooth movement with clear aligners[J]. ISRN Dent, 2012,2012:1-7.
[10] Lombardo L, Colonna A, Carlucci A, et al. ClassⅡsubdivision correction with clear aligners using intermaxilary elastics[J]. Prog Orthod, 2018,19(1):32.
[11] 赖文莉. 浅谈无托槽隐形矫治技术减数矫治的临床体会[J]. 中华口腔医学杂志, 2017,52(9):534-537.
Lai WL. Extraction cases using clear aligners[J]. Chin J Stomatol, 2017,52(9):534-537.
[12] 白煜, 李晨, 曹猛, 等. 无托槽隐形矫治器联合微种植钉内收上前牙的三维有限元分析[J]. 中华口腔正畸学杂志, 2020,27(1):21-26.
Bai Y, Li C, Cao M, et al. Combination of mini-screws and clear aligner to retract maxillary anterior teeth: a three-dimensional finite element analysis[J]. Chin J Orthod, 2020,27(1):21-26.
[13] Janson G, Sathler R, Fernandes TM, et al. Correction of ClassⅡmalocclusion with ClassⅡelastics: a systematic review[J]. Am J Orthod Dentofacial Orthop, 2013,143(3):383-392.
[14] 寻春雷, 曾祥龙, 王兴. 正畸支抗的新手段: 种植体支抗系统的发展和应用[J]. 口腔正畸学, 2003,10(1):47-50.
Xun CL, Zeng XL, Wang X. New methods of ortho-dontic anchorage: development and application of implant anchorage system[J]. J Orthod, 2003,10(1):47-50.
[15] 谢贤聚. 无托槽隐形矫治技术推磨牙向远中的机制与优势[J]. 中国实用口腔科杂志, 2019,12(8):459-463.
Xie XJ. Mechanism and advantage of tooth movement in molar distalization with aligner orthodontics[J]. Chin J Pract Stomatol, 2019,12(8):459-463.
[16] Ravera S, Castroflorio T, Garino F, et al. Maxillary molar distalization with aligners in adult patients: a multicenter retrospective study[J]. Prog Orthod, 2016,17:12.
[17] Brezniak N. The clear plastic appliance: a biomechanical point of view[J]. Angle Orthod, 2008,78(2):381-382.
[18] Kravitz ND, Kusnoto B, BeGole E, et al. How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign[J]. Am J Orthod Dentofacial Orthop, 2009,135(1):27-35.
[19] Garino F, Castroflorio T, Daher S, et al. Effectiveness of composite attachments in controlling upper-molar movement with aligners[J]. J Clin Orthod, 2016,50(6):341-347.
[20] Hennessy J, Al-Awadhi EA. Clear aligners generations and orthodontic tooth movement[J]. J Orthod, 2016,43(1):68-76.
[21] 周洁珉, 白玉兴, 郝玮. 无托槽隐形矫治技术远中移动磨牙效果的三维分析与评价[J]. 北京口腔医学, 2011,19(3):157-159.
Zhou JM, Bai YX, Hao W. Three dimensional evalua-tion of maxillary molar distal movement using invisible bracketless appliance[J]. Beijing J Stomatol, 2011,19(3):157-159.
[22] 张晶晶, 张莹莹, 刘妍. 隐形矫治技术远移上颌磨牙的三维分析[J]. 中华口腔正畸学杂志, 2017,24(2):70-78.
Zhang JJ, Zhang YY, Liu Y. Three dimensional eva-luation of maxillary molar distal movement using invisible aligners[J]. Chin J Orthod, 2017,24(2):70-78.
[23] 杨偲偲, 黄远亮, 张蕾. 应用CBCT评价隐形矫治技术远中移动上颌磨牙的临床疗效[J]. 口腔材料器械杂志, 2016,25(2):86-90.
Yang SS, Huang YL, Zhang L. CBCT evaluation of the clinic efficacy of Invisalign on upper molar distalization[J]. Chin J Dent Mater Devices, 2016,25(2):86-90.
[24] 幸丹, 曹丽, 谢贤聚. 无托槽隐形矫治技术推磨牙向远中牙齿移动类型的研究[J]. 中国实用口腔科杂志, 2020,13(5):295-300.
Xing D, Cao L, Xie XJ. The type of tooth movement in molar distalization with aligner orthodontics[J]. Chin J Pract Stomatol, 2020,13(5):295-300.
[25] Simon M, Keilig L, Schwarze J, et al. Treatment outcome and efficacy of an aligner technique-regarding incisor torque, premolar derotation and molar distalization[J]. BMC Oral Heal, 2014,14:68.
