基于目标试验模拟(TTE)框架的固定与隐形矫治后长期稳定性的回顾性队列研究

注册号:

Registration number:

ChiCTR2600131095 

最近更新日期:

Date of Last Refreshed on:

2026-08-28 10:58:49 

注册时间:

Date of Registration:

2026-08-28 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

基于目标试验模拟(TTE)框架的固定与隐形矫治后长期稳定性的回顾性队列研究

Public title:

Retrospective Cohort Study on Long-Term Stability After Fixed and Incisible Orthodontic Treatment Based on the Target Trial Emulation (TTE) Framework

注册题目简写:

English Acronym:

研究课题的正式科学名称:

基于目标试验模拟(TTE)框架的固定与隐形矫治后长期稳定性的回顾性队列研究

Scientific title:

Retrospective Cohort Study on Long-Term Stability After Fixed and Incisible Orthodontic Treatment Based on the Target Trial Emulation (TTE) Framework

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

李亚祯 

研究负责人:

房兵 

Applicant:

Li Yazhen  

Study leader:

Fang Bing  

申请注册联系人电话:

Applicant telephone:

+86 21 23271699

研究负责人电话:

Study leader's
telephone:

+86 21 53315667

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

liyazhenqd@163.com

研究负责人电子邮件:

Study leader's E-mail:

2334944496@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国上海市黄浦区制造局路639号

研究负责人通讯地址:

中国上海市黄浦区制造局路639号

Applicant address:

639 Zhizaoju Road, Huangpu District, Shanghai, China

Study leader's address:

No. 639 Zhizaoju Road, Huangpu District, Shanghai,China.

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

上海交通大学医学院附属第九人民医院

Applicant's institution:

Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine

研究负责人所在单位:

上海交通大学医学院附属第九人民医院

Affiliation of the Leader:

Shanghai Ninth Peoples Hospital,Shanghai JiaoTong University School of Medicine

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

SH9H-2026-T259-1

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

上海交通大学医学院附属第九人民医院研究者发起的临床研究伦理审查专委会

Name of the ethic committee:

Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine Ethics Committee

伦理委员会批准日期:

Date of approved by ethic committee:

2026-05-12 00:00:00

伦理委员会联系人:

甄红

Contact Name of the ethic committee:

Zhen Hong

伦理委员会联系地址:

中国上海市黄浦区制造局路639号

Contact Address of the ethic committee:

No. 639 Zhizaoju Road, Huangpu District, Shanghai,China.

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 21 23271699

伦理委员会联系人邮箱:

Contact email of the ethic committee:

shjyiec@126.com

研究实施负责(组长)单位:

上海交通大学医学院附属第九人民医院

Primary sponsor:

Shanghai Ninth Peoples Hospital,Shanghai JiaoTong University School of Medicine

研究实施负责(组长)单位地址:

中国上海市黄浦区制造局路639号

Primary sponsor's address:

No. 639 Zhizaoju Road, Huangpu District, Shanghai,China.

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学医学院附属第九人民医院

具体地址:

中国上海市黄浦区制造局路639号

Institution
hospital:

Shanghai Ninth Peoples Hospital,Shanghai JiaoTong University School of Medicine

Address:

No. 639 Zhizaoju Road, Huangpu District, Shanghai,China.

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

Self-funded

研究疾病:

错𬌗畸形及固定或透明隐形矫治后牙列中线、覆合、覆盖和头影测量指标的长期复发与稳定性变化  

Target disease:

Long-term Recurrence and Stability Changes in Dental Midline, Overbite, Overjet, and Cephalometric Indicators After Fixed or Clear Aligner Treatment for Malocclusion

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

1、主要研究目的 (Primary Objective) 明确在长周期随访中(至 2026 年),金属固定矫治器与透明隐形矫治器在维持上下颌中线稳定方面的真实世界因果风险比(Hazard Ratio)。本研究将突破传统模糊判定,以 T3 期(长期随访)中线复发量>=1.0 mm 作为“学术级失败终点”,以复发量 >=2.0 mm作为“临床美学级失败终点”,分别构建长期稳定性的生存曲线。 2、次要研究目的 (Secondary Objectives) 牙列局部复发对比:评估两种矫治器系统在覆合、覆盖指标上发生显著反弹(定义为较 T2 期增加>=1.5 mm)的长期风险差异。三维失代偿与骨性反弹评估:通过嵌套亚组的 T3 期头影测量分析,对比两种体系在控制前牙转矩(U1-SN, IMPA)、颌骨矢状向关系(ANB, Wits)及垂直向高度(FMA)长期稳定性上的差异。因果效应的剥离与对比:分别计算并对比意向性分析效应(ITT,真实世界综合效能)与符合方案效应(PP,理想依从性下的生物学极限),以量化保持期患者依从性对远期复发率的真实影响权重。  

