Improved eruption path quantification and treatment time prognosis in alignment of impacted maxillary canines using CBCT imaging
Improved eruption path quantification and treatment time prognosis in alignment of impacted maxillary canines using CBCT imaging
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DOI：
10.1093/ejo/cjy028
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发表时间：
2018-12-01
影响因子：
2.6
通讯作者：
Kirschneck, Christian
中科院分区：
文献类型：
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作者：
Schubert, Michael;Proff, Peter;Kirschneck, Christian
背景/目的：上颌埋伏尖牙的正畸矫治对于功能和美观都是必要的，但耗时且困难。因此，估计的治疗时间是治疗计划中的一个重要因素，其可预测性基于迄今可用的二维放射测量，然而，相当有限（最大值）。39.1-42%）。因此，我们的目的是改善治疗时间预后腭嵌顿上犬齿的基础上三维量化的萌出路径长度的基线锥束计算机断层扫描（CBCT）诊断数据。材料和方法：基线CBCT和正断层扫描（OPT）数据和治疗时间的30名青少年非综合征/唇腭裂正畸患者的单侧腭阻生上尖牙，方法：回顾性分析2010年12月~ 2011年12月采用固定正畸非拔牙牵引治疗（闭合萌出）的病例资料。萌出路径长度通过传统的二维和新的三维方法进行量化，与犬齿对齐的时间和通过线性回归得出的预测方程相关。CBCT和OPT萌出路径长度和尖牙对齐时间没有显示出显著的性别、年龄或嵌塞侧差异，但CBCT方法具有明显的相关性（r = 0.856/0.844，P < 0.001），高度一致性[林氏一致性相关系数（CCC）= 0.9438]。线性回归产生了一个预测性（r（2）× 100%）的时间，从73.3%的爆发路径长度的犬齿对齐（CBCT三角法），71.3%（简化CBCT）和50.0%（被占领土）。所提出的治疗时间预测模型仅对萌出路径长度达8 mm有效。在某些情况下，犬齿被定义为阻生，这些可能有自发喷发的可能性。可能的个体间差异必须被考虑。结论：治疗时间预测的影响上犬齿对齐可以实现在一个改进的确定性高达73.3%的建议CBCT方法量化喷发路径长度相比，OPT测量。由于没有性别、年龄和阻生侧差异，推导出的回归公式应普遍适用于非综合征/唇腭裂青少年腭部阻生尖牙。
Background/objective: Orthodontic alignment of impacted upper canines is desirable for functional and aesthetic reasons, but time-consuming and difficult. Estimated treatment time is thus an important factor in treatment planning, its predictability based on hitherto available two-dimensional radiological measurements, however, quite limited (max. 39.1-42%). We thus aimed to improve treatment time prognosis of palatally impacted upper canines based on a three-dimensional quantification of eruption path length in baseline cone-beam computed tomographical (CBCT) diagnostic data.Materials and methods: Baseline CBCT and orthopantomogram (OPT) data and treatment times of 30 adolescent non-syndromic/cleft orthodontic patients with an unilaterally palatally impacted upper canine, aligned by fixed orthodontic non-extraction traction treatment (closed eruption), were retrospectively analysed. Eruption path length was quantified by conventional two-dimensional and new three-dimensional methods, correlated with time to canine alignment and a prediction equation derived by linear regression.Results: CBCT and OPT eruption path length and time to canine alignment did not show significant gender, age, or impaction side differences, but CBCT methods a distinct correlation (r = 0.856/0.844, P < 0.001) and high concordance [Lin's concordance correlation coefficient (CCC) = 0.9438]. Linear regression yielded a predictability (r(2) x 100%) of time to canine alignment from eruption path length of 73.3 per cent (CBCT trigonometry), 71.3 per cent (CBCT-simplified), and 50.0 per cent (OPT), respectively.Limitations: The proposed model for treatment time prediction is only valid for eruption path lengths up to 8 mm. In some cases of canines being defined as impacted, these may have had the potential of spontaneous eruption. Possible inter-individual differences have to be considered.Conclusions: Treatment time prediction for alignment of impacted upper canines can be achieved at an improved certainty of up to 73.3 per cent by the proposed CBCT methods for quantifying eruption path length compared to OPT measurements. Due to absence of gender, age, and impaction side differences, the derived regression formula should be universally usable in nonsyndromic/cleft adolescents with palatally impacted upper canines.