口腔医学研究

口腔医学研究 ›› 2022, Vol. 38 ›› Issue (8): 757-761.DOI: 10.13701/j.cnki.kqyxyj.2022.08.012

• 口腔正畸学研究 • 上一篇    下一篇

无托槽隐形矫治中牙周炎患者下切牙压低的三维有限元研究

胥鹏飞1, 张闵1, 范智博1, 杨彬彬2, 徐晓梅1*   

  1. 1.西南医科大学附属口腔医院正畸科 四川 泸州 646000;
    2.口颌面修复重建和再生泸州重点实验室 四川 泸州 646000
  • 收稿日期:2022-03-21 出版日期:2022-08-28 发布日期:2022-08-24
  • 通讯作者: *徐晓梅,E-mail:648012557@qq.com
  • 作者简介:胥鹏飞(1996~ ),男,四川绵阳人,硕士研究生,医师,研究方向:口腔正畸牙移动研究。

Finite Element Analysis of Incisors Intrusion with Clear Aligners in Periodontitis Patients

XU Pengfei1, ZHANG Min1, FAN Zhibo1, YANG Binbin2, XU Xiaomei1*   

  1. 1. Department of Orthodontics, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou 646000, China;
    2. Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou 646000, China
  • Received:2022-03-21 Online:2022-08-28 Published:2022-08-24

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摘要： 研究不同硬度及矫治位移量隐形矫治器在牙周炎患者切牙压低时的生物力学机制。方法: 建立轻、中度牙周炎患者的三维有限元模型,分析415.6 MPa、528.0 MPa、816.31 MPa硬度及0.15 mm、0.2 mm隐形矫治器在切牙压低时牙齿位移趋势及牙周膜应力分布情况。结果: 8组工况切牙均表现为伴唇侧倾斜的压低,隐形矫治器硬度增加,垂直向位移趋势增加,唇侧倾斜趋势减小而随着矫治位移量增加,唇侧倾斜趋势增大。牙周膜最大应力分布于牙颈部和根尖区,最小应力分布于根中部。随着硬度增加,牙周膜整体应力值增大,牙颈部应力分布更均匀而随着矫治位移量增加牙颈部应力更集中。结论: 隐形矫治器硬度增大,有利于提高矫治器效能和三维向控制,矫治位移量增加不利于三维向控制。临床上建议使用中等硬度矫治器,配合较小的步距可以实现牙齿压低,维护牙周组织健康。

关键词: 无托槽隐形矫治器, 压低, 有限元分析, 牙周炎

Abstract: Objective: To study the biomechanical mechanism of different hardness and displacement Clear Aligner during incisor intrusion in patients with periodontitis. Methods: A three-dimensional finite element model with mild and moderate periodontitis was established. The tooth displacement trend and periodontal ligament stress distribution were analyzed. Results: The incisors of 8 groups all showed intrusion with labial inclination. With the increase of hardness of Clear Aligner, the vertical displacement trend increased, and the labial inclination trend decreased. With the increase of displacement, the labial inclination trend increased. The maximum stress was concentrated in the tooth neck and apical area, and the minimum stress was distributed in the middle of the root. With the increase of hardness, the overall stress value of periodontal ligament increased, and the stress distribution of tooth neck became more uniform, but the stress of tooth neck was more concentrated with the increase of displacement. Conclusion: With the increase of the hardness of invisible appliance, the efficacy and three-dimensional control of the appliance are enhanced, while the increase in the displacement is not conducive to the three-dimensional control. Clinically, it is recommended to use a medium hardness appliance, which can achieve both tooth intrusion and maintain the health of periodontal tissue in patients with periodontitis.

Key words: clear aligner, intrusion, finite element, periodontitis