隐形矫治器上前牙内收过程中侧切牙不同附件设计的三维有限元分析  

Three-dimensional finite element analysis of different attachment designs for lateral incisors during inward retraction of upper anterior teeth in clear aligner

作　　者：陈精诚 赵梦丽 程志恒 刘昕[2] CHEN Jing-cheng;ZHAO Meng-li;CHENG Zhi-heng;LIU Xin(Wannan Medical College,Wuhu 241000;School of Stomatology Clinical College of Anhui Medical University(Hefei Stomatological Hospital),Hefei 230000;Bengbu Medical College,Bengbu 233000,Anhui Province,China)

机构地区：[1]皖南医学院,安徽芜湖241000 [2]安徽医科大学口腔临床学院(合肥市口腔医院),安徽合肥230000 [3]蚌埠医学院,安徽蚌埠233000

出　　处：《上海口腔医学》2024年第4期360-366,共7页Shanghai Journal of Stomatology

基　　金：合肥市卫生健康应用医学研究项目基金(Hwk2022yb035)。

摘　　要：目的:探讨隐形矫治器在上前牙内收过程中侧切牙上不同形状附件的生物力学表达,为改善临床设计提供思路。方法:通过三维有限元技术将CBCT数据进行体外仿真,分别在侧切牙上设计无附件(A1)、矩形附件(A2)、楔形附件(A3)和弯弧形附件(A4),利用Ansys计算相同载荷设计下侧切牙、牙列和隐形矫治器的三维变化及牙周膜等效应力(von Mises)分布。结果:侧切牙位移冠状向变化量A1>A4>A3>A2,矢状向变化量A3>A4>A1>A2,垂直向伸长量A4>A3>A1>A2;各组牙列整体位移呈现弓形趋势;隐形矫治器不同部位形变存在差异。A1与A2组牙周膜von Mises分布大致相似,A3组仅在根1/3舌侧区域出现应力集中,A4组牙颈部应力远大于A1组与A2组。结论:矩形附件与弯弧形附件在冠状向控制上具有优势,矩形附件在垂直向的控制效果最佳,附件受力面积与实际位移效率并不存在绝对关联,其受力面的形状会大幅度干扰具体力学表达效果。PURPOSE:To investigate the biomechanical expression of different shapes of attachments on the maxillary anterior teeth during the lingual tooth movement process using clear aligners,providing new insights for orthodontists to improve the clinical design.METHODS:In this study,CBCT data were simulated using the three-dimensional finite element technique.Attachments of various shapes,including no attachment(A1),rectangular attachment(A2),wedge-shaped attachment(A3),and curved arc attachment(A4),were designed on the lateral incisors.Ansys software was employed to calculate the three-dimensional changes in the lateral incisors,dental arch,and clear aligners and the distribution of equivalent stress on the periodontal ligament(von Mises)under the same load conditions.RESULTS:The coronal displacement of the lateral incisors showed the following variations:A1>A4>A3>A2.The sagittal displacement exhibited the following variations:A3>A4>A1>A2.The vertical elongation demonstrated the following variations:A4>A3>A1>A2.The overall displacement of each dental arch displayed an arch-shaped trend.Different regions of the clear aligners exhibited variations in deformation.The von Mises distribution of the periodontal ligament in A1 and A2 group showed similarities,while A3 group exhibited stress concentration only in the lingual area of the root's one-third region.Group A4 experienced significantly higher stress in the cervical region compared to A1 and A2 group.CONCLUSIONS:Rectangular attachments and curved arc attachments possess advantages in coronal control,with rectangular attachments exhibiting the best control effect in vertical control.The area of attachment force and actual displacement efficiency do not have an absolute correlation,as the shape of the force-bearing surface can significantly affect its specific biomechanical expression.

关 键 词：三维有限元分析 隐形矫治器形变趋势 侧切牙附件 隐形矫治器 

分 类 号：R783.5[医药卫生—口腔医学]