拔牙病例隐形矫治内收前牙伴不同压低方式的有限元研究  

Effect of different intrusion patterns on anterior retraction with clear aligner in tooth extraction cases:a three-dimensional finite element study

作　　者：张艺严 范存晖[1] 丁弘[1] 许涛[1] 马翔宇 刘洋[1] Zhang Yiyan;Fan Cunhui;Ding Hong;Xu Tao;Ma Xiangyu;Liu Yang(Department of Orthodontics,The Affiliated Hospital of Qingdao University,School of Stomatology of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院口腔正畸科,青岛大学口腔医学院,青岛266003

出　　处：《中华口腔正畸学杂志》2024年第2期61-66,共6页Chinese Journal of Orthodontics

基　　金：国家自然科学基金(82001086);中国牙病防治基金会"爱笑少年"科研项目(A2023-023)。

摘　　要：目的本研究通过三维有限元分析方法,探讨拔牙患者隐形矫治过程中上前牙内收时采取不同压低方式对牙齿移动趋势的影响。方法构建拔除第一前磨牙的上颌牙列三维有限元模型,使用初始位移量评估关闭拔牙间隙时,单纯内收前牙、内收前牙并压低切牙、内收并压低前牙3种不同牙齿移动方式对牙齿位移趋势和平面旋转趋势的影响。结果前牙单纯内收组、前牙内收切牙压低组和前牙压低内收组的中切牙伸长量依次为7.52E-03 mm、6.12E-03 mm、7.52E-03 mm;侧切牙伸长量依次为7.68E-03 mm、-7.92E-03 mm、8.73E-03 mm;尖牙的伸长量依次为1.84E-02 mm、3.26E-02 mm、1.34E-02 mm;第二前磨牙伸长量依次为-4.42E-03 mm、-4,99E-03 mm、-0.90E-03 mm。结论前牙整体内收时通过增加切牙或前牙的压低量可以优化牙齿的移动方式:当对前牙进行整体压低时,后牙平面的角度变化最小,牙弓中段牙齿的倾斜趋势减小;当对切牙进行整体压低时,切牙的相对伸长量最小,尖牙的伸长和远中倾斜趋势增大。但是在推荐的步距范围内,仅通过增加前牙垂直向位移的方式无法实现前牙的整体移动。ObjectiveTo investigate the effect of different intrusion patterns on tooth movement during retraction of upper anterior teeth in clear-aligner-treated extraction cases.MethodsA three-dimensional finite element model of the maxillary dentition with first premolar extraction was developed.Initial displacement was used to evaluate the effects of three different tooth movement patterns on tooth displacement and occlusal plane rotation trend during the closing of extraction spaces:anterior retraction group,anterior retraction with incisor intrusion group,and anterior retraction with anterior teeth intrusion group.ResultsIn anterior retraction group,anterior retraction with incisor intrusion group,and anterior retraction with anterior teeth intrusion group,the extrusion values for central incisors were 7.52E-03 mm、6.12E-03 mm、7.52E-03 mm;for lateral incisors were 7.68E-03 mm、-7.92E-03 mm、8.73E-03 mm;and for canines were 1.84E-02 mm、3.26E-02 mm、1.34E-02 mm.The second premolars showed extrusion values of-4.42E-03 mm、-4.99E-03 mm、-0.90E-03 mm.ConclusionsThe tooth movement can be optimized by the intrusion of incisors or anterior teeth during the bodily retraction of anterior teeth.The posterior occlusal plane rotated least when intruding anterior teeth,and the inclination trend decreased in the middle part of the dentition.The intrusion of the incisors resulted in minimal relative extrusion,whereas the extrusion and distal tilt tendency of the canine exhibited an increase.However,within the recommended step distance,the bodily movement of the anterior teeth cannot be achieved by the intrusion of the anterior teeth only.

关 键 词：三维有限元分析 隐形矫治 拔牙病例 垂直向控制 

分 类 号：R783.5[医药卫生—口腔医学]