Clinical Study on the Occlusal Change of Skeletal Class Ⅰ Malocclusion Treated with Invisible Appliance and Fixed Appliance
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摘要:
目的 对比评价隐形与固定矫治器治疗骨性I类错畸形患者的临床疗效。 方法 使用最小样本量为每组不低于19例研究对象的前瞻性队列研究，最终纳入骨性I类的成年患者46例，其中隐形矫治器组（A组）25例，固定矫治器组（B组）21例。分别测量分析治疗前（T0）以及治疗后（T1）静态与动态咬合指数变化差异。 结果 矫治前后静态咬合指标及PAR总分均有所改善，差异有统计学意义（P<0.01）；矫治前后包括OT、OFAT、OFPT、AOF、DT在内的动态咬合指标均取得较大改善，差异有统计学意义（P<0.01）；并且，组间在AOF、前伸及侧方DT的改变，差异有统计学意义（P<0.01），隐形组优于固定组。 结论 隐形与固定矫治器治疗骨性I类错 畸形患者在动静态咬合变化上均能获得较大改善；隐形矫治器在平衡咬合力、消除和减少咬合干扰的功能上优于固定矫治器。 Abstract:Objective To compare the clinical efficacy of invisible appliance and fixed appliance in the treatment of skeletal class I malocclusion. Methods A prospective cohort study with a minimum sample size of no less than 19 subjects in each group was used, and 46 adult patients with bone type I were eventually enrolled. According to the type of appliance, they were divided into the invisible appliance group（group A） with 25 patients and the fixed appliance group（group B） with 21 patients . Data were analyzed before orthodontic treatment（T0） after（T1） between invisible and traditional fixed orthodontics. Results The static occlusion index and PAR score were improved after treatment, and the differences were statistically significant（P< 0.01）. The occlusal dynamic parameters including OT, OFAT, OFPT, AOF and DT were significantly improved after treatment（P< 0.01）. There were significant differences in AOF, forward and lateral DT between the two groups（P< 0.01）, the invisible group was better than the fixed group. Conclusion Both the dynamic and static occlusal changes can be greatly improved with invisible and fixed appliance in the treatment of patients with class I malocclusion. Invisible appliance is better than fixed appliance in balancing occlusion, eliminating and reducing occlusal interference. -
Key words:
- Invisible appliance /
- Fixed appliance /
- PAR index /
- Dynamic occlusion /
- T-scan
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表 1 2组矫治前后静态咬合变化比较（$ \bar x \pm s $）
Table 1. Static occlusal changes before and after treatment were compared between the two groups（$ \bar x \pm s $）
测量项目 A组 B组 A、B组治疗后 差值T1-T0（分） t P 差值T1-T0（分） t P t P 上颌前牙段错位 1.350±1.089 5.542 <0.001** 1.541±1.102 6.850 <0.001** 0.344 0.733 上颌右后段错位 0.850±0.875 4.344 <0.001** 0.667±0.963 3.391 0.0025** −0.880 0.384 上颌左后段错位 0.650±0.587 4.951 <0.001** 0.75±0.897 4.097 0.0004** −0.410 0.684 下颌前牙段错位 1.450±0.759 8.542 <0.001** 1.375±0.924 7.292 <0.001** 1.289 0.204 下颌右后段错位 0.850±0.875 4.344 <0.001** 0.625±0.875 3.498 0.0019** −0.880 0.384 下颌左后段错位 0.650±0.587 4.951 <0.001** 0.708±0.806 4.303 0.0003** −0.410 0.684 右侧颊区咬合
关系1.500±1.469 4.567 <0.001** 1.417±1.283 5.411 <0.001** −1.136 0.262 左侧颊区咬合
关系1.850±1.565 5.286 <0.001** 1.292±1.459 4.337 0.0002** −2.861 0.07 覆盖 1.450±0.945 6.866 <0.001** 1.462±1.240 6.008 <0.001** / / 覆 1.050±0.887 5.294 <0.001** 1.125±1.035 5.326 <0.001** −0.996 0.325 中线 0.700±0.657 4.765 <0.001** 0.583±0.717 3.984 0.0006** −0.127 0.899 总分 19.35±1.358 11.761 <0.001** 17.375±9.929 8.573 <0.001** −0.672 0.506 *P <0.05；**P<0.01。 
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表 2 隐形和固定矫治组PAR得分改善率（%）
Table 2. Improvement ratio of PAR score ratings for invisible and fixed appliance groups （%）
分组 改善（减少30%） 极大改善
（减少22分以上）χ2 P 隐形矫治组 100.00 30.00 2.443 0.169 固定矫治组 95.83 20.83 *P<0.05；** P <0.01。
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表 3 2组矫治前后动态咬合变化比较（$ \bar x \pm s $）
Table 3. Comparison of dynamic occlusal changes before and after correction between 2 groups（$ \bar x \pm s $）
测量项目 A组 B组 A、B组
治疗后差值T1-T0（s/%） t P 差值T1-T0（s/%） t P t P OT（s） 0.229±0.133 9.917 <0.001** 0.248±0.121 11.743 <0.001** 1.573 0.121 OFAT（%） −5.703±4.155 −7.885 <0.001** −6.064±2.698 −1.291 <0.001** 0.129 0.898 OFPT（%） 5.703±4.155 7.885 <0.001** 0.061±2.698 12.912 <0.001** −0.129 0.898 AOF（%） 9.242±0.759 9.889 <0.001** 6.333±5.344 6.808 <0.001** −2.669 0.010* 前伸DT（s） 0.354±0.157 12.622 <0.001** 0.201±0.183 6.299 <0.001** −3.536 0.010* 左侧方DT（s） 0.328±0.265 7.089 <0.001** 0.213±0.207 5.892 <0.001** −2.841 0.006** 右侧方DT（s） 0.302±0.219 7.914 <0.001** 0.212±0.207 5.894 <0.001** −3.966 <0.001** *P<0.05；** P <0.01。
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