[26] Caruso S, Nota A, Ehsani S, et al. Impact of molar teeth distalization with clear aligners on occlusal vertical dimension: a retrospective study[J]. BMC Oral Health, 2019,19(1):182.
[27] 迟敬文, 王玉俏, 冯枫, 等. 隐形矫治与固定矫治技术远移上颌磨牙的三维有限元分析[J]. 实用口腔医学杂志, 2020,36(1):100-104.
Chi JW, Wang YQ, Feng F, et al. Three dimensional finite element analysis of maxillary molar distalization by invisible appliance and fixed appliance[J]. J Pract Stomatol, 2020,36(1):100-104.
[28] 吴迪, 向美玲, 唐林, 等. 无托槽隐形矫治器推磨牙向远中的阶段性研究[J]. 口腔医学, 2019,39(11):987-992.
Wu D, Xiang ML, Tang L, et al. A phased study on molars distalization with bracketless invisible app-liance[J]. Stomatology, 2019,39(11):987-992.
[29] Ke YY, Zhu YF, Zhu M. A comparison of treatment effectiveness between clear aligner and fixed app-liance therapies[J]. BMC Oral Health, 2019,19(1):24.
[30] 赖文莉. 无托槽隐形矫治技术推磨牙向后的临床应用策略[J]. 国际口腔医学杂志, 2019,46(4):373-382.
Lai WL. Molar distalisation by using clear aligner treatment[J]. Int J Stomatol, 2019,46(4):373-382.
[31] 韩世智. 无托槽隐形矫治技术远中移动磨牙效果的三维分析与评价[J/CD]. 全科口腔医学电子杂志, 2018,5(23):49-50.
Han SZ. Three-dimensional analysis and evaluation of the effect of removable molars with invisible orthodontics without brackets[J/CD]. Gen J Stomatol, 2018,5(23):49-50.
[32] 任玉仲秀, 张继武, 马俐丽, 等. 无托槽隐形矫治技术推上颌第二磨牙向远中的三维有限元分析[J]. 中华口腔正畸学杂志, 2018,25(2):108-112.
Ren YZX, Zhang JW, Ma LL, et al. The biomechanical mechanism of invisible appliance in pushing the second molar backwards[J]. Chin J Orthod, 2018,25(2):108-112.
[33] Hohmann A, Wolfram U, Geiger M, et al. Periodontal ligament hydrostatic pressure with areas of root resorption after application of a continuous torque moment[J]. Angle Orthod, 2007,77(4):653-659.
[34] Krieger E, Drechsler T, Schmidtmann I, et al. Apical root resorption during orthodontic treatment with a-ligners? A retrospective radiometric study[J]. Head Face Med, 2013,9:21.
[35] Rossini G, Parrini S, Castroflorio T, et al. Efficacy of clear aligners in controlling orthodontic tooth mo-vement: a systematic review[J]. Angle Orthod, 2015,85(5):881-889.
[36] Park HS, Lee SK, Kwon OW. Group distal movement of teeth using microscrew implant anchorage[J]. Angle Orthod, 2005,75(4):602-609.
[37] Krieger E, Seiferth J, Marinello I, et al. Invisalign ® treatment in the anterior region: were the predicted tooth movements achieved [J]. J Orofac Orthop, 2012,73(5):365-376.
[38] Cassetta M, Altieri F, Barbato E. The combined use of corticotomy and clear aligners: a case report[J]. Angle Orthod, 2016,86(5):862-870.
[39] Ojima K, Dan C, Kumagai Y, et al. Invisalign treatment accelerated by photobiomodulation[J]. J Clin Orthod, 2016,50(5):309-320.
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[2] 汤庆奋,王学侠. 17β-雌二醇对人类阴道和口腔颊粘膜的渗透性[J]. 国际口腔医学杂志, 1999, 26(06): .
[3] 潘劲松. 颈总动脉指压和颈内动脉球囊阻断试验在大脑血液动力学中的不同影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 王昆润. 后牙冠根斜形牙折的治疗[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 杨锦波. 嵌合体防龋疫苗的研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[6] 王昆润. 下颔骨成形术用网状钛板固定植骨块[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 汪月月,郭莉莉. 口腔机能与老化—痴呆危险因素流行病学研究[J]. 国际口腔医学杂志, 1999, 26(04): .
[8] 丁刚. 应用硬组织代用品种植体行丰颏术[J]. 国际口腔医学杂志, 1999, 26(04): .
[9] 田磊. 局部应用脂多糖后结合上皮反应性增生的变化[J]. 国际口腔医学杂志, 1999, 26(04): .
[10] 戴青. 口腔念珠菌病的新分类[J]. 国际口腔医学杂志, 1999, 26(04): .