个性化矫治器在正畸治疗中的应用
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摘要
个性化矫治器自问世以来已有20余年,其设计理念是以矫治目标位为导向,通过一系列数字化技术辅助设计与生产,越来越为大众所认知与接受。目前,应用于临床的个性化矫治器主要有个性化舌侧矫治器、无托槽隐形矫治器和个性化唇侧矫治器3种类型,因其在正畸方面有较好的治疗效果,逐渐成为正畸治疗的主流矫治工具,但对其在临床治疗中的选择还有诸多疑虑。本文就3种个性化矫治器发展历程、设计原理与特点作一综述。文献复习结果表明,CAD/CAM与CBCT为个性化矫治器提供硬件基础保障,使个性化矫治过程更加简便,个性化矫治也对正畸医生提出更高要求。本文拟为临床选择和使用个性化矫治器提供更多的参考和帮助。
More than 20 years have passed since the advent of individualized appliances, which are designed according to the corrective target position. Through a series of digital technology-aided design and production processes, individual appliances have been increasingly recognized and accepted by the public. At present, there are three types of individualized orthodontic appliances: individualized lingual orthodontic appliances, non-bracket invisible appliances and individualized labial appliances. Because of their good effects in orthodontics, these appliances have gradually become mainstream orthodontic treatment tools. However, many doubts persist regarding their use in clinical treatment. This article reviews the development history, design principles and characteristics of the three types of individualized appliances. The results of a literature review showed that CAD/CAM and CBCT provide a hardware foundation for personalized orthodontic appliances that simplifies the therapeutic process. Additionally, individualized appliances also place higherdemands on orthodontists. This article could provide references for and help with the clinical selection and use of individualized appliances.
More than 20 years have passed since the advent of individualized appliances, which are designed according to the corrective target position. Through a series of digital technology-aided design and production processes, individual appliances have been increasingly recognized and accepted by the public. At present, there are three types of individualized orthodontic appliances: individualized lingual orthodontic appliances, non-bracket invisible appliances and individualized labial appliances. Because of their good effects in orthodontics, these appliances have gradually become mainstream orthodontic treatment tools. However, many doubts persist regarding their use in clinical treatment. This article reviews the development history, design principles and characteristics of the three types of individualized appliances. The results of a literature review showed that CAD/CAM and CBCT provide a hardware foundation for personalized orthodontic appliances that simplifies the therapeutic process. Additionally, individualized appliances also place higherdemands on orthodontists. This article could provide references for and help with the clinical selection and use of individualized appliances.
引文
[1]Cai Y,Du WL,Lin FO,et al.Agreement of young adults and orthodontists on dental aesthetics&influencing factors of self-perceived aesthetics[J].BMC Oral Health,2018,18(1):113.
[2]Grauer D,Wiechmann D,Heymann GC,et al.Computer-aided design/computer-aided manufacturing technology in customized orthodontic appliances[J].J Esthet Restor Dent,2012,24(1):3-9.
[3]Wiechmann D.A new bracket system for lingual orthodontic treatment[J].J Orofac Orthop,2003,64(5):372-388.
[4]George RD,Hirani S.Fully-customized lingual appliances:how lingual orthodontics became a viable treatment option[J].J Orthod,2013,40(S 1):8-13.
[5]Sha HN,Choi SH,Yu HS,et al.Debonding force and shear bond strength of an array of CAD/CAM-based customized orthodontic brackets,placed by indirect bonding-an in vitro study[J].PLOSONE,2018,13(9):e0202952.
[6]Kn?sel M,Klang E,Helms HJ,et al.Completely customized lingual appliances reduce the risk of enamel decalcification many times over[J].Inf Orthod Kieferorthop,2015,47(3):149-157.
[7]Kong WD,Li SS,Feng Y,et al.Customized lingual orthodontic treatment of skeletal class Ⅱ malocclusion with bilateral maxillary first premolar extraction:case report[J].Int J Orthod Milwa-kee,2017,28(1):53-60.
