Outcomes in a 2-phase randomized clinical trial of early Class II treatment
Outcomes in a 2-phase randomized clinical trial of early Class II treatment
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DOI：
10.1016/j.ajodo.2004.02.008
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发表时间：
2004-06-01
影响因子：
3
通讯作者：
Phillips, C
中科院分区：
文献类型：
--
作者：
Tulloch, JFC;Proffit, WR;Phillips, C
在一项两阶段的平行随机试验中，早期(青春期前)和晚期(青春期)治疗严重(覆盖7 mm)II类错牙合的儿童，最初至少在青春期生长高峰期前一年发育，约75%的儿童早期接受头盔或功能性矫治器治疗后，观察到良好的生长变化。然而，在对之前接受治疗的儿童和未接受治疗的儿童进行第二阶段的固定矫治器治疗后，早期治疗对随后的治疗结果几乎没有影响，这些结果包括骨骼变化、牙齿的排列和咬合、或治疗的长度和复杂性。当两组在青春期接受综合固定矫治器治疗时，治疗组和未治疗组在青春期前通过第一阶段治疗而产生的差异消失。这表明在混合牙期青春期前开始的2期治疗可能并不比在恒牙期早期青春期开始的1期治疗更有效。早期治疗似乎也没有那么有效，因为在第二阶段的治疗中，它没有减少儿童使用固定矫治器的平均时间，也没有减少涉及拔牙或正颌手术的复杂治疗的比例。
In a 2-phased, parallel, randomized trial of early (preadolescent) versus later (adolescent) treatment for children with severe ( > 7 mm overjet) Class II malocclusions who initially were developmentally at least a year before their peak pubertal growth, favorable growth changes were observed in about 75% of those receiving early treatment with either a headgear or a functional appliance. After a second phase of fixed appliance treatment for both the previously treated children and the untreated controls, however, early treatment had little effect on the subsequent treatment outcomes measured as skeletal change, alignment, and occlusion of the teeth, or length and complexity of treatment. The differences created between the treated children and untreated control group by phase 1 treatment before adolescence disappeared when both groups received comprehensive fixed appliance treatment during adolescence. This suggests that 2-phase treatment started before adolescence in the mixed dentition might be no more clinically effective than 1-phase treatment started during adolescence in the early permanent dentition. Early treatment also appears to be less efficient, in that it produced no reduction in the average time a child is in fixed appliances during a second stage of treatment, and it did not decrease the proportion of complex treatments involving extractions or orthognathic surgery.