摘要
目的:探讨无托槽隐形矫治器设计压低上颌第一磨牙时结合不同微种植钉辅助支抗下上颌各牙齿的生物力学效应以及矫治器与牙周膜的应力分布情况。方法:选取符合纳排患者的上颌CBCT数据,采用三维有限元的分析方法,建立单纯矫治器、双侧植入微种植钉、颊侧植入微种植钉、腭侧植入微种植钉4种不同的三维有限元模型,分析各牙齿的位移变化及矫治器与牙周膜的应力分布情况。结果:当单纯使用矫治器时,第一磨牙垂直向、矢状向、横向移动量分别为5.59E-03 mm、-3.97E-04 mm、-2.12E-03 mm,表现为远中颊向压低的移动趋势,结合微种植钉后可以增加第一磨牙的压低移动趋势,但不同的设计会产生不同的作用结果。结论:增加微种植钉支抗能够实现对后牙段的辅助压低和牙齿控制。其中,在颊腭双侧植入微种植辅助钉效果最佳。3种微种植钉植入方式均不能显著抑制无托槽隐形矫治器造成的中牙段及前牙段移动趋势,这意味着我们需要额外增设附件去辅助牙齿控制。
Objective:To explore the biomechanical effects and the stress distribution of aligner and periodontal membrane under different design methods when the clear aligner combined with micro-implant screws for the maxillary first molar intrusion.Methods:Appropriate maxillary CBCT data of a case were selected.Four 3D finite element models were established for maxillary molar intrusion:the clear aligner,bilateral implantation of micro-implant screws,buccal implantation of micro-implant screws and palatal implantation of micro-implant screws respectively integrated with periodontal membrane-alveolar bone-teeth.The changes in teeth displacement arrangement,the aligner and periodontal membrane stress distribution were investigated.Results:When only the appliance was used,the vertical,sagittal and lateral movements of the first molar is respectively 5.59E-03 mm,-3.97E-04 mm and-2.12E-03 mm,showing a trend of distal buccal intrusion movement.Combined with micro-implant screws,the intrusion movement trend of the first molar could be increased,but different designs will produce different results.Conclusion:The combination of the micro-implant anchorage is beneficial for the auxiliary intrusion and tooth control of the posterior teeth.Among them,the bilateral implantation of micro-implant screws has the best auxiliary effect.All kinds of micro-implant screw implantation methods cannot significantly inhibit the trend of middle and anterior teeth movement caused by the clear aligner,which means that we need to add additional accessories to assist tooth control.
作者
陈达
徐国祥
刘露
曹元
郭佳
李妮
成伟
王智伟
金钫
CHEN Da;XU Guoxiang;LIU Lu;CAO Yuan;GUO Jia;LI Ni;CHENG Wei;WANG Zhiwei;JIN Fang(State Key Laboratory of Military Stomatology,National Clinical Research Center for Oral Diseases&Shaanxi Clinical Research Center for Oral Diseases,The Third Affiliated Hospital of Air Force Medical University,China,Xi'an,710032)
出处
《实用口腔医学杂志》
CAS
CSCD
北大核心
2022年第4期479-485,共7页
Journal of Practical Stomatology
关键词
隐形矫治
微种植钉
三维有限元
磨牙压低
生物力学分析
Clear aligner
Micro-implant screw
Three dimensional finite element analysis
Molar intrusion
Biomechanical analysis
