无托槽隐形拔牙矫治上颌后牙不同转矩对前牙三维力学影响的体外实验  

The effects of differential torque of maxillary posterior teeth with clear aligner of tooth extraction correction on anterior teeth 3D mechanics in vitro

作　　者：樊永杰 魏俊婷 王秉乐 吴刚 杨森森 王星星 FAN Yongjie;WEI Junting;WANG Bingle;WU Gang;YANG Sensen;WANG Xingxing(Department of Orthodontics,The Fourth Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia Autonomous Region,China,014030 Baotou;Department of Clinical Medicine,Shanghai Smartee Denti-Technology Company Limited;Department of Technology,Shanghai Smartee Denti-Technology Company Limited)

机构地区：[1]内蒙古医科大学第四附属医院正畸科,包头014030 [2]正雅齿科科技(上海)有限公司临床医学系统 [3]正雅齿科科技(上海)有限公司技术系统

出　　处：《实用口腔医学杂志》2025年第1期104-109,共6页Journal of Practical Stomatology

基　　金：包头市卫生健康科技计划项目(编号:wsjkkj014)。

摘　　要：目的:研究无托槽隐形矫治上颌后牙不同转矩对前牙三维力学影响的变化规律。方法:以三维力学试验模型为基础,模拟拔除两侧上颌第一前磨牙并设计4组上颌后牙不同转矩的模型,三维打印成与标准模型同等大小的树脂模型。根据Andrews正常6项标准中的转矩,设置A1组后牙为Andrews标准转矩,A2组后牙为冠舌向转矩5°,A3组和A4组后牙分别为冠颊向转矩5°和10°。用厚度为0.75 mm的膜片制作4组相应的12副相同的无托槽隐形矫治器。设计前牙整体内收0.25 mm。用矫治器六轴力测量系统测量矫治器施加于前牙在三维方向上的力。结果:前牙的受力情况,颊舌向:A1组中,4颗切牙受到舌向力,A2~A4组中,前牙则受到唇向力,中切牙的受力值大于侧切牙。近远中向:A1~A4组中,4颗切牙均受到近中向力,侧切牙的受力值均大于中切牙。A1~A4组中,尖牙均受到远中向力,A4组中双侧尖牙受力值大于A2、A3组(P<0.05)。4组中多数牙齿在垂直向无统计学意义(P>0.05)。结论:无托槽隐形拔牙矫治前牙整体内收时应注意控制切牙转矩、尖牙轴倾度。当后牙为正常转矩时,应增加前牙冠唇向过矫治,而后牙为冠舌向转矩或冠颊向转矩时,可适当减小前牙冠唇向过矫治量。增加尖牙近中向的过矫治设计,避免因尖牙远中倾斜而造成前牙伸长继而覆加深。Objective:To investigate the effects of differential torque of maxillary posterior teeth with clear aligner on anterior teeth 3D mechanics.Methods:4 maxillary models were designed for differential torque of posterior teeth on the basis of 3D mechanical test model with first premolar extraction.The stereolithography models were made with the same size as the standard model by 3D printing.According to the torque of the 6 keys to normal occlusion of Andrews,the standard torque of Andrews was used in group A1.The posterior teeth with lingual-crown torque of 5°were used in groups A2,and those with buccal-crown torque of 5°and 10°were respecitvely used in group A3 and A4.4 sets of corresponding clear aligners were fabricated with a 0.75 mm thick thermoplastic material.Each group had 12 pairs of the same clear aligners.The anterior teeth underwent 0.25 mm activation for en-mass retraction.The six-axis force/torque transducer measurement system was used to measure the force applied by the clear aligners on the anterior teeth in the 3D directions.Results:In buccolingual direction:in group A1,the 4 incisors received lingual force,in groups A2-A4,the anterior teeth received labial force,and the force on the central incisors was greater than that on lateral incisors.In mesiodistal direction:in group A1-A4,4 incisors received mesial force,and the force on lateral incisors was greater than that on central incisors;in group A1-A4,the canines received distal force;the force on canine in group A4 was greater than that in A2 or A3 groups(P<0.05).The force in the vertical direction on the anterior teeth among the 4 groups(P>0.05).Conclusion:When en-mass retraction of the anterior teeth with clear aligner,attention should be taken to the torque of the incisors and the tip of the canines.When the posterior teeth with standard torque,the activation of labial-crown overcorrection of the anterior teeth should be increased.When the posterior teeth with lingual-crown torque or buccal-crown torque,the activation of labial-crown over-cor

关 键 词：无托槽隐形矫治器 后牙转矩 前牙三维力学 

分 类 号：R783.5[医药卫生—口腔医学]