[8]Alouini O,Wiechmann D.Completely-customized lingual orthodontics to correct class Ⅱ malocclusion in adolescents[J].Orthod Fr,2018,89(1):3-19.
[9]Wang XD,Lei FF,Liu DW,et al.Miniscrew-assisted customized lingual appliances for predictable treatment of skeletal classⅡmalocclusion with severe deep overbite and overjet[J].Am J Orthod Dentofacial Orthop,2017,152(1):104-115.
[10]Inami T,Ito G,Miyazawa K,et al.Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect[J].Angle Orthodontist,2018,88(6):830-840.
[11]Mcmullin A,Waring D,Malik O.Invisible orthodontics part 2:lingual appliance treatment[J].Dent Update,2013,40(5):391-402.
[12]Gorbunkova A,Pagni G,Brizhak A,et al.Impact of orthodontic treatment on periodontal tissues:a narrative review of multidisciplinary literature[J].Int J Dent,2016(11):4723589.
[13]Weir T.Clear aligners in orthodontic treatment[J].Aust Dent J,2017,62(1):58-62.
[14]Gay G,Ravera S,Castroflorio T,et al.Root resorption in mandibular incisors during orthodontic treatment with invisalign:a radiometric study[J].Iran J Ortho,2017,12(1):e7915.
[15]Shin K.The invisalign appliance could be an effective modality for treating overbite malocclusions within a mild to moderate range[J].J Evid Based Dent Pract,2017,17(3):278-280.
[16]Abbate GM,Caria MP,Montanari PA,et al.Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances[J].J Orofac Orthop,2015,76(3):240-250.
[17]Karkhanechi M,Chow D,Sipkin J,et al.Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy[J].Angle Orthodontist,2013,83(1):146-151.
[18]Han JY.A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis[J].J Periodontal Implant,2015,45(6):193-204.
[19]Houle JP,Piedade L,Todescan R,et al.The predictability of transverse changes with invisalign[J].Angel Orthod,2017,87(1):19-24.
[20]Schupp W,Haubrich J,Neumann Ⅰ.Class Ⅱ correction with the invisalign system[J].J Clin Orthod,2010,44(1):28-35.
[21]Ravera S,Castroflorio T,Garino F,et al.Maxillary molar distalization with aligners in adult patients:a multicenter retrospective study[J].Prog Orthod,2016,17(1):12.
[22]Simon M,Keilig L,Schwarze J,et al.Treatment outcome and efficacy of an aligner technique-regarding incisor torque,premolar derotation and molar distalization[J].BMC Oral Health,2014,14(1):68.
[23]Rossini G,Parrini S,Castroflorio T,et al.Efficacy of clear aligners in controlling orthodontic tooth movement:a systematic review[J].Angle Orthod,2015,85(5):881-889.
[24]Fontana M,Cozzani M,Mutinelli S,et al.Maxillary molar distalization therapy in adult patients:a multicentre study[J].Orthod Craniofac Res,2015,18(4):221-231.
[25]Bowman SJ,Celenza F,Sparaga J,et al.Creative adjuncts for clear aligners,part 3:extraction and interdisciplinary treatment[J].JClin Orthod,2015,49(4):249-262.
[26]Baldwin DK,King G,Ramsay DS,et al.Activation time and material stiffness of sequential removable orthodontic appliances.Part3:premolar extraction patients[J].Am J Orthod Dentofacial Orthop,2008,133(6):837-845.
[27]Kravitz ND,Kusnoto B,Begole E,et al.How well does Invisalign work?A prospective clinical study evaluating the efficacy of tooth movement with Invisalign[J].Am J Orthod Dentofacial Orthop,2009,135(1):27-35.
[28]Lam A.Digital planning and custom orthodontic treatment[J].Eur J Orthod,2018,40(1):113-114.
