有限元分析不同尖牙远移量在隐形矫正中对前牙压低的影响  

Finite element study on the effect of canine distal movement on anterior tooth intrusion by clear aligners

作　　者：陈琳 徐晓梅 张丽 胥鹏飞 郑茜 Chen Lin;Xu Xiaomei;Zhang Li;Xu Pengfei;Zheng Qian(Department of Orthodontics,Affiliated Stomatological Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属口腔医院正畸科,四川省泸州市646000

出　　处：《中国组织工程研究》2022年第35期5669-5675,共7页Chinese Journal of Tissue Engineering Research

基　　金：四川省科技厅计划项目(2021YJ0151),项目名称:AMPK-mTOR信号通路调控正畸牙压力侧PDLCs自噬动态变化的机制研究,项目负责人:徐晓梅;西南医科大学校级科研项目(2021LZMS019),项目名称:压应力作用下Hippo-YAP信号通路介导PDLCs自噬调控骨吸收的效应和机制,项目负责人:徐晓梅;西南医科大学口腔医学院院级教育教学改革研究项目(KQJG202104),项目名称:翻转课堂联合CBL教学模式在口腔正畸实验教学中的应用探究,项目负责人:郑茜。

摘　　要：背景:在应用隐形矫治器矫治的拔牙病例中,尖牙先远移的内收方式有利于节约后牙支抗,对抗牙套的弓状效应,但尖牙远移后改变了牙套对牙齿的包裹及矫治器拔牙空泡处的弹性,减轻邻牙移动约束,这可能会对前牙压低产生影响。目的:运用有限元技术研究隐形矫治拔牙方案中尖牙远移量对前牙压低效果的影响。方法:建立包括牙齿、牙周膜、牙槽骨、隐形矫治器、附件的减数第一前磨牙下颌有限元模型,模拟临床尖牙远移方式进行分步压低前牙的操作,对照组尖牙不移动,实验1组为尖牙远移1 mm,实验2组为尖牙远移至拔牙间隙1/3处,分析尖牙远移后对前牙压低的影响。结果与结论:(1)实验1组前牙压低量最大,尖牙切缘垂直向位移为0.0178670 mm,中切牙垂直向位移为0.0096470 mm,侧切牙垂直向位移为0.0077775 mm;对照组前牙压低量最少,尖牙切缘垂直向位移为0.0081953 mm,中切牙垂直向位移为0.0052380 mm,侧切牙垂直向位移为0.0056892 mm;实验2组尖牙切缘垂直向位移为0.0144630 mm,中切牙切缘垂直向位移为0.0092947 mm,侧切牙垂直向位移为0.0070139 mm;(2)3组组内,支抗磨牙的等效应力最小,切牙切缘位移大于根尖位移,唇、舌侧等效应力分布存在显著差异;(3)结果显示,尖牙远移可改善矫治器对前牙的压低量,但不同的远移量对前牙压低效果不同;支抗牙距离目标牙越近受力越大,反之受力越小;隐形矫治主要为倾斜压低前牙。BACKGROUND:When invisible appliances are used in tooth extraction,canine distal movement is a retraction pattern that is beneficial to save the anchorage of posterior teeth and resist the arch effect of braces.However,canine distal movement changes the wrapping of braces around the teeth and the vacuole elasticity due to tooth extraction using the appliance,and relieves the constraint to the movement of adjacent teeth,which may have an impact on anterior tooth intrusion.OBJECTIVE:To study the effect of canine distal movement on ante rior tooth intrusion in invisible orthodontic treatment by using finite element method METHODS:The mandibular finite element model of the subtractive first premolar was established,including teeth,periodontal ligament,alveolar bone,invisible appliance,and accessories.Ste p-by-step intrusion of the anterior teeth was conducted through simulation of clinical canine distal movement.In control group,the canines did not move.In experimental group 1,the canines moved 1 mm away,while in experimental group 2,the canines moved 1/3 of the extraction space.The effect of canine distal movement on ante rior tooth intrusion was analyzed.RESULTS AND CONCLUSION:The maximum anterior tooth intrusion occurred in the experimental group 1,with the vertical dis placement of the canine incisal edge by 0.0178670 mm,the vertical dis placement of the central incisor by 0.0096470 mm,and the vertical displacement of the lateral incisor by 0.0077775 mm.The minimum ante rior tooth intrusion occurred in the control group,with the vertical displacement of the canine incisal edge by 0.0081953 mm,the vertical dis placement of the central incisor by 0.0052380 mm,and the vertical dis placement of the lateral incisor by 0.0056892 mm.In the experimental group 2,the canine incisal edge moved 0.0144630 mm vertically,the central incisor moved 0.0092947 mm vertically,and the lateral incisor moved 0.0070139 mm vertically.In all cases,the von Mises stress of anchorage mola rs was smallest,the displacement of the incisor edge wa

关 键 词：正畸矫治 无托槽隐形矫治 减数拔牙 前牙压低 尖牙远移 三维有限元 

分 类 号：R459.9[医药卫生—治疗学] R319[医药卫生—临床医学]