下牙列整体远移时不同牵引钩对牙齿移动影响的有限元分析
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1.广州医科大学附属口腔医院 正畸科广州市口腔再生医学基础与应用研究重点实验室;2.解放军南部战区总医院口腔科;3.山西省长治市人民医院口腔科;4.第四军医大学 口腔医院 正畸科

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Finite element analysis of the influence of tooth movement by different traction hooks on in distal lower dentition
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    摘要:

    目的 利用三维有限元方法比较下颌外斜线区微种植钉远移下牙列时,使用不同长度牵引钩放置不同位点时下颌牙齿的应力分布情况。方法 根据患者CBCT影像数据,依次构建高度2 mm、7 mm的牵引钩分别固定于侧切牙与尖牙托槽间以及尖牙与第一前磨牙托槽间四种微种植体钉远移下颌全牙列的三维有限元模型。在牵引钩与微种植钉间加载 3N力/侧,观察四种工况下下颌牙齿及牙列等效应力、初始位移变化情况。结果 除高度7mm牵引钩置于侧切牙与尖牙间时,下中切牙发生冠唇向根舌向的顺时针旋转外,其余三种工况下中切牙均发生冠根均舌向的逆时针旋转趋势;除高度7mm牵引钩置于尖牙与第一前磨牙间时,下尖牙发生冠向近中移动,其余三种工况下尖牙冠根均向远中移动趋势;四种工况,下磨牙均发生冠根向远中的逆时针方向旋转趋势。结论 通过三维有限元分析,阐明了外斜线区微种植钉远移下牙列时,不同牵引钩对下颌牙齿移动影响的生物力学机制。在充分理解生物力学机制的情况下,恰当选择牵引钩及放置位置可以实现下颌牙列的正确远移。

    Abstract:

    Objective To study the stress distribution of distally moved dentition with miniscrews in the external oblique line area when the traction hooks of different lengths were used to place different positions by the three-dimensional finite element method. Methods Construction of traction hooks with heights of 2 mm and 7 mm respectively were fixed between the lateral incisors and the canine brackets and between the canines and the first premolar brackets, and constructed four kinds of three-dimensional finite element models of distally moved full dentition with miniscrews. Load 3N force/side between the traction hook and the miniscrews. the maximum von Mises stress and initial displacement of the mandibular teeth and dentition under four loading conditions were analyzed. Result When the traction hook with a height of 7mm is placed between the lateral incisor and the canine, the lower central incisor rotates clockwise, but the central incisor rotates counterclockwise under the other three working conditions.In the four working, the mandibular molars rotate counterclockwise. Conclusion Through three-dimensional finite element analysis,the influence of tooth movement by different traction hooks on in distal lower dentition was elucidated.With a full understanding of the biomechanical mechanism, proper selection of traction hook and placement can achieve correct distal movement of the entire mandibular dentition.

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  • 收稿日期:2021-07-14
  • 最后修改日期:2021-11-01
  • 录用日期:2021-11-03
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