隐形矫治磨牙远移所获间隙用于前牙内收的三维力学分析  

Three-dimensional analysis of anterior retraction after creating space by molar distalization

作　　者：范亚杰 贺旭辉 许益蒙 杨泽轩 张夏雨 顾泽旭 Fan Yajie;He Xuhui;Xu Yimeng;Yang Zexuan;Zhang Xiayu;Gu Zexu(State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Clinical Research Center for Oral Diseases,Department of Orthodontics,School of Stomatology,The Fourth Military Medical University,Xi’an 710032,China)

机构地区：[1]口颌系统重建与再生全国重点实验室,国家口腔疾病临床医学研究中心,陕西省口腔疾病临床医学研究中心,第四军医大学口腔医院正畸科,西安710032

出　　处：《中华口腔正畸学杂志》2024年第2期67-71,共5页Chinese Journal of Orthodontics

基　　金：陕西省社发攻关重点项目(2023-YBSF-229);空军军医大学第三附属医院临床新技术项目(LX2022-301);空军军医大学临床研究项目(2022LC2238)。

摘　　要：目的比较无托槽隐形矫治磨牙远移到位,间隙位于尖牙远中时不同内收前牙设计上颌牙列的三维受力情况,以期为临床医师设计内收前牙牙齿移动方案提供理论依据。方法体外实验研究选择磨牙远移到位,间隙位于尖牙远中的上颌牙列模型,根据不同内收前牙方式分为一步法内收组和两步法内收组;两步法内收组按不同牙齿移动阶段分为两步法尖牙远移组和两步法切牙内收组。一步法内收组(A组)同时设计切牙的舌向移动、尖牙的远中移动;两步法尖牙远移组(B1组)只设计尖牙的远中移动;两步法切牙内收组(B2组)只设计切牙舌向移动。每组设计移动的牙齿移动量均为0.2 mm。利用无托槽隐形矫治器上颌牙列三维力学测力装置,测量每组上颌牙列各牙位的三维受力数据并进行组间比较。结果在A组和B2组中,切牙均受到舌向力,在B2组中,中切牙受力较大为(3.43±0.91)N,大于其在A组所受力值(1.88±0.89)N,受力差异有统计学意义(P<0.001);而B1组中切牙却受到唇向矫治力,力值为(-1.44±0.46)N。尖牙在A组受到(1.80±0.44)N的远中向力,小于其在B1组所受力值(4.08±0.66)N,受力差异具有统计学意义(P<0.001),而在B2组中,尖牙却受到(-2.30±0.93)N的近中向力。3组中,支抗后牙均受到近中向反作用力,A组支抗后牙受到的反作用力>B1组和B2组中相应牙齿所受力值,每组中第一前磨牙和第二磨牙受到的近中反作用力较同组其他牙齿受力大,其中,A组第一前磨牙受到(-1.63±0.57)N的近中向力,第二磨牙受到(-2.38±0.85)N的近中向力,为3组中最大。结论无托槽隐形矫治磨牙远移到位,间隙位于尖牙远中时一步法内收设计,前牙受到的矫治力较小,支抗后牙会受到较大的反作用力;而两步法内收前牙设计,后牙受到的反作用力较小,但尖牙远移阶段,切牙会受到唇向的反作用力;切牙内收阶段,尖牙又会受到近中力。因此,无�ObjectiveTo provide a theoretical basis for clinicians to design anterior retraction tooth movement schemes with clear aligners after molars distalization and space created distal to canines before retraction,this study compared the three dimensional forces of the maxillary dentition under different anterior retraction designs.MethodsIn this in vitro experiment,based on anterior retraction mode with clear aligners,items were divided into the en masse retraction group and the two-step retraction group.According to different tooth movement stages,the two-step retraction group was divided into two subgroups:canine distalization group and incisor retraction group.In the en masse retraction group(Group A),the lingual movement of incisors and the distal movement of canine were designed simultaneously.In the canine distalization group(Group B1),only canine was designed to move distally.In the incisor retraction group(Group B2),only incisors was designed to move lingually.And the displacement of each tooth was set as 0.2 mm.Using a three-dimensional force measurement device,force data of the maxillary dentition in each group were measured and compared.ResultsIn Group A and B2,incisors experienced lingual forces.In Group B2,central incisors experienced a larger lingual force(3.43±0.91)N,compared to(1.88±0.89)N in Group A,with a statistically significant difference(P<0.001).However,in Group B1,incisors experienced labial forces,with a labial force on central incisors of(-1.44±0.46)N.The distal force on canines in Group A was(1.80±0.44)N,smaller than(4.08±0.66)N in Group B1,with a statistically significant difference(P<0.001),while the mesial force on canines in Group B2 was(-2.30±0.93)N.In all groups,posterior anchorage teeth experienced mesial counterforces.In Group A,counterforces on anchorage posterior teeth were greater than those in Groups B1 and B2.The first premolars and second molars in each group experienced larger mesial counterforces compared to other anchorage posterior teeth.In Group A,the first premolar

关 键 词：隐形矫治器 内收前牙 一步法内收 两步法内收 

分 类 号：R783.5[医药卫生—口腔医学]