Intrusion of overerupted molars with modified clear aligners in implant-prosthodontic patients

目的 评价应用改良无托槽隐形矫治器压低过长磨牙辅助种植修复治疗的有效性.方法 本研究包括25名种植修复前正畸患者,平均年龄39.2±10.1岁.样本人群总计41颗过长磨牙需正畸压低治疗,其中上颌第一磨牙21颗,上颌第二磨牙16颗,下颌第一磨牙1颗,下颌第二磨牙3颗.完善牙周治疗并达到健康牙周状况.所有患者均接受了无托槽数字化隐形矫治器(IROK隐形矫治系统,西安恒惠科技有限公司)治疗.为了使压低磨牙的力量有更好的贮存和释放形式,我们改良设计了无托槽隐形矫治器压低牙齿的结构形式.过长磨牙压低治疗前后分别拍摄头颅侧位定位片,并进行头影测量的分析比较.结果 25名患者的41颗过长磨牙均取得良好的正畸压低治疗效果,压低治疗的平均时间7.4±2.3个月.21颗过长上颌第一磨牙和16颗过长上颌第二磨牙,相对于腭平面,分别平均压低3.3 mm(P＜0.001)和2.8 mm(P＜0.001).相对于下颌平面,3颗过长下颌第二磨牙平均压低2.7mm,一颗过长下颌第一磨牙治疗后压低3.5 mm.磨牙压低治疗后未见明显根吸收.结论 应用改良无托槽数字化隐形矫治器压低过长磨牙,是一种有效的辅助种植修复的正畸治疗方法.Objective The purpose of this study was to evaluate the efficacy of modified Clear Aligners for intrusion of overeruped molars in implant-prosthodontic patients.Methods 25 implantprosthodontic patients (aged 39.2± 10.1 years) who needed molar intrusions before implant denture therapy were selected.There were 41 overerupted molars altogether,including 21 upper first molars,16 upper second molars,1 lower first molars and 3 lower second molars.The periodontal treatments were performed before orthodontic intrusion if necessary.All the patients were treated with Clear Aligners (IROK,Align Technologies,Xi'an,China).The aligners were modified to improve the applied intrusion force.Cephalographs before and after intrusion treatment were measured and compared.Results All patients had achieved satisfactory orthodontic and prosthodontic treatment effects.The average treatment period was 7.4±2.3 months.Intrusion distance relative to the palatal plane were 3.3 mm (P＜0.001) and 2.8 mm (P＜0.001) for the overerupted upper first molars and upper second molars,respectively.The overerupted lower second molars were intruded 2.7 mm in average relative to mandibular plane and the intrusion distance for lower first molar was 3.5 mm.Conclusions Intrusion of overerupted molars by modified Clear Aligners could be used as an efficient method to recover the restoration space in implant-prosthodontic patients.中国科技核心期刊(ISTIC)03121-1272