摘要
目的 分析隐形矫治器联合前方牵引矫治上颌发育不足时不同牵引位点及方向对上颌骨及上牙列的影响。方法 构建包含颧上颌复合体、上颌牙列及隐形矫治器的三维有限元模型,矫治器分为组1(牵引扣位于侧切牙远中)及组2(牵引扣位于尖牙远中),每组分别设置前牵引方向为与[牙合]平面呈向前下0°、10°、20°、30°的4组工况,并加载单侧500 g牵引力。分析不同加载工况下各组颌骨及牙列的应力及位移差异。结果 当牵引方向为30°时,两组上颌骨均表现为向前向下的位移趋势,其余方向则有逆时针旋转趋势;相同牵引方向下,组2上颌骨总位移及各方向位移均大于组1。组1上中切牙呈舌向位移趋势,且随牵引角度的增加而增大;组2上牙列则为向前的位移趋势,当牵引方向为30°时,上牙列的总位移及矢状向位移最小。两组上颌骨应力集中于颧上颌缝和上前牙牙槽骨,且随牵引角度的增加而减小。结论 隐形矫治器联合前方牵引可应用于轻度上颌骨发育不足的骨性Ⅲ类患者;当牵引位点位于尖牙远中、牵引方向为与[牙合]平面呈向前下30°时,上颌骨可实现理想的向前向下的位移,同时上前牙的唇向位移最小。
Objective To analyze the effects of different traction sites and directions on the maxilla and upper dentition when using clear aligners combined with protraction for the treatment of maxillary deficiency.Methods A three-dimensional(3D)finite element model including the zygomaticomaxillary complex,maxillary dentition,and clear aligners was constructed.The models were divided into Group 1(traction hook at the distal of the lateral incisor)and Group 2(traction hook at the distal of the canine).Each group was analyzed under four loading conditions with protraction angles of 0°,10°,20°,and 30°relative to the occlusal plane.A unilateral protraction force of 500 g was applied.The differences in stress distribution and displacement of the maxillary bone and dentition under different loading conditions were analyzed.Results When the protraction angle was 30°,both groups showed forward and downward displacement of the maxilla,while other angles resulted in counterclockwise rotation.Under the same protraction direction,the total displacement of the maxilla and displacements in all directions in Group 2 were greater than those in Group 1.The upper central incisors in Group 1 showed lingual displacement,which increased with the protraction angle.The maxillary dentition in Group 2 showed forward displacement,with the minimum total and sagittal displacements at a protraction angle of 30°.Stress concentration was mainly observed in the zygomaticomaxillary suture and anterior alveolar bone regions in both groups,decreasing as the protraction angle increased.Conclusions Clear aligners combined with protraction can be applied to skeletal ClassⅢpatients with mild maxillary deficiency.When the protraction site is located at the distal of the canine with a 30°downward and forward angle to the occlusal plane,the maxilla can achieve ideal forward and downward displacement with the minimum labial movement of the upper anterior teeth.
作者
张倩文
姜春苗
刘沂
马翔宇
尚添玮
杨志洁
范存晖
ZHANG Qianwen;JIANG Chunmiao;LIU Yi;MA Xiangyu;SHANG Tianwei;YANG Zhijie;FAN Cunhui(Department of Orthodontics,the Affiliated Hospital of Qingdao University;School of Stomatology,Qingdao University;The Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong,China)
出处
《医用生物力学》
北大核心
2025年第4期836-843,共8页
Journal of Medical Biomechanics
关键词
隐形矫治器
牵引位点
牵引方向
上颌骨
上牙列
clear aligners
traction site
traction direction
maxillary
upper dentition
