摘要
目的:探讨长臂牵引钩应用于隐形矫治中提高尖牙整体远移效率的作用。方法:建立尖牙整体远中移动的三维有限元模型,在尖牙牙冠颈部加入高度不同的长臂牵引钩,分析在3 mm高度长臂牵引钩+50 g牵引力、5 mm高度长臂牵引钩+50 g牵引力、7 mm高度长臂牵引钩+50 g牵引力、9 mm高度长臂牵引钩+50 g牵引力整体移动尖牙4种不同工况下尖牙的瞬时最大位移,牙周膜最大等效应力以及尖牙在X、Y、Z 3个轴向上的瞬时位移,并对临床患者矫治效果进行观察。结果:4种工况下,尖牙的瞬时最大位移分别为0.014431、0.014740、0.016677、0.020684 mm,尖牙的牙周膜最大等效应力分别为0.54046、0.56242、0.58422、0.60612 kPa,牙周膜等效应力主要集中在前牙区,即尖牙牙根部、侧切牙根部,且在尖牙牙根均匀分布,并未集中于某一区域,且随着长臂牵引钩长度的增加,尖牙牙周膜的最大等效应力呈现缓慢增加的趋势。对于尖牙X、Y、Z 3个轴向的位移趋势分析,尖牙在远移的过程中有发生扭转的趋势。结论:(1)随着牵引钩长度的增加,牙周膜的等效应力在尖牙牙根均匀分布,并未集中于某一区域,说明移动方式安全有效,不会引起牙齿某部分受力过大从而导致牙根吸收。临床患者应用长臂牵引钩进行尖牙远移的矫治效果也说明长臂牵引钩应用于隐形矫治中可以显著提高尖牙远移表达率,对于临床矫治效率的提高以及有效节约患者矫治时间具有重要意义。(2)通过将4种不同长度的长臂牵引钩应用于尖牙远中整体移动,在三维有限元分析的理论结果中,尖牙在X、Y、Z 3个轴向上均有一定的位移趋势,提示尖牙有发生扭转等副作用的可能,并提出了在临床中预防副作用产生的措施。
Objective:To explore the role of long arm traction hook in improving the overall distal movement efficiency of canines in invisible orthodontics.Methods:Establish a three-dimensional finite element model of canine distal bodily movement,and long arm traction hooks with different heights were added to the crown neck of canines.The instantaneous maximum displacement of canine,the equivalent stress of periodontal ligament and the instantaneous displacement of canine in X,Y and Z directions were analyzed under four different working conditions:3 mm high long arm traction hook 50 g,5 mm high long arm traction hook 50 g,7 mm high long arm traction hook 50 g,9 mm high long arm traction hook 50 g traction moving canine integrally,combined with the clinical observation of patients with orthodontic effect.Results:Under the four working conditions,the instantaneous maximum displacement of canine is 0.014431,0.014740,0.016677 and 0.020684 mm,and the maximum equivalent stress of periodontal ligament of canine is 0.54046,0.56242,0.58422 and 0.60612 kPa,respectively.The equivalent stress of periodontal ligament is mainly concentrated in the anterior area,that is,the root of canine and lateral incisor,and evenly distributed in the root of canine,but not concentrated in a certain area,and with the increase of the length of long arm traction hook.The maximum equivalent stress of periodontal ligament of canines increased slowly,but no obvious rule was found in the rest.According to the analysis of the displacement trend of canine X,Y and Z,there is a tendency of torsion in the process of distal movement.Conclusion:(1)with the increase of the length of the traction hook,the equivalent stress of the periodontal ligament is uniformly distributed in the root of the canine,but not concentrated in a certain area,indicating that the way of movement is safe and effective,and will not cause excessive force on a certain part of the tooth and lead to root resorption.The effect of clinical application of long arm traction hook in the correction of distal canine movement also shows that the application of long arm traction hook in invisible correction can significantly increase the expression rate of distal canine movement.It is of great significance to improve the clinical orthodontic efficiency and effectively save the treatment time of patients.(2)By applying four kinds of long arm traction hooks of different lengths to the whole distal canine movement,in the theoretical results of three-dimensional finite element analysis,the canines have a certain displacement trend in X,Y and Z axes,suggesting that in clinical practice,canines may have side effects such as torsion.Through the observation and analysis of clinical cases,the measures to prevent side effects were summarized and put forward.
作者
张欣钰
钟杰童
黄跃
ZHANG Xinyu;ZHONG Jietong;HUANG Yue(School of Stomatology,Southwest Medical University,Luzhou 646000,Sichuan,China;School of Stomatology,Jinan University,Guangzhou 510000,Guangdong,China)
出处
《暨南大学学报（自然科学与医学版）》
CAS
CSCD
北大核心
2022年第5期521-531,共11页
Journal of Jinan University(Natural Science & Medicine Edition)
基金
广州市科技计划基金项目(202201020045)。
关键词
长臂牵引钩
尖牙整体移动
有限元分析
long arm traction hook
canine bodily movement
finite element analysis
