Orthodontic treatment outcomes obtained by application of a finishing protocol

ABSTRACT Objective: To evaluate the results of a finishing protocol implemented in patients treated in the Orthodontics graduate program at Universidad de Antioquia. Evaluation was carried out by means of the criteria set by the Objective Grading System (OGS) of the American Board of Orthodontics (ABO). Methods: Cast models and panoramic radiographs of 34 patients were evaluated. The intervention group (IG) consisted of 17 patients (19.88 ± 4.4 years old) treated under a finishing protocol. This protocol included training in finishing, application of a finishing guide, brackets repositioning and patient's follow-up. Results of the IG were compared to a control group of 17 patients (21.88 ± 7.0 years old) selected by stratified randomization without finishing intervention (CG). Results: The scores for both CG and IG were 38.00 ± 9.0 and 31.41 ± 9.6 (p = 0.048), respectively. The score improved significantly in the IG group, mainly regarding marginal ridges (CG: 5.59 ± 2.2; IG: 3.65 ± 1.8) (p = 0.009) and root angulation (CG: 7.59 ± 2.8; IG: 4.88 ± 2.6) (p = 0.007). Criteria that did not improve, but had the highest scores were: alignment (CG: 6.35 ± 2.7; IG: 6.82 ± 2.8) (p = 0.62) and buccolingual inclination (CG: 3.6 ± 5.88; IG: 5.29 ± 3.9) (p = 0.65). Conclusions: Standardization and implementation of a finishing protocol contributed to improve clinical performance in the Orthodontics graduate program, as expressed by occlusal outcomes. Greater emphasis should be given on the finishing phase to achieve lower scores in the ABO grading system.

摘要
目的：评估安蒂奥基亚大学正畸研究生项目中实施的正畸精细调整方案的临床效果，本次评估采用美国正畸委员会（American Board of Orthodontics, ABO）制定的客观评分系统（Objective Grading System, OGS）。
方法：本研究对34例患者的石膏模型与曲面断层片进行评估。干预组（intervention group, IG）共17例患者，年龄为19.88±4.4岁，均采用该精细调整方案完成治疗。该方案涵盖精细调整操作培训、精细调整导板应用、托槽重新定位及患者随访。同时通过分层随机抽样选取17例未接受精细调整干预的患者作为对照组（control group, CG），年龄为21.88±7.0岁，将两组的治疗结果进行对比分析。
结果：对照组与干预组的最终评分分别为38.00±9.0与31.41±9.6（p=0.048），干预组评分显著更优。其中，边缘嵴指标（对照组：5.59±2.2；干预组：3.65±1.8）（p=0.009）与牙根角度指标（对照组：7.59±2.8；干预组：4.88±2.6）（p=0.007）的改善效果最为显著。未出现显著改善但评分最高的两项指标为：牙列排列（对照组：6.35±2.7；干预组：6.82±2.8）（p=0.62）与颊舌向倾斜度（对照组：3.6±5.88；干预组：5.29±3.9）（p=0.65）。
结论：标准化并实施该正畸精细调整方案，可有效提升安蒂奥基亚大学正畸研究生项目的临床诊疗质量，具体体现为咬合结局的优化。临床实践中应进一步重视正畸精细调整阶段，以降低美国正畸委员会客观评分系统中的得分。