不同加载方式滑动法关闭双颌前突患者拔牙间隙的三维有限元分析  

Finite element analysis of different load mode on tooth movement for space closure in patient with bimaxillary protrusion

作　　者：张晓波[1] 尹燕飞[1] 姚红梅[1] 韩耀辉[2] 王宁[1] 葛振林[1] 

机构地区：[1] 兰州大学口腔医学院正畸科,730030 [2]甘肃省酒泉市人民医院口腔科,735000

出　　处：《中华口腔医学杂志》2016年第7期415-419,共5页Chinese Journal of Stomatology

摘　　要：目的 通过三维有限元方法,探讨种植体支抗滑动法关闭间隙时不同加载方式下上颌牙列的应力分布和牙位移,以期为临床提供参考.方法 锥形束CT扫描个别正常（牙合）志愿者颌骨及牙列,用Mimics软件进行三维重建,Creo软件建立托槽和弓丝实体模型,Pro/Engineer软件实体化后组装,有限元软件Abaqus进行分析.设计种植体支抗高度为8 mm,分别在牵引钩高度为0、2、4、6、8、10 mm处及弓丝上尖牙远中距离托槽远中翼2 mm、第二前磨牙近中距离托槽近中翼2 mm、第二前磨牙远中距离托槽远中翼2 mm处加载2N力,分析上颌前牙及后牙的初始位移及应力分布,以及上颌（牙合）平面旋转方向.结果 力加载于低位牵引钩（0 mm）时,上颌中切牙顺时针旋转0.021°,上颌第一磨牙向上移动0.005 mm,（牙合）平面顺时针旋转0.012°;力加载于高位牵引钩（10 mm）时,上颌中切牙逆时针旋转0.235°,上颌第一磨牙向下移动0.015 mm,（牙合）平面逆时针旋转0.075°.弓丝加载位置由牵引钩最低点逐渐向后移动时,上颌中切牙顺时针旋转的趋势逐渐减小,上颌第一磨牙颊向移动的趋势逐渐增大.结论 种植体支抗滑动法关闭间隙时可通过调整牵引钩高度和弓丝加力位置,对前牙段旋转和内收、后牙段垂直向位移及（牙合）平面的旋转进行控制.Objective To investigate the stress distribution on the maxillary anterior teeth retracted with sliding mechanics and micro-implant anchorage using different retraction hook heights and positions.Methods DICOM image data including maxilla and upper teeth were obtained with cone-beam CT.The three-dimensional finite element model was constructed using Mimics software.Brackets and archwire model were constructed using Creo software.The models were instantiated using Pro/Engineer software.Abaqus software was used to simulate the sliding mechanics by loading 2 N force on 0,2,4,6,8,10 mm retraction hooks and three different positions,repectively.Rotation of the occlusal plane,the initial displacement and stress distribution of teeth were analyzed.Results Lingual rotation of maxillary central incisor（0.021°）,gingival movement of the maxillary first molar（0.005 mm）,and clockwise rotation of the maxillary occlusal plane（0.012°） were observed when the force application point located at the archwire level （0 mm）.In contrast,0.235° labial rotation of the maxillary central incisor,0.015 mm occlusal movement of the maxillary first molar,and 0.075° anti-clockwise rotation of the maxillary occlusal plane were observed when the force application point located at the higher level（10 mm retraction hook）.The more the force application point was located posteriorly at the archwire level,the less lingual rotation of the maxillary central incisor and the more buccal displacement of maxillary first molar was observed.Conclusions Maxillary anterior tooth rotation and retraction,vertical displacement of posterior segment,and rotation of the occlusal plane could be controlled by adjusting the height and position of the retraction hook in space closure using miniscrew and sliding mechanics.

关 键 词：有限元分析 正畸缺隙闭合 正畸矫正器设计 

分 类 号：R783.5[医药卫生—口腔医学]