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目的:研究无托槽隐形矫治三维设计中未设计移动的上颌支抗磨牙实际治疗前后三维方向位移变化。方法:选取26例上颌磨牙未设计移动的非拔牙隐形矫治成人病例，根据前牙唇舌向设计将病例分为内收组和非内收组。收集矫治前后石膏模型，使用三维扫描仪获取数字化模型，通过腭皱襞表面重叠，研究上颌磨牙矫治前后横向、垂直向、矢状向的位移变化。结果:未设计移动的支抗磨牙在三维方向均发生了移动(n P<0.05)。内收组支抗磨牙颊移(0.41±0.53) mm；伸长(0.45±0.37) mm舌尖伸长大于颊尖，远中尖伸长大于近中尖；磨牙近移(0.53±0.53) mm。非内收组磨牙颊移(0.46±0.53) mm；压低(0.24±0.29) mm，磨牙颊舌尖、近远中尖位移量无统计学差异；磨牙远移(0.28±0.32) mm。n 结论:无托槽隐形矫治三维设计中未设计移动的上颌支抗磨牙存在三维方向的位移。内收组磨牙发生颊向倾斜、伸长、近中倾斜移动；非内收组磨牙发生颊向、压低、远中移动。“,”Objective:To investigate the actual three-dimensional displacement of maxillary molars which are planned as unmovable in clear aligner virtual treatment design.Methods:26 non-extraction adult cases treated with clear aligner were enrolled in this study, and all the maxillary molars are planned as unmovable. According to the designed labial-lingual movements of anterior teeth, the patients were divided into anterior retraction group and anterior non-retraction group. The plaster models of pre-treatment and post-treatment were collected and laser-scanned. The digital models were superimposed by the palatal rugae surface to analyze the transverse, vertical and sagittal displacement of the maxillary molar.Results:The plan-to-be-unmovablemolars have moved in three dimensions (n P<0.05). In anterior retraction group, the buccal movement (0.41±0.53)mm, extrusion (0.45±0.37)mm and mesial movement (0.53±0.35)mm occurred in molars, the extrusion of lingual cusps and distal cusps are larger than that of buccal cusps and mesial cusps, respectively. In anterior teeth non-retraction case, the buccal movement (0.44±0.53)mm, intrusion (0.28±0.29)mm and distal movement (0.28±0.32)mm occurred in molars, the intrusion difference between buccal and lingual cusps, mesial and distal cusps was not statistically significant.n Conclusions:The maxillary molars moved in all three dimensions though they were planned unmovable. In the anterior retraction group, buccal tipping, extrusion and mesial tipping occurred in molars. In the anterior non-retraction group, buccal, intrusive and distal movements occurred in molars.