无托槽隐形矫治器联合微种植体内收并压低上前牙的三维有限元分析

doi:10.7518/hxkq.2022.05.013

华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (5): 589-596.doi: 10.7518/hxkq.2022.05.013

无托槽隐形矫治器联合微种植体内收并压低上前牙的三维有限元分析

施则安(), 夏恺, 罗良语, 赵志河, 刘钧()

口腔疾病研究国家重点实验室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

收稿日期:2022-04-13 修回日期:2022-07-04 出版日期:2022-10-01 发布日期:2022-10-17
通讯作者: 刘钧 E-mail:344655604@qq.com;junliu@scu.edu.cn
作者简介:施则安，硕士，E-mail：344655604@qq.com
基金资助:
国家自然科学基金(81870743);时代天使隐形矫治科研专项基金(SDTS21-4-08)

Three-dimensional finite element analysis of upper anterior teeth retraction and intrusion using clear aligners and mini-implants

Shi Zean(), Xia Kai, Luo Liangyu, Zhao Zhihe, Liu Jun.()

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Si-chuan University, Chengdu 610041, China

Received:2022-04-13 Revised:2022-07-04 Online:2022-10-01 Published:2022-10-17
Contact: Liu Jun. E-mail:344655604@qq.com;junliu@scu.edu.cn
Supported by:
The National Natural Science Foundation of China(81870743);Angelalign Scientific Research Fund(SDTS21-4-08);Correspondence: Liu Jun, E-mail: junliu@scu.edu.cn

摘要/Abstract

摘要：

目的运用三维有限元技术研究无托槽隐形矫治器联合微种植体内收并且压低上前牙时，使用不同方式的微种植体牵引的治疗效果差异。方法获取患者上颌骨及牙体等锥形束CT数据，使用Mimics、Geomagic、Solidworks和Ansys软件建立所需要的三维有限元模型以及无托槽隐形矫治器。根据微种植体的设计不同，分为4个实验组。第1组为空白对照组；第2组在上颌双侧第二前磨牙和第一磨牙之间各植入一颗微种植体，在双侧尖牙牙套上沿内收方向加0.98 N的力；第3组在第2组基础上，在中切牙之间植入一颗微种植体加力0.98 N压低上前牙；第4组在第2组基础上，在双侧中切牙和侧切牙之间各植入一颗微种植体加力0.56 N压低上前牙。对各组进行受力分析，比较不同位点植入微种植体牵引加力时前牙转矩的改变、运动趋势以及应力分布。结果 4组中所有上颌切牙皆表现出内收和压低的趋势，且伴有不同程度的转矩改变。第3组上颌中切牙及侧切牙在矢状向冠根位移差最小，第4组上颌中切牙及侧切牙压低值最大，第2组最大应力集中值最大。结论将微种植体植入上颌中切牙之间进行牵引更利于转矩控制；而植入上颌中切牙与侧切牙之间并联合前牙垂直牵引时更利于单纯压低，在一定程度上避免了“过山车”效应。

关键词: 三维有限元, 内收, 上颌前牙压低, 微种植体, 无托槽隐形矫治器

Abstract:

Objective This study aimed to investigate the differences in treatment outcomes of upper anterior teeth retraction and intrusion with clear aligners and different types of elastics on mini-implants via the 3D finite element method. Methods Cone-beam computed tomography (CBCT) was conducted to construct a 3D finite element model of maxillary bone, dentition, and clear aligners using Mimics, Geomagic, Solidworks, and Ansys. Four model groups were developed. Group 1 was the control group. Group 2 implanted a mini-implant between the upper second premolar and the upper first molar with a force of 0.98 N applied to the canine cut along the retracting direction for each side. Group 3 was based on Group 2, which implanted an additional mini-implant between the upper central incisors with a force of 0.98 N applied to the upper anterior teeth cuts. Group 4 was also based on Group 2, which implanted 2 additional mini-implants between the upper central and lateral incisors with a force of 0.56 N applied to the upper anterior teeth cuts for both sides. Anterior teeth torque changes, displacement patterns, and stress distributions were analyzed. Results Among all the experimental groups, the anterior teeth demonstrated intrusion and distal inclination, accompanied with varied degrees of torque loss. In Group 3, the maxillary and lateral incisors had the smallest sagittal coronal displacement. In Group 4, the intrusion values of the maxillary and lateral incisors were the largest among all the experimental groups. The maximum stress concentration in Group 2 was the most significant among all the experimental groups. Conclusion Implanting the mini-implant between the central incisors for traction is conducive to torque control. By contrast, implanting the mini-implants between the central incisors and lateral incisors combined with vertical traction is conducive to simple intrusion, avoiding the “bowing effect” to a certain extent.

Key words: three-dimensional finite element, retraction, intrusion of upper anterior teeth, mini-implant, clear aligner

中图分类号:

R 783.5

施则安, 夏恺, 罗良语, 赵志河, 刘钧. 无托槽隐形矫治器联合微种植体内收并压低上前牙的三维有限元分析[J]. 华西口腔医学杂志, 2022, 40(5): 589-596.

Shi Zean, Xia Kai, Luo Liangyu, Zhao Zhihe, Liu Jun.. Three-dimensional finite element analysis of upper anterior teeth retraction and intrusion using clear aligners and mini-implants[J]. West China Journal of Stomatology, 2022, 40(5): 589-596.

图/表 7

图 1

表 1

图 2

图 3

图 4

表 2

表 3

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参数	杨氏模量/MPa	泊松比
牙槽骨	1 370	0.3
牙齿	18 600	0.3
牙周膜	0.87	0.35
隐形矫治器	528	0.36
附件	12 500	0.36

牙齿	第1组		第2组		第3组		第4组
牙齿	牙冠	牙根	牙冠	牙根	牙冠	牙根	牙冠	牙根
中切牙	4.97	4.23	5.46	4.32	6.89	4.89	7.17	6.57
侧切牙	1.99	1.23	2.86	2.15	3.39	2.82	3.99	3.12
尖牙	-1.42	-0.93	2.58	2.80	3.06	2.03	2.99	3.19

组别	中切牙			侧切牙
组别	牙冠	牙根	冠根位移差	牙冠	牙根	冠根位移差
第1组	1.32×10^-2	-5.17×10^-3	1.84×10^-2	1.05×10^-2	-4.92×10^-3	1.54×10^-2
第2组	1.37×10^-2	-5.29×10^-3	1.90×10^-2	1.16×10^-2	-5.29×10^-3	1.70×10^-2
第3组	4.20×10^-3	-2.14×10^-3	6.34×10^-3	5.68×10^-3	-2.12×10^-3	7.79×10^-3
第4组	7.11×10^-3	-3.11×10^-3	1.02×10^-2	7.07×10^-3	-2.84×10^-3	9.91×10^-3

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无托槽隐形矫治器联合微种植体内收并压低上前牙的三维有限元分析

Three-dimensional finite element analysis of upper anterior teeth retraction and intrusion using clear aligners and mini-implants

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