安氏Ⅱ类错[牙合]畸形佩戴Twin-block矫治器时上颌骨的应力分布  

Stress distribution on the maxilla when wearing the Twin-block appliance for Class II malocclusion

作　　者：李帅 刘桦[2] 商永慧 刘义琮 赵启航 刘文[2] Li Shuai;Liu Hua;Shang Yonghui;Liu Yicong;Zhao Qihang;Liu Wen(Dalian Medical University,Dalian 116000,Liaoning Province,China;Center of Stomatology,Qingdao Hospital of Rehabilitation University/Qingdao Municipal Hospital,Qingdao 266000,Shandong Province,China;Qingdao Grace Jiamei Dental Clinic of Laoshan District,Qingdao 266100,Shandong Province,China)

机构地区：[1]大连医科大学,辽宁省大连市116000 [2]康复大学青岛医院/青岛市市立医院口腔医学中心,山东省青岛市266000 [3]青岛市崂山区青岛恩典嘉美口腔门诊部,山东省青岛市266100

出　　处：《中国组织工程研究》2025年第5期881-887,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:Twin-block矫治器常用于安氏Ⅱ类错[牙合]畸形的矫治,其刺激下颌骨生长的作用机制已得到许多研究证实,但对上颌骨生长的影响尚不清楚。目的:通过有限元法分析安氏Ⅱ类错[牙合]畸形患者佩戴Twin-block矫治器时上颌骨复合体、周围骨缝及上颌牙列的应力分布。方法:选择在山东省康复大学青岛医院/青岛市市立医院口腔正畸科进行正畸治疗的安氏Ⅱ类错[牙合]畸形患者1例,测量患者佩戴Twin-block矫治器时的咬合力数据,采集其锥形束CT数据,建立包含上颌骨复合体、周边各骨缝、Twin-block矫治器及上颌牙列在内的有限元模型,通过ABAQUS软件模拟患者戴入Twin-block时上颌骨、骨缝及上颌牙列的应力分布与位移。结果与结论:①上颌前牙受到的等效应力明显小于后牙,两侧牙齿的最大等效应力分别为4.7975 MPa和8.7161 MPa,均位于第一前磨牙处;最大位移呈现在两侧上颌切牙处,分别为0.0805 mm和0.0810 mm;②骨缝的最大等效应力为1.284 MPa,主要集中在两侧翼腭缝及额颌缝,其余骨缝受力情况几乎无差异;骨缝的最大位移为0.07 mm,其中翼腭缝的位移量最大,其次是额颌缝;③上颌骨复合体受到的最大等效应力为27.18 MPa,主要集中在上颌骨前面梨状孔两侧、鼻额缝周边及颚骨后部翼腭缝附近;上颌骨的最大位移值为0.07 mm,主要集中于上颌牙槽骨;④结果显示,咬合力通过Twin-block矫治器作用于上颌骨复合体,导致上颌骨顺时针旋转、牙合平面变陡,应采取相应措施补偿这种趋势,例如建牙合过程中考虑上颌磨牙伸长、下颌磨牙压低,不仅能够将牙合平面整平,同时有利于下颌前伸,这将进一步提高Ⅱ类错[牙合]正畸治疗效果。BACKGROUND:The Twin-block orthodontic appliance is commonly used for the correction of Class II malocclusion.Its mechanism of action in stimulating mandibular growth has been confirmed in many studies,but its impact on maxillary growth is not very clear.OBJECTIVE:By establishing a finite element model to analyze the stress distribution of the maxillary complex,surrounding bone sutures,and maxillary dentition in patients with Class II malocclusion wearing Twin-block orthodontic appliances.METHODS:One patient with Class II malocclusion who underwent orthodontic treatment at Qingdao Hospital/Qingdao Municipal Hospital of Shandong Rehabilitation University was selected.The bite force data of the patient when wearing the Twin-block orthodontic appliance was measured,and CBCT data were collected.A finite element model was established,including the maxillary complex,peripheral sutures,Twin-block orthodontic appliance,and maxillary dentition.ABAQUS software was used to simulate the stress distribution in the maxilla and maxillary dentition when the patient was wearing the Twin-block appliance.RESULTS AND CONCLUSION:The equivalent stress on the maxillary anterior teeth was significantly smaller than that on the posterior teeth,and the maximum equivalent stress on both sides of the teeth were 4.7975 MPa and 8.7161 MPa,respectively,which were located at the first premolar.The maximum displacements were presented at the maxillary incisors on both sides of the teeth,which were 0.0805 mm and 0.0810 mm,respectively.The maximum equivalent stress on the bone suture was 1.284 MPa,which was mainly concentrated in the pterygopalatine suture and the frontal-maxillary suture on both sides,and there was almost no difference in the force of the rest of bone sutures;the maximum displacement of the bone suture was 0.07 mm,with the pterygopalatine suture having the largest displacement,followed by the frontal-maxillary suture.The maximal equivalent stress on the maxillary complex was 27.18 MPa,which was mainly concentrated on both sides of

关 键 词：错牙合畸形 组织构建 骨组织工程 TWIN-BLOCK矫治器 功能矫治 有限元分析 

分 类 号：R459.9[医药卫生—治疗学] R318.01[医药卫生—临床医学] R783.5