摘要： 目的 比较3种不同支抗设计对上颌第一磨牙控制的效果。方法 将67例侧貌较突的拔牙患者分为3组，第1组采用隐适美G6方案矫治，第2组采用直丝弓矫治，设计强支抗（横腭杆联合Nance弓）关闭拔牙间隙，第3组采用直丝弓矫治，设种植体支抗关闭拔牙间隙。测量3组治疗前后的头颅侧位片上颌第一磨牙位置变化量，先用配对t检验分析每组治疗前后数据的差异，再用单因素方差分析3组上颌第一磨牙近中移动的情况，进而比较3种不同支抗设计对磨牙控制的效果。结果 第1组和第2组治疗前后上颌第一磨牙长轴与上颌腭平面交角（U₆ to PP）、上颌第一磨牙近中最凸点到翼上颌裂点至上颌平面垂线的距离（U₆M-Hor）及近中根尖点到翼上颌裂点与上颌平面垂线的距离（U₆A-Hor）显著变化，差异有统计学意义（P < 0.05），而第3组治疗前后测量数据未发生显著变化，差异无统计学意义（P > 0.05）。第1组隐形矫治治疗后U₆M-Hor、U₆A-Hor变化量大于第2组，但无统计学差异（P > 0.05），而第1组和第2组上颌第一磨牙近移量均大于第3组，且存在统计学差异（P < 0.05）。结论 隐适美G6方案设计的最大支抗并没有完全达到预期的效果，支抗控制能力与Nance弓联合横腭杆相近，但弱于种植体支抗。

3种不同支抗设计对上颌第一磨牙控制的效果对比

陈劲宏, 丁睿啟, 王亚楠, 任亚敏, 张科科, 崔淑霞

郑州大学第一附属医院正畸科, 郑州 450052

收稿日期:2020-04-23出版日期:2021-01-30发布日期:2021-01-06
通讯作者:崔淑霞E-mail:cui-shuxia@163.com
作者简介:陈劲宏(1990-),男,医师,硕士研究生.
基金资助:河南省高等学校重点科研项目（20A320080）


关键词: invisalign, 直丝弓矫治器, 上颌第一磨牙, 支抗控制
Abstract: Objective To compare the effects of three different anchorage designs on control of maxillary first molars. Methods A total of 67 cases with high-profile sharpness of tooth extraction were included in the study. The first group (25 cases) was treated with the invisalign G6 protocol,the second group was treated with a straight-wire appliance to close the tooth extraction gap with strong anchorage (transverse palatal rod combined with Nance bow),and the third group was treated with a straight-wire appliance to close the tooth extraction gap with strong anchorage (implant nail). Position changes of the first molar before and after treatment were measured in the three groups. A paired t-test was used to analyze differences before and after treatment,one-way analysis of variance was used to analyze the mesial movement of the first molar in the three groups. The effects of the three different anchorage designs on control of maxillary first molars were compared. Results In the first and second groups,the angle of intersection between the long axis of the first molar and the maxillary palatal plane (U₆ to PP),the distance between the most convex point near the middle of the first molar and the pterygomaxillary fissure point and the vertical line of the maxillary plane (U₆M-Hor),and the distance between the near middle root tip and the pterygomaxillary fissure point and the vertical line of the maxillary plane (U₆A-Hor) were significantly changed after treatment (P < 0.05). However,there no significant change in the abovementioned parameters was observed after treatment in the third group (P > 0.05). After invisible orthodontic treatment,the distance between the most convex point near the middle of the first molar and the pterygomaxillary fissure point and the vertical line of the maxillary plane and between the first molar and the pterygomaxillary fissure point and the vertical line of the maxillary plane was greater than that in the second group,but there was no statistically significant difference (P > 005). Furthermore,the proximal displacement of the maxillary first molar in the first and second group was significantly higher than that in the third group (P < 0.05). Conclusion The invisalign G6 protocol did not achieve the expected maximum anchorage control. The anchorage control ability of the invisalign G6 protocol was similar to that of Nance arch with transverse palatal rod,but it was weaker than that of implant anchorage.
Key words: invisalign, straight wire appliance, maxillary first molar, anchorage control
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