透明矫治技术研究新进展OA
Research advances in clear aligner
本文系统梳理了透明矫治技术在材料学、临床治疗效果及对口腔健康影响方面的最新研究进展.在材料学领域,研究聚焦于膜片的生物相容性、生物/智能复合矫治器的研发及直接打印透明矫治器技术.尽管主流材料总体安全,但部分仍存在细胞毒性隐患;智能复合材料通过集成传感器或添加抗菌成分,为监测和预防釉质脱矿提供了新策略;直接打印透明矫治器技术则因其可定制化和高精度展现出巨大潜力.临床疗效方面,对于轻中度错(牙合)畸形,透明矫治器与固定矫治器疗效相当,但在复杂拔牙病例中其效率与效果稍逊.具体牙移动控制上,扩弓主要通过牙冠倾斜移动实现,效果低于设计预期;磨牙远移的实现度也有限;同时,研究否定了其具有特异性的"(牙合)垫效应",并能导致下颌逆旋的观点.对于儿童骨性Ⅱ类错(牙合)畸形,结合功能矫治模块的透明矫治器显示出良好的应用前景,但证据等级仍需提高.在对口腔健康的影响上,与固定矫治器相比,透明矫治器能有效降低釉质脱矿风险,减少菌斑堆积,改善牙周健康状况.透明矫治技术正朝着更精准、高效和个性化的方向发展,但医生需明确其工具属性,成功治疗的根本仍在于全面的诊断、恰当的治疗计划与细致的临床操作.
This study systematically reviews the latest research advances in clear aligners across materials science,clinical treatment outcomes,and impacts on oral health.In materials science,research focuses on membrane biocompati-bility,development of bio/smart composite aligners,and direct printing technology for clear aligners.Although main-stream materials are generally safe,some still harbor cytotoxic risks.Smart composite materials offer novel strategies for monitoring and preventing enamel demineralization and bacterial biofilm formation by integrating sensors or incorporat-ing antimicrobial agents.Directly printed aligner technology demonstrates significant potential due to its customizability and high precision.Regarding clinical efficacy,evidence indicates that clear aligners achieve comparable results with fixed appliances for mild-to-moderate malocclusions,though their efficiency and effectiveness are slightly inferior in complex extraction cases.Regarding specific tooth movement control,arch expansion primarily relies on crown inclina-tion,yielding results below design expectations;molar distalization achievement is also limited.Studies refute the notion that a specific"bite-ramp effect"causes mandibular counterclockwise rotation.For skeletal class Ⅱ malocclu-sions in children,clear aligners combined with functional orthodontic modules show promising applications,though evidence levels require further enhancement.Re-garding oral health impacts,multiple studies confirm that clear aligners effectively reduce enamel demineralization risk,decrease plaque accumulation,and improve periodontal health compared with fixed appliances.In summary,clear align-er technology has advanced toward great precision,efficiency,and personalization.However,clinicians must recognize its tool-like nature.Successful treatment fundamentally relies on comprehensive diagnosis,appropriate treatment plan-ning,and meticulous clinical execution.
陈嵩
口腔疾病防治全国重点实验室 国家口腔医学中心 口腔疾病国家临床医学研究中心四川大学华西口腔医院正畸科,成都 610041
医药卫生
正畸治疗透明矫治器固定矫治器
orthodontic treatmentclear alignerfixed appliance
《华西口腔医学杂志》 2026 (1)
29-33,5
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