滑动法关间隙过程中横腭杆对上牙弓宽度的影响:三维有限元研究  

The maxillary dentition width variation of sliding space closure with transpalatal arch:A 3D finite element analysis

作　　者：李毕超 高瑜 武姗 项桦 任利玲[1] LI Bichao;GAO Yu;WU Shan;XIANG Hua;REN Liling(Department of Orthodontics, School of Stomatology, Lanzhou University, Lanzhou 730000,China)

机构地区：[1]兰州大学口腔医学院正畸科

出　　处：《实用口腔医学杂志》2019年第5期691-695,共5页Journal of Practical Stomatology

摘　　要：目的:研究横腭杆(TPA)在滑动法关间隙过程中对上牙弓中后段牙齿横向移动的影响。方法:将患者上颌牙颌系统CBCT数据信息以DICOM格式导入Mimics软件进行三维重建,建立滑动法关间隙的三维有限元模型;在ANSYS软件中计算间隙关闭量分别为0、2、4 mm及使用TPA与否6种工况下上颌尖牙、第二前磨牙、第一磨牙与第二磨牙横向(颊舌向)的初始位移。结果:滑动法关间隙过程中,无论使用TPA与否,尖牙、第二前磨牙、第一磨牙均表现为牙冠舌向移动,牙冠间宽度变小;第二磨牙则相反,牙冠为颊向移动,牙冠间宽度增大;TPA组尖牙、第二前磨牙及第一磨牙牙冠舌向位移量均比对照组(Non-TPA组)小,分别减少了14.8%、29.7%、27.7%,第二磨牙牙冠颊向位移量则较对照组平均增加了48.2%。结论:滑动法关间隙过程中,使用TPA可减少牙弓中后段牙冠舌向位移有利于弓形稳定,但有加大第二磨牙颊向倾斜的趋势,治疗中应注意第二磨牙的转矩控制及横向位置的调整。Objective: To clarify the influence of the transpalatal arch(TPA) on the transverse movement of the upper posterior teeth in the course of space closure with sliding mechanics. Methods: The CBCT data of a male patient who had maxillary first premolars ex tracted was imported into the Mimics software for 3D reconstruction. Six loading conditions of the amount of space closure, 0, 2, 4 mm with or without TPA, were calculated by ANSYS software for the analysis of the transverse initial displacement of maxillary canine, the second premolar,the first molar and second molar. Results: The transverse movement type of the canine, the second premolar and the first molar were all lingual crown tipping, by contrast, the second molar was buccal crown tipping at different stages of space closure with or without TPA;the dispalcement of lingual crown tipping of the canine, the second premolar, and the first molar in TPA group were smaller than that of the control group, with the average decrease of 14.8%, 14.8% and 29.7% respectively. Buccal crown tipping of the second molar was increased by 48.2% on average. Conclusion: During the space closure with sliding mechanics, the use of TPA is beneficial to the stability of the upper arch, but which may increase buccal crown tipping of the second molar.

关 键 词：滑动法 横腭杆(TPA) 弓形变化 三维有限元(FEA) 

分 类 号：R783.5[医药卫生—口腔医学]