Objectives of Study:

1. Main Research Objective (Primary Objective) Clarify, in a long-term follow-up (until 2026), the real-world causal hazard ratio between metal braces and clear aligners in maintaining the stability of the upper and lower dental midlines. This study will move beyond traditional vague judgments by using a relapse of the midline ≥1.0 mm at T3 (long-term follow-up) as an 'academic-level failure endpoint,' and a relapse ≥2.0 mm as a 'clinical aesthetic-level failure endpoint,' constructing survival curves for long-term stability accordingly. 2. Secondary Research Objectives (Secondary Objectives) Comparison of localized dental relapse: Assess the long-term risk differences between the two orthodontic systems in cases of significant rebound in overbite/overjet (defined as an increase ≥1.5 mm compared with T2). 3D compensation loss and skeletal rebound evaluation: Through nested subgroup T3 cephalometric analysis, compare the long-term stability of the two systems in controlling incisor torque (U1-SN, IMPA), sagittal jaw relationships (ANB, Wits), and vertical height (FMA). Separating and comparing causal effects: Calculate and compare the intention-to-treat effect (ITT, real-world comprehensive effectiveness) and per-protocol effect (PP, the biological limit under ideal compliance) to quantify the real impact of patient compliance during retention on long-term relapse rates.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.非“新使用者”排除:既往接受过全面的正畸治疗或早期阻断性干预治疗者(旨在确保入组患者为正畸干预的初次使用者,消除既往治疗对牙周膜记忆及骨改建的潜在干扰)。
2.严重解剖与发育限制:伴有先天性唇腭裂、严重的骨性颅面部综合征,或有明确的颌面部严重创伤及手术史者。
3.基线牙周混杂控制:在治疗前(T1)患有活跃期或未受控制的重度牙周炎患者。

Exclusion criteria:

1.Non-new users: Patients with a history of comprehensive orthodontic treatment or early interceptive orthodontic treatment were excluded, to ensure that all included patients were first-time recipients of orthodontic intervention and to minimize the potential residual effects of previous treatment on periodontal ligament adaptation and bone remodeling.
2.Severe anatomical or developmental abnormalities: Patients with congenital cleft lip and/or palate, severe craniofacial syndromes, or a documented history of severe maxillofacial trauma or surgery.
3.Baseline periodontal conditions: Patients with active or uncontrolled severe periodontitis before the initiation of orthodontic treatment (T1).

研究实施时间:

Study execute time:

From 2026-05-01 00:00:00 To 2028-04-30 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-09-01 00:00:00 To 2026-11-30 00:00:00

干预措施:

Interventions:

组别:

金属固定矫治组

样本量:

200

Group:

Metal fixed appliance group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

透明隐形矫治组

样本量:

200

Group:

Clear aligner group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学医学院附属第九人民医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Ninth Peoples Hospital,Shanghai JiaoTong University School of Medicine

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

正畸后临床显著牙列中线复发(>=2.0 mm)

指标类型:

主要指标

Outcome:

Clinically significant long-term dental midline relapse (>=2.0 mm)

Type:

Primary indicator

测量时间点:

T2期(正畸治疗结束时)和T3期(2026年长期随访时)

测量方法:

由两名经一致性培训且对矫治器分组设盲的医师,基于标准化口内照片及数字化牙列模型测量T2和T3期上下颌牙列中线位置。以T3期相较于T2期的水平位移变化量≥2.0 mm定义为具有临床美学意义的中线复发。

Measure time point of outcome:

At T2 (completion of orthodontic treatment) and T3 (long-term follow-up in 2026)

Measure method:

Two calibrated examiners blinded to the orthodontic treatment group will assess standardized intraoral photographs and digital dental models at T2 and T3. Clinically significant dental midline relapse is defined as a horizontal displacement of the maxillary or mandibular dental midline of ≥2.0 mm at T3 relative to T2.

指标中文名:

长期头影测量指标变化

指标类型:

次要指标

Outcome:

Long-term changes in cephalometric measurements

Type:

Secondary indicator

测量时间点:

T2期和T3期

测量方法:

对T2和T3期头颅侧位片进行标准化头影测量,计算上中切牙倾角(U1-SN)、下中切牙倾角(IMPA)、ANB角、Wits值及下颌平面角(FMA)在T3期相较于T2期的变化量。

Measure time point of outcome:

At T2 and T3

Measure method:

Standardized cephalometric analysis will be performed using lateral cephalograms obtained at T2 and T3. Changes in U1-SN, IMPA, ANB, Wits appraisal, and FMA from T2 to T3 will be calculated.

