上海口腔医学

上海口腔医学 ›› 2025, Vol. 34 ›› Issue (5): 524-529.doi: 10.19439/j.sjos.2025.05.013

• 论著 • 上一篇    下一篇

利用数字化配准法评估无托槽隐形矫治器的扩弓效果

姜威1, 唐天弘2, 张修银2   

  1. 1.上海市嘉定区牙病防治所 口腔正畸科,上海 201800;
    2.上海交通大学医学院附属第九人民医院 口腔修复科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2024-10-23 修回日期:2024-11-23 出版日期:2025-10-25 发布日期:2025-10-31
  • 通讯作者: 唐天弘,E-mail：463497507@qq.com
  • 作者简介:姜威（1969-）,女,博士,副主任医师,E-mail：fukuoka2009@163.com
  • 基金资助:
    上海市卫健委卫生行业临床研究专项（201940402）

Study on arch expansion effect with the clear aligner using digital registration method

Jiang Wei1, Tang Tianhong2, Zhang Xiuyin2   

  1. 1. Department of Orthodontics, Jiading District Dental Disease Prevention and Treatment Institute. Shanghai 201800;
    2. Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China
  • Received:2024-10-23 Revised:2024-11-23 Online:2025-10-25 Published:2025-10-31

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摘要： 目的:使用数字化配准新方法检测无托槽隐形矫正扩弓治疗轻度牙列拥挤的实际效果,评估无托槽隐形矫治的有效性。方法:选择2019年1月—2023年12月于上海市嘉定区牙病防治所接受无托槽隐形矫治器（Invisalign）扩弓治疗的轻度牙列拥挤患者30例。应用Geomagic Studio 2012软件系统录入光学扫描扩弓治疗的硬石膏模型（石膏组）及隐形矫正设计时的数字模型（设计组）,获得三维模型数据,测量牙弓宽度的变化值及扩弓率。分别自动配准两组扩弓前后的模型数据,测量牙弓颊舌向偏差值。结果:上颌第一前磨牙平均扩弓率为87.26%,第一磨牙为86.57%;下颌第一前磨牙平均扩弓率为90.50%,第一磨牙为89.88%。设计组与石膏组间扩弓变化量有显著差异（P<0.01）;设计组与石膏组上颌颊向平均偏差值分别为0.40和0.59 mm,下颌分别为0.41和0.53 mm,两组间均有显著差异（P<0.01）。上颌舌向平均偏差值分别为-0.36和-0.39 mm,下颌分别为-0.36和-0.11 mm,两组间均无统计学差异（P>0.05）。结论:数字化配准法可作为正畸临床评价手段。无托槽隐形矫正扩弓治疗轻度牙列拥挤有效,扩弓后颊向移动不易受控制,加剧颊侧倾斜移动。牙体颊舌向偏差变量可考虑用于正畸治疗效果的评判指标。

关键词: 无托槽隐形矫治, 轻度牙列拥挤, 扩弓, 数字化配准

Abstract: PURPOSE: To introduce a digital registration method to compare the design effect and the actual effect of the clear aligner aided expansion in treating mild crowding, and to evaluate its clinical effectiveness. METHODS: A total of 30 patients with mild crowding who were treated by clear aligner aided expansion in Jiading District Dental Disease Prevention and Treatment Institute from January 2019 to December 2023 were selected. The anhydrite models of patients during treatment were scanned by using a D-station 3D-RI optical scanner,and the STL format data of plaster group were obtained. The STL format data of the design group were also obtained from Clincheck. The STL format data of the two groups were imported into Geomagic Studio 2012 software. The change value of arch widths and expansion rate were measured for first premolars and first molars at buccal cusps. The digital registration method was used to measure positive and negative deviation of the arch width. RESULTS: The average expansion rate of maxillary first premolar, first molar, mandibular first premolar and first molar was 87.26%, 86.57%, 90.5% and 89.88% respectively. There was significant difference between the design group and the plaster group (P<0.01). The average deviation values of maxillary buccal direction in the design group and plaster group were 0.40 mm and 0.59 mm, respectively, and those of the mandible were 0.41 mm and 0.53 mm, with significant differences between the two groups (P<0.01). The average deviation values of the maxilla and mandible were -0.36 mm and -0.39 mm, -0.36 mm and -0.11 mm, respectively, and there was no significant difference between the two groups(P>0.05). The buccal-lingual bias variable could be considered as a criterion for the efficacy of orthodontic treatment. CONCLUSIONS: Digital registration method can be used to evaluate the effect of the clear aligner. Clear aligner aided expansion in treating mild crowding is effective. After expansion, buccal movement is difficult to control and exacerbates buccal tipping. The buccal-lingual bias variable can be considered as a criterion for the efficacy of orthodontic treatment.

Key words: Clear aligner, Mild crowding, Arch expansion, Digital registration

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