个体化舌侧矫治内收上前牙时牙齿移动趋势的三维有限元分析及临床验证  

Tooth movement tendency of retracting maxillary anterior teeth with customized lingual appliance:a 3-dimensional finite element analysis and clinical validation

作　　者：冯素亚 蔡留意 张月兰[2] 杨金刚 乔守莲 FENG Suya;CAI Liuyi;ZHANG Yuelan;YANG Jingang;QIAO Shoulian(Department of Stomatology, Henan Provincial Corps Hospital,Chinese People′s Armed Police Forces, Zhengzhou 450052;Department of Orthodontics,the First Affiliated Hospital, Zhengzhou University,Zhengzhou 450052)

机构地区：[1]武警河南省总队医院口腔科,郑州450052 [2]郑州大学第一附属医院正畸科,郑州450052

出　　处：《郑州大学学报（医学版）》2020年第3期381-385,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：郑州市科技局科技攻关项目(153Pkjgg167)。

摘　　要：目的:根据已有三维有限元模型,分析个体化舌侧矫治内收上前牙时牙齿的移动趋势,并加以临床验证。方法:基于已有的三维有限元模型,设置不同微种植体位置(第二前磨牙和第一磨牙间距离牙槽嵴顶2、6或10 mm处),在尖牙和侧切牙之间的牵引钩与微种植体间施加1.5 N的载荷,观察并分析三维方向上牙齿的移动趋势,并在临床选择合适病例加以验证。结果:随着微种植体向根方移动,前牙的内收及伸长趋势减小,但内收趋势比伸长趋势减小明显;后牙区牙齿整体较为稳定,位移趋势较小。临床矫治结果与其基本一致,并证实微种植体植入位置在距牙槽嵴顶6 mm处矫治效果较为理想。结论:在上颌第二前磨牙与第一磨牙间距牙槽嵴顶6 mm处植入微种植体较为合适,可较好避免舌侧拔牙矫治后后牙在垂直向及水平向的“弓形效应”,但前牙区的舌倾和伸长趋势应加以控制。Aim:To analyze the tooth movement tendency using 3-dimensional finite element models,which should also be verified in clinic,during maxillary anterior teeth retraction.Methods:The dentition movement tendency in three dimensions were analyzed when 1.5 N force was loaded on retraction hooks and micro-implants at different positions respectively.The retraction hooks were set between literal incisor and canine bilaterally.The micro-implants were set between the second premolar and the first molar at 2,6 or 10 mm from the alveolar ridge crest.Proper clinical cases were selected to verify the dentition movement tendency.Result:The retraction and extrusion tendency of maxillary anterior teeth decreased when the position of micro-implant was getting closed to the apical of teeth roots.However,the decreasing tendency of retraction of maxillary anterior teeth was more obvious than that of extrusion.The movement tendency of posterior teeth was slight.The clinical practice proved that the micro-implants implanted at 6 mm from the alveolar ridge crest could obtain good efficacy.Conclusions:The implanting of micro-implants between the second premolar and the first molar at 6 mm from the alveolar ridge crest should be recommended to avoid the vertical and transverse bowing effect of posterior teeth when extraction cases are treated with lingual appliances.Considering maxillary anterior lingual inclination and extrusion,effective solutions have to be operated to resist side effects.

关 键 词：舌侧矫治 生物力学 内收前牙 微种植体 

分 类 号：R783.5[医药卫生—口腔医学]