指标中文名:

覆合复发

指标类型:

次要指标

Outcome:

Overbite relapse

Type:

Secondary indicator

测量时间点:

T2期和T3期

测量方法:

基于数字化牙列模型测量T2和T3期覆合,以T3期覆合较T2期增加≥1.5 mm定义为覆合复发。

Measure time point of outcome:

At T2 and T3

Measure method:

Overbite will be measured using digital dental models at T2 and T3. Overbite relapse is defined as an increase of ≥1.5 mm at T3 relative to T2.

指标中文名:

正畸后长期牙列中线复发(>=1.0 mm)

指标类型:

主要指标

Outcome:

Long-term dental midline relapse (>=1.0 mm)

Type:

Primary indicator

测量时间点:

T2期(正畸治疗结束时)和T3期(2026年长期随访时)

测量方法:

由两名经一致性培训且对矫治器分组设盲的医师,基于标准化口内照片及数字化牙列模型,分别测量T2和T3期上下颌牙列中线位置。以T3期相较于T2期的水平位移变化量≥1.0 mm定义为中线复发。

Measure time point of outcome:

At T2 (completion of orthodontic treatment) and T3 (long-term follow-up in 2026)

Measure method:

Two calibrated examiners blinded to the orthodontic treatment group will assess standardized intraoral photographs and digital dental models at T2 and T3. Dental midline relapse is defined as a horizontal displacement of the maxillary or mandibular dental midline of ≥1.0 mm at T3 relative to T2.

指标中文名:

覆盖复发

指标类型:

次要指标

Outcome:

Overjet relapse

Type:

Secondary indicator

测量时间点:

T2期和T3期

测量方法:

基于数字化牙列模型测量T2和T3期覆盖,以T3期覆盖较T2期增加≥1.5 mm定义为覆盖复发。

Measure time point of outcome:

At T2 and T3

Measure method:

Overjet will be measured using digital dental models at T2 and T3. Overjet relapse is defined as an increase of ≥1.5 mm at T3 relative to T2.

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age 10 years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

研究完成并发表主要研究结果后,经合理申请、研究团队审核,并符合伦理审查、数据安全及受试者隐私保护要求的前提下,可向符合条件的研究者共享支持论文研究结果的去标识化个体受试者数据。申请者可联系主要研究者房兵教授(fangbing@sjtu.edu.cn)。数据仅限用于经批准的科研目的,不提供可识别受试者身份的信息。

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

After completion of the study and publication of the primary results, de-identified individual participant data supporting the published findings may be made available to qualified researchers upon reasonable request, subject to review by the study team and compliance with ethical, data-security, and participant-privacy requirements. Requests should be directed to the principal investigator, Prof. Bing Fang (fangbing@sjtu.edu.cn). Data will be provided only for approved research purposes, and no personally identifiable information will be shared.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

本研究采用统一设计的电子病例报告表(eCRF)进行数据采集。研究人员从电子病历系统、医学影像系统及数字化模型资料库中提取符合研究方案要求的数据,并录入密码保护的Excel电子数据库。研究数据库采用唯一研究编号替代患者姓名、病历号等直接身份识别信息,实现研究数据与身份信息分离保存。 数据录入后由数据管理员进行完整性、一致性、逻辑关系及异常值核查;关键研究变量由两名研究人员进行复核,并根据原始病历、影像和数字化模型进行源数据核对。数据库设置访问权限,仅授权研究人员、伦理委员会及依法具有审核权限的人员查阅。数据清理完成后锁定数据库,并按照医院和伦理委员会的相关规定保存和管理。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data will be collected using a standardized electronic case report form (eCRF). Eligible data will be extracted from the electronic medical record system, medical imaging system, and digital dental model database and entered into a password-protected Microsoft Excel database. Each participant will be assigned a unique study identification number, and direct identifiers, including names and medical record numbers, will be stored separately from the research database.The data manager will perform checks for completeness, consistency, logical errors, missing values, and outliers. Key study variables will be independently verified by two researchers against source medical records, imaging data, and digital dental models. Access to the database will be restricted to authorized study personnel and other authorized reviewers in accordance with institutional and ethical requirements. The database will be locked after data cleaning and retained in accordance with the applicable institutional data-management policies.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2026-08-28 10:58:28