牙周膜减阻牵张移动上下颌尖牙的三维有限元分析  

Three-dimensional finite element analysis of rapid canine movement through reducing resistance on parodontium

作　　者：王飞宇[1] 薛俊杰[2] 王璟[3] 徐远志[3] 舒林径[1] 黄稔欢[1] 

机构地区：[1]四川大学华西口腔医学院,成都610041 [2]首都医科大学附属北京口腔医院正畸科 [3]同济大学附属第十人民医院口腔科

出　　处：《中华口腔医学研究杂志（电子版）》2014年第3期6-9,共4页Chinese Journal of Stomatological Research(Electronic Edition)

摘　　要：目的分别建立牙周膜减阻牵张成骨术远移尖牙的上下颌三维有限元模型,探讨在尖牙远移过程中上下颌尖牙及牙周组织的应力分布和位移情况,为临床应用提供理论依据。方法通过64排螺旋CT扫描,获得样本的颞下颌关节(TMJ)、上下颌骨、上下颌牙列的DICOM数据文件,建立上下颌牙周膜牵张成骨术远移尖牙的三维有限元模型。分别于尖牙颊侧及腭侧加载近远中向的牵引力,观察尖牙、牙周组织应力分布情况和位移趋势。结果上下颌尖牙最大瞬时位移部位均位于牙冠1/3,从尖牙牙冠到根尖逐渐减少;最大瞬时位移数值:上颌尖牙>下颌尖牙;支抗牙均未见明显位移。上、下颌尖牙最大等效应力部位:上颌集中于尖牙远中牙槽嵴顶略偏颊侧处,下颌最大等效应力主要集中在尖牙远中牙槽嵴顶偏舌侧处;最大等效应力:上颌尖牙>下颌尖牙。结论牙周膜减阻牵张成骨术可以有效减少支抗丧失的风险。上下颌尖牙在减阻牵张过程中有远中倾斜移动趋势;其中上颌尖牙远移时有颊向旋转趋势,下颌尖牙远移时有舌向旋转趋势,应用减阻牵张辅助尖牙远移过程中应控制尖牙的旋转移动或加以适当的纠正。Objective To compare force distribution and periodontal tissue on maxillary and mandibular canines during canine distalization,we established three-dimensional finite element analysis of rapid canine movement through reducing resistance on parodontium.Methods DICOM data of teeth,temporomandibular joints,maxilla and mandible was obtained by 64-slice spiral scanning.Establishing a three-dimensional finite element model of canine movement by reducing resistance on parodontium.The force was loaded on the buccal and lingual side of canine,and the force distribution and displacement of canine was observed.Results The maximum displacement occurred on 1/3 of the canine crown,and gradually reduced towards the root apex of canine.No anchorage loss was observed.The maximum equivalent stress was observed on the distal buccal alveolar ridge of upper canine and distal lingual alveolar ridge of lower canine.Conclusions The model of rapid canine movement by reducing resistance on periodontium can reduce the risk of anchorage loss effectively.However,the canine had the tendency of tipping movement during distalization.Furthermore,Canines had the tendency to rotate buccally on the maxilla and lingually on the mandible.The findings suggest that a control of canine tipping and rotation be applied when reducing resistence on parodontium to accelerate canine distalization.

关 键 词：牙周膜 牵张成骨 牙齿移动 三维有限元 

分 类 号：R783.5[医药卫生—口腔医学]