打开咬合的三维有限元分析的研究进展  

Research progress on the three-dimensional finite element analysis of bite opening

作　　者：程兰欣 刘钧[1] CHENG Lanxin;LIU Jun(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Disease,Department of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院正畸科,四川成都610041

出　　处：《口腔疾病防治》2022年第11期827-831,共5页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(81870743)。

摘　　要：深覆[牙合]是临床常见的错[牙合]畸形,对患者颜面、咬合功能都有较大影响。打开咬合是治疗深覆[牙合]的关键步骤,对下颌骨的正常发育和治疗的顺利进行有决定性作用。如何在打开咬合的同时兼顾前后牙转矩、轴倾度的控制是正畸领域的热点。三维有限元方法可以精确模拟临床现象并进行动态受力分析。微种植体为打开咬合中支抗控制等问题提供了新的思路,有限元分析发现高位微种植体更易整体压入前牙。对于摇椅弓的有限元模拟则发现其对前牙的压低及唇倾作用随着弓丝角度的增加而增加。隐形矫治器在打开咬合中的应用也日渐受到重视,但其作用力尚难以有效控制,关于其附件设计及相应牙齿移动方式的有限元研究有助于快速有效地打开咬合。但现有的有限元建模精确性不够,研究多针对于初始位移,缺乏对于骨改建后的长期牙移动的研究,未来有待进一步研究和完善。Deep bite is a common clinical malocclusion that has a great impact on patients’facial aesthetics and oral function.Bite opening is the key step in the treatment of deep bite,playing a decisive role in the development of mandible and the progress of orthodontic treatment.Torque and tip control during the correction of deep bites is a hot topic in orthodontics.The three-dimensional finite element method can accurately simulate clinical processes and conduct dynamic stress analysis,which provides the basis of the biomechanical mechanism.This paper reviewed the finite element analysis of various orthodontic systems for bite opening to provide a reference for clinical application.The emergence of mini-implants provided a new idea for anchorage control in bite opening.Finite element studies found that high-positioned mini-implants are beneficial for bodily tooth intrusion and proposed the ideal position for force application.For the finite element simulation of the reverse curve archwire,it was found that the intrusion and inclination of the anterior teeth increased with the curve depth of the archwire.The application of clear aligners has also been flourishing,but these forces are still difficult to effectively control.Finite element studies on their attachment design and corresponding tooth movement may be helpful to open the bite quickly and effectively.However,the existing studies still have modeling limitations.The structural simplification,linearization and nonstandard parameter definition of the model reduce model accuracy.Additionally,the existing research mostly focused on initial tooth movement,and studies on long-term tooth movement after bone remodeling are lacking.These studies are needed in the future.

关 键 词：深覆[牙合] 错[牙合]畸形 打开咬合 正畸牙移动 三维有限元分析 生物力学 微种植体 摇椅弓 隐形矫治器 转矩 

分 类 号：R78[医药卫生—口腔医学]