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目的探讨正畸治疗最后阶段的效果。方法共收集上下颌牙齿排列拥挤而未见颌骨位置异常的32例患者,随机分为两组各16例。A组患者采用传统正畸治疗即直丝弓矫治器托槽主动自我结扎技术,B组患者在矫正开始时通过重新再固定托槽的方法间接粘合。在正畸治疗结尾检验两组患者在正中咬合及正中关系的牙列闭合,采用下颌位置指示器(mandibular position indicator,MPI)定义下颌关节头在正中咬合及正中关系的不同位置。数据处理采用Mann-Whitney秩和检验,P<0.05为差异有统计学意义。结果 B组患者对齐在前庭-口侧方向的后牙冠及后牙在颊-舌侧准确的倾斜面比A组显著减少,差异均有统计学意义(Z=49.5、68.0,均P<0.05)。B组患者在校准步骤与ABO分级系统相应的地方用必要的托槽间接粘结方法重新再固定,左右两边的ΔZ、ΔX平均值均低于A组,差异均有统计学意义(Z=42.0、16.5、76.5、97.0,均P<0.05)。MPI指数与后牙颊-舌侧倾斜面正确大小呈正相关(r=0.10,P<0.05)。结论在结尾步骤运用ABO记存模型数量分数系统,然后在不正确的位置用托槽间接粘结的方法重新再固定,有助于有效提升MPI指数,可接受为最准确和最稳定的正畸治疗结果。
Objective To investigate the effect of orthodontic treatment in the final stage. Methods A total of 32 patients with crowded mandibular teeth and no abnormal jaw position were collected and randomly divided into two groups of 16 patients. A group of patients with traditional orthodontic treatment that is straight wire appliance brackets active self-ligation, B group at the beginning of correction by re-fixing brackets indirect adhesion. Mandibular position indicator (MPI) was used to define the different positions of the mandibular head in the median occlusion and median relationship between the two groups at the end of orthodontic treatment. Data processing using Mann-Whitney rank sum test, P <0.05 for the difference was statistically significant. Results In group B, the accuracy of anterior incisor and posterior teeth in the vestibule-lateral direction was significantly lower than that in group A (P <0.05), and the difference was statistically significant (Z = 49.5 and 68.0, all P <0.05 ). Patients in group B were re-fixed with the necessary indirect bond method of brackets where the calibration procedure corresponds to the ABO classification system. The average values of ΔZ and ΔX on both the left and right sides were lower than those in group A (Z = 42.0 , 16.5,76.5,97.0, all P <0.05). The MPI index was positively correlated with the correct size of the buccal-lingual ramps (r = 0.10, P <0.05). Conclusions At the end of the procedure, the ABO memory model score system was used and then re-fixed in the wrong place with indirect bond of the brackets to help improve the MPI index effectively, accepting the most accurate and stable orthodontic Treatment results.