[29]Nd WD,Koroluk LD,Phillips C,et al.Clinical effectiveness and efficiency of customized vs.conventional preadjusted bracket systems[J].J Clin Orthod,2013,47(4):261-266.
[30]Perri A,Gracco A,Siviero L,et al.Customized orthodontics:the insignia system[J].Int J Orthod,2014,25(4):17-20.
[31]Kim J,Chun YS,Kim M.Accuracy of bracket positions with a CAD/CAM indirect bonding system in posterior teeth with different cusp heights[J].Am J Orthod Dentofacial Orthop,2018,153(2):298-307.
[32]Müller-Hartwich R,Jost-Brinkmann PG,Schubert K.Precision of implementing virtual setups for orthodontic treatment using CAD/CAM-fabricated custom archwires[J].J Orofac Orthop,2016,77(1):1-8.
[33]Brown MW,Koroluk L,Ko CC,et al.Effectiveness and efficiency of a CAD/CAM orthodontic bracket system[J].Am J Orthod Dentofacial Orthop,2015,148(6):1067-1074.
[34]Aldrees AM.Do customized orthodontic appliances and vibration devices provide more efficient treatment than conventional methods?[J].Korean J Orthod,2016,46(3):180-185.
[2]Grauer D,Wiechmann D,Heymann GC,et al.Computer-aided design/computer-aided manufacturing technology in customized orthodontic appliances[J].J Esthet Restor Dent,2012,24(1):3-9.
[3]Wiechmann D.A new bracket system for lingual orthodontic treatment[J].J Orofac Orthop,2003,64(5):372-388.
[4]George RD,Hirani S.Fully-customized lingual appliances:how lingual orthodontics became a viable treatment option[J].J Orthod,2013,40(S 1):8-13.
[5]Sha HN,Choi SH,Yu HS,et al.Debonding force and shear bond strength of an array of CAD/CAM-based customized orthodontic brackets,placed by indirect bonding-an in vitro study[J].PLOSONE,2018,13(9):e0202952.
[6]Kn?sel M,Klang E,Helms HJ,et al.Completely customized lingual appliances reduce the risk of enamel decalcification many times over[J].Inf Orthod Kieferorthop,2015,47(3):149-157.
[7]Kong WD,Li SS,Feng Y,et al.Customized lingual orthodontic treatment of skeletal class Ⅱ malocclusion with bilateral maxillary first premolar extraction:case report[J].Int J Orthod Milwa-kee,2017,28(1):53-60.
[8]Alouini O,Wiechmann D.Completely-customized lingual orthodontics to correct class Ⅱ malocclusion in adolescents[J].Orthod Fr,2018,89(1):3-19.
[9]Wang XD,Lei FF,Liu DW,et al.Miniscrew-assisted customized lingual appliances for predictable treatment of skeletal classⅡmalocclusion with severe deep overbite and overjet[J].Am J Orthod Dentofacial Orthop,2017,152(1):104-115.
[10]Inami T,Ito G,Miyazawa K,et al.Ribbon-wise customized lingual appliance and orthodontic anchor screw for the treatment of skeletal high-angle maxillary protrusion without bowing effect[J].Angle Orthodontist,2018,88(6):830-840.
[11]Mcmullin A,Waring D,Malik O.Invisible orthodontics part 2:lingual appliance treatment[J].Dent Update,2013,40(5):391-402.
[12]Gorbunkova A,Pagni G,Brizhak A,et al.Impact of orthodontic treatment on periodontal tissues:a narrative review of multidisciplinary literature[J].Int J Dent,2016(11):4723589.
[13]Weir T.Clear aligners in orthodontic treatment[J].Aust Dent J,2017,62(1):58-62.
[14]Gay G,Ravera S,Castroflorio T,et al.Root resorption in mandibular incisors during orthodontic treatment with invisalign:a radiometric study[J].Iran J Ortho,2017,12(1):e7915.
