隐形拔牙矫治不同垂直骨面型上颌前牙移动特征的三维有限元研究  

Movement characteristics of upper anterior teeth in clear aligner therapy with tooth extraction orthodontics with different vertical facial patterns in finite element analysis

作　　者：李汪儒 杨璞[1] Li Wangru;Yang Pu(State Key Laboratory of Oral Diseases&National Center for Stomatology&National Clinical Research Center for Oral Diseases&Dept.of Orthodontics,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病防治全国重点实验室、国家口腔医学中心、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,成都610041

出　　处：《国际口腔医学杂志》2025年第1期69-75,共7页International Journal of Stomatology

基　　金：中国牙病防治基金会科研项目(A2021-143)。

摘　　要：目的通过三维有限元分析,探讨不同垂直骨面型患者在无托槽隐形拔牙矫治过程中上颌前牙的移动特征。方法采集1例正畸患者的上颌骨锥形束CT数据和上颌牙列口内扫描数据,使用Mimics、Geomagic Studio、HyperMesh等软件,建立3种不同垂直骨面型(高角组、均角组、低角组)拔除上颌第一前磨牙的三维有限元模型,模拟透明矫治器内收上颌前牙,分析上颌前牙的移动趋势,分析各向位移量、转矩变化及牙周膜等效应力。结果各垂直骨面型组均表现为牙齿向拔牙侧移动,移动方式为倾斜移动,根位移量小于冠位移量;中切牙和侧切牙的垂直向及矢状向位移量、牙周膜等效应力和转矩变化均表现为低角组、均角组、高角组依次增多;尖牙的垂直向及矢状向位移量、牙周膜等效应力和转矩变化则表现为均角组最多,低角组最小。结论在进行无托槽隐形拔牙矫治设计时,应充分考虑不同垂直骨面型的前牙移动特征,制订个性化设计方案。Objective This study aims to investigate the movement dynamics of maxillary anterior teeth during extrac‐tion and correction utilizing clear aligner therapy among patients exhibiting distinct vertical facial patterns.Methods Oral and cone beam computed tomography data of the patient’s maxillary anatomy and oral scan data of maxillary denti‐tion were collected.By employing software such as Mimics,Geomagic Studio,and HyperMesh,three vertical facial pat‐terns were established via a three-dimensional finite element model.This model simulated clear aligner adduction of the upper anterior teeth,facilitating analysis of movement trends,sagittal and vertical displacements,alterations in anterior tooth torque,and periodontal ligament equivalent stress.Results Across all vertical facial pattern groups,the teeth exhi-bited migration towards the extraction site,with root displacement inferior to crown displacement and concurrent oblique movement.Vertical and sagittal displacements of maxillary incisors and periodontal ligament effects demonstrated pro‐gressive increment from the brachyfacial group to the mesofacial and dolichofacial groups.Conversely,vertical and sagit‐tal displacements of canines,periodontal ligament equiva-lent stress,and torque changes remained consistent.No‐tably,the dolichofacial group exhibited the highest mag‐nitude,whereas the brachyfacial group displayed the lowest.Conclusion Clear aligner therapy with tooth extraction and correction induces a clockwise moment on the anterior teeth,intensifying sequentially across the brachyfa‐cial,mesofacial,and dolichofacial groups.

关 键 词：无托槽隐形矫治 拔牙矫治 生物力学 垂直骨面型 有限元分析 

分 类 号：R783[医药卫生—口腔医学]