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Title: [Factors affecting stability after fixed orthodontic treatment].
Author: Ren SS, Dai X, Ying M, Wang WX, Chang J, Hou ZM.
Journal: Zhonghua Kou Qiang Yi Xue Za Zhi; 2018 Sep 09; 53(9):599-603. PubMed ID: 30196619.
Abstract:
Objective: To analyze factors affecting stability after fixed orthodontic treatment. Methods: Five hundred and forty-four patients who had finished fixed orthodontic treatment more than two years in First Department of Orthodontics, China Medical University from January, 2000 to December, 2017 were investigated and the rate of regular revisit was counted. The data of 288 patients were successfully collected by calling or sending text messages and the rate of standard use of retainers as prescribed (patients wore retainers for 24 months or longer) was counted. According to the variation of peer assessment rating (PAR) index at the start of retention and the time the data collected, the patients were divided into relapse group (variation of PAR index >5) and non-relapse group (variation of PAR index ≤5). Difference significance analysis and multiple-factor logistic regression analysis were used. Sixty patients wearing retainers well were collected and the curative effects of Hawley retainer and vacuum formed retainer (VFR) were compared, which included overbite, overjet, maxillary irregularity index, mandibular irregularity index, width betwenn canine and width between first molar. Results: The rate of regular revisit was 41.0% (223/544). Two hundred and one of 288 patients (69.8%) who were visited successfully had regular revisit, and 60.4%(174/288) of the patients wore retainers well; 30.2% (87/288) of the patients who were visited successfully didn't have regular revisit, and 10.4% (30/288) of the patients wore retainers well. Difference significance analysis showed that there was highly significant difference between relapse group and non-relapse group in the type of retainer and duration of retention (P<0.01). One hundred and forty of 224 patients (62.5%) in non-relapse group and 37.5% (24/64) of the patients in relapse group used VFR, and the duration of retention in non-relapse group was significantly longer than that in relapse group (P<0.01). Multiple-factor Logistic regression analysis showed that wearing Hawley retainers (OR=3.067, P<0.05) was the risk factor influencing relapse. The duration of retention (OR=0.832, P<0.01) was the protective factor influencing relapse. Independent-sample t test indicated that the variations of maxillary [(0.82±0.36) mm] and mandibular [(1.05±0.22) mm] irregularity index in Hawley retainer group were larger than maxillary [(0.64±0.29) mm] and mandibular [(0.72±0.35) mm)] irregularity index in VFR group, respectively. The differences between the two groups were significant (P<0.05). Conclusions: Duration of retention was implicated in stability after orthodontic treatment. VFR had better effect in the aspects of irregularity index than Hawley retainer. 目的：分析影响全口固定矫治疗效稳定性的相关因素，为临床提供参考。 方法：收集2000年1月至2017年12月期间就诊于中国医科大学口腔医学院正畸一科、由同一名口腔正畸专业主任医师完成全口固定矫治、矫治结束满2年的544例患者资料，成功回访288例，统计按时复诊者比例及保持器戴用良好（保持器戴用≥24个月）比例。根据回访时与矫治结束时的PAR（peer assessment rating）指数变化量，将288例患者分为复发组（PAR指数变化量>5）和未复发组（PAR指数变化量≤5），分析两组患者初诊年龄、错■类型等因素的差异，并使用多因素Logistic回归分析各因素是否与复发相关。从288例患者中配对选取霍利保持器和压膜保持器戴用良好的患者各30例，对比两组患者保持效果，包括前牙覆■及覆盖、上牙列及下牙列不齐指数、尖牙及第一磨牙间宽度。 结果： 544例患者中按时复诊者占41.0%（223/544）。288例回访患者中，按时复诊者占69.8%（201/288），其中保持器戴用良好者占60.4%（174/288）；未按时复诊者占30.2%（87/288），其中保持器戴用良好者占10.4%（30/288）。未复发组62.5%（140/224）使用压膜保持器，复发组37.5%（24/64）使用压膜保持器，未复发组保持器戴用时间[24.0（1.0）个月]显著大于复发组[12.8（16.0）个月]（P<0.01）。多因素Logistic回归分析显示，保持器类型是复发的危险因素（OR=3.067，P<0.05），保持器戴用时间是复发的保护因素（OR=0.832，P<0.01）。独立样本t检验显示霍利保持器组上牙列和下牙列不齐指数的变化量[分别为（0.82±0.36）和（1.05±0.22）mm]分别显著大于压膜保持器组[分别为（0.64±0.29）和（0.72±0.35）mm]（P<0.05）。 结论：正畸疗效稳定性与保持器戴用时间密切相关，压膜保持器在牙列不齐的保持方面优于霍利保持器。.

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