[15]Shin K.The invisalign appliance could be an effective modality for treating overbite malocclusions within a mild to moderate range[J].J Evid Based Dent Pract,2017,17(3):278-280.
[16]Abbate GM,Caria MP,Montanari PA,et al.Periodontal health in teenagers treated with removable aligners and fixed orthodontic appliances[J].J Orofac Orthop,2015,76(3):240-250.
[17]Karkhanechi M,Chow D,Sipkin J,et al.Periodontal status of adult patients treated with fixed buccal appliances and removable aligners over one year of active orthodontic therapy[J].Angle Orthodontist,2013,83(1):146-151.
[18]Han JY.A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis[J].J Periodontal Implant,2015,45(6):193-204.
[19]Houle JP,Piedade L,Todescan R,et al.The predictability of transverse changes with invisalign[J].Angel Orthod,2017,87(1):19-24.
[20]Schupp W,Haubrich J,Neumann Ⅰ.Class Ⅱ correction with the invisalign system[J].J Clin Orthod,2010,44(1):28-35.
[21]Ravera S,Castroflorio T,Garino F,et al.Maxillary molar distalization with aligners in adult patients:a multicenter retrospective study[J].Prog Orthod,2016,17(1):12.
[22]Simon M,Keilig L,Schwarze J,et al.Treatment outcome and efficacy of an aligner technique-regarding incisor torque,premolar derotation and molar distalization[J].BMC Oral Health,2014,14(1):68.
[23]Rossini G,Parrini S,Castroflorio T,et al.Efficacy of clear aligners in controlling orthodontic tooth movement:a systematic review[J].Angle Orthod,2015,85(5):881-889.
[24]Fontana M,Cozzani M,Mutinelli S,et al.Maxillary molar distalization therapy in adult patients:a multicentre study[J].Orthod Craniofac Res,2015,18(4):221-231.
[25]Bowman SJ,Celenza F,Sparaga J,et al.Creative adjuncts for clear aligners,part 3:extraction and interdisciplinary treatment[J].JClin Orthod,2015,49(4):249-262.
[26]Baldwin DK,King G,Ramsay DS,et al.Activation time and material stiffness of sequential removable orthodontic appliances.Part3:premolar extraction patients[J].Am J Orthod Dentofacial Orthop,2008,133(6):837-845.
[27]Kravitz ND,Kusnoto B,Begole E,et al.How well does Invisalign work?A prospective clinical study evaluating the efficacy of tooth movement with Invisalign[J].Am J Orthod Dentofacial Orthop,2009,135(1):27-35.
[28]Lam A.Digital planning and custom orthodontic treatment[J].Eur J Orthod,2018,40(1):113-114.
[29]Nd WD,Koroluk LD,Phillips C,et al.Clinical effectiveness and efficiency of customized vs.conventional preadjusted bracket systems[J].J Clin Orthod,2013,47(4):261-266.
[30]Perri A,Gracco A,Siviero L,et al.Customized orthodontics:the insignia system[J].Int J Orthod,2014,25(4):17-20.
[31]Kim J,Chun YS,Kim M.Accuracy of bracket positions with a CAD/CAM indirect bonding system in posterior teeth with different cusp heights[J].Am J Orthod Dentofacial Orthop,2018,153(2):298-307.
[32]Müller-Hartwich R,Jost-Brinkmann PG,Schubert K.Precision of implementing virtual setups for orthodontic treatment using CAD/CAM-fabricated custom archwires[J].J Orofac Orthop,2016,77(1):1-8.
[33]Brown MW,Koroluk L,Ko CC,et al.Effectiveness and efficiency of a CAD/CAM orthodontic bracket system[J].Am J Orthod Dentofacial Orthop,2015,148(6):1067-1074.
[34]Aldrees AM.Do customized orthodontic appliances and vibration devices provide more efficient treatment than conventional methods?[J].Korean J Orthod,2016,46(3):180-185.
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