无托槽隐形矫治器近中移动下颌第二磨牙的三维有限元分析  

Three-dimensional finite element analysis of mandibular second molar mesial movement by clear aligner

作　　者：邱生磊 李道堃 王春娟 李娜[2] Qiu Shenglei;Li Daokun;Wang Chunjuan;Li Na(School of Stomatology,North Sichuan Medical College,Nanchong 637000,Sichuan Province,China;Silk Road Stomatology Clinic,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan Province,China;Chongqing Key Laboratory of Oral Disease and Biomedicine,Chongqing Key Laboratory of Municipal Dental Biomedical Engineering of Chongqing Colleges and Universities,Chongqing 401147,China)

机构地区：[1]川北医学院口腔医学院,四川省南充市637000 [2]川北医学院附属医院丝绸路口腔门诊,四川省南充市637000 [3]口腔疾病与生物医学重庆市重点实验室,重庆市高校市级口腔生物医学工程重点实验室,重庆市401147

出　　处：《中国组织工程研究》2026年第4期832-840,共9页Chinese Journal of Tissue Engineering Research

基　　金：川北医学院科研基金项目(2023LC002),项目负责人:李娜。

摘　　要：背景:正畸移动下颌第二磨牙替代缺失的第一磨牙是一种保留天然牙的良好办法,然而使用无托槽矫治器近中移动磨牙时磨牙会发生近中倾斜移动,附件和过矫治的应用对磨牙近中移动的影响尚不明确。目的:探究附件及过矫治对下颌第二磨牙近中移动位移和生物力学的影响。方法:使用1名志愿者的锥形束CT及口内扫描数据构建左侧下第一磨牙缺失的有限元模型。实验根据左下颌第二磨牙附件位置分为无附件组、颊侧附件组、舌侧附件组和颊舌附件组,4组均设计0°,1°,2°,3°,4°过矫治,总共20组模型。在Abaqus软件中分析计算牙齿位移趋势和应力。结果与结论:(1)无托槽隐形矫治器近中移动左下颌第二磨牙时,磨牙发生近中倾斜和压低,尖牙和前磨牙发生远中倾斜,切牙发生舌侧倾斜;(2)附件应用使第二磨牙位移量增加,使用颊舌附件时位移量最大,在单侧应用附件时磨牙会向无附件侧倾斜,而附件的应用对第二磨牙近中倾斜度无改善;(3)应用过矫治后,磨牙近中倾斜和压低趋势改善,磨牙更接近整体移动,牙周膜应力降低且分布更均匀,且随着过矫治程度增加更显著;(4)附件可以增强过矫治的作用效果,使用颊舌附件时作用效果最强,两者联合应用有利于控制磨牙近中倾斜和压低,但仍无法实现磨牙整体移动。BACKGROUND:Orthodontic treatment to move the mandibular second molar in place of the missing first molar is a good method for preserving natural teeth.However,molars often exhibit mesial tipping when using clear aligners.The impact of attachments and overcorrection on the molar mesialization with clear aligners is unclear.OBJECTIVE:To investigate the effects of attachments and overcorrection on displacement and biomechanics of the mandibular second molar mesialization.METHODS:A finite element model with the left mandibular first molar missing was constructed using a volunteer's cone-beam CT and intraoral scan data.The experiment was divided into four groups based on the position of attachments on the left mandibular second molar:without attachment,buccal attachment,lingual attachment,and buccal-lingual attachment,with overcorrection degrees(0°,1°,2°,3°,and 4°)for each group,totaling 20 models.The calculation and analysis of the displacement trends and stress were performed using Abaqus software.RESULTS AND CONCLUSION:(1)Mesial tipping and intrusion of the molar,distal tipping of the canines and permolars,and linguaing of the incisors occurred during molar mesialization.(2)The displacement of molars increased when attachments were used,with the maximum displacement occurring when buccal-lingual attachments were applied.Molars tended to tip towards the side without attachments when attachments were designed unilaterally.However,the inclination of molars did not decrease when attachments were used.(3)Molars exhibited reduced mesial tipping and intrusion,approaching overall movement,and the stress of periodontal ligament was relieved and more evenly distributed during overcorrection treatment,and this effect became more pronounced with increased degrees of overcorrection.(4)Attachments can enhance the effectiveness of overcorrection,with the best performance observed when buccal-lingual attachments are used.Using attachments and overcorrection together helps control molar mesial tipping and intrusion,but overall

关 键 词：无托槽隐形矫治器 有限元 磨牙 近中移动 附件 过矫治 

分 类 号：R496[医药卫生—康复医学] R318[医药卫生—临床医学] R783.5