无托槽隐形矫治器联合微种植钉整体内收上前牙的三维有限元研究
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摘要
目的:探讨隐形矫治器联合微种植钉整体内收上前牙时不同加力方式下上颌前后牙生物力学效应。方法:采集患者上颌骨及上牙列的CBCT数据,采用逆向工程方法建立拔除第一前磨牙的隐形矫治器联合微种植钉整体内收前牙的三维有限元模型,分析①矫治器施力、②矫治器施力+1. 47 N力牵引矫治器、③矫治器施力+1. 47 N力牵引尖牙工况下前后牙的初始位移。结果:3种工况条件下矢状方向,中切牙冠根位移差分别为1. 12E-02 mm、1. 29E-02 mm、9. 62E-03 mm;第一磨牙牙冠近移量分别为-2.49E-02 mm、-2.09E-02 mm、-2.00E-02 mm;垂直方向,中切牙牙冠伸长量分别为1. 77E-03 mm、2. 93E-03 mm、6. 53E-04 mm。结论:工况③更有利于切牙转矩的控制及后牙支抗保护,也更有利于切牙的垂直向控制。
Objective: To evaluate the biomechanical effects of combined use of miniscrew and clear aligner in different kinds of loading condition on the en-mass retraction of maxillary anterior teeth. Methods: 3 D finite element models of the maxillary bone with miniscrews and clear aligner were reconstructed using the method of reverse engineering with CBCT data of an adult patient who had maxillary first premolars extracted. The orthodontic force was loaded by(1)clear aligner,(2) clear aligner and 1. 47 N force of retraction at appliance and(3) clear aligner and 1. 47 N force of retraction at canine,respectively. Results: Under the working condition of(1),(2)and(3),in sagittal direction,the displacement difference of crown and root of the maxillary central incisor was 1. 12 E-02 mm,1. 29 E-02 mm and 9. 62 E-03 mm respectively,the displacement of the first molar crown was-2. 49 E-02 mm,-2. 09 E-02 mm and-2. 00 E-02 mm respectively; in vertical direction,extrusion of the maxillary central incisor was 1. 77 E-03 mm,2. 93 E-03 mm and 6. 53 E-04 mm respectively. Conclusion: The working condition(3) is more advantageous to control the torque of incisors and to save the anchorage of posterior teeth,and more effective to control the extrusion of the incisors.
Objective: To evaluate the biomechanical effects of combined use of miniscrew and clear aligner in different kinds of loading condition on the en-mass retraction of maxillary anterior teeth. Methods: 3 D finite element models of the maxillary bone with miniscrews and clear aligner were reconstructed using the method of reverse engineering with CBCT data of an adult patient who had maxillary first premolars extracted. The orthodontic force was loaded by(1)clear aligner,(2) clear aligner and 1. 47 N force of retraction at appliance and(3) clear aligner and 1. 47 N force of retraction at canine,respectively. Results: Under the working condition of(1),(2)and(3),in sagittal direction,the displacement difference of crown and root of the maxillary central incisor was 1. 12 E-02 mm,1. 29 E-02 mm and 9. 62 E-03 mm respectively,the displacement of the first molar crown was-2. 49 E-02 mm,-2. 09 E-02 mm and-2. 00 E-02 mm respectively; in vertical direction,extrusion of the maxillary central incisor was 1. 77 E-03 mm,2. 93 E-03 mm and 6. 53 E-04 mm respectively. Conclusion: The working condition(3) is more advantageous to control the torque of incisors and to save the anchorage of posterior teeth,and more effective to control the extrusion of the incisors.
引文
[1]Chung KR,Jeong DM,Kim SH,et al.En-masse retraction dependent on a temporary skeletal anchorage device without posterior bonding or banding in an adult with severe bidentoalveolar protrusion:Seven years posttreatment[J].Am JOrthod Dentofacial Orthop,2012,141(4):484-494.
[2]Kim T,Suh J,Kim N,et al.Optimum conditions for parallel translation of maxillary anterior teeth under retraction force determined with the finite element method[J].Am JOrthod Dentofacial Orthop,2010,137(5):639-647.
[3]Rossini G,Parrini S,Castroflorio T,et al.Efficacy of clear aligners in controlling orthodontic tooth movement:A systematic review[J].Angle Orthod,2015,85(5):881-889.
[4]Uribe F,Cutrera A,Nanda R.A segmented appliance for space closure followed by Invisalign and fixed appliances[J].Orthodontics(Chic.),2011,12(4):386-395.
[5]唐娜,赵志河,王军,等.无托槽隐形矫治技术生物力学效应的有限元法研究[J].医用生物力学杂志,2010,25(6):399-405.
[6]Zhang N,Bai Y,Li S.Treatment of a Class II Division 1malocclusion with miniscrew anchorage[J].Am J Orthod Dentofacial Orthop,2012,141(6):e85-e93.
[7]Ammar HH,Ngan P,Crout RJ,et al.Three-dimensional modeling and finite element analysis in treatment planning for orthodontic tooth movement[J].Am J Orthod Dentofacial Orthop,2011,139(1):e59-e71.
[8]Kesling HD.Coordinating the predetermined pattern and tooth positioner with conventional treatment[J].Am J Orthod Oral Surg,1946,32:285-293.
[9]Melsen B.Northcroft lecture:How has the spectrum of orthodontics changed over the past decades?[J].J Orthod,2011,38(2):134-143.
[10]Rosvall MD,Fields HW,Ziuchkovski J,et al.Attractiveness,acceptability,and value of orthodontic appliances[J].Am J Orthod Dentofacial Orthop,2009,135(3):276.
[11]潘裕炯,黄盛沛,田杰.双颌前突用无托槽隐形矫治器矫治1例[J].实用口腔医学杂志,2012,28(5):659-661.
[12]郑钰婷,陈琳,吴嘉桦,等.无托槽隐形矫治器整体内收上颌前牙的三维有限元分析[J].实用口腔医学杂志,2017,33(5):621-624.
[13]Linkow LI.The endosseous blade vent[J].Newsl Am Acad Implant Dent,1969,18(2):15-24.
[14]Kim SH,Hwang YS,Ferreira A,et al.Analysis of temporary skeletal anchorage devices used for en-masse retraction:A preliminary study[J].Am J Orthod Dentofacial Orthop,2009,136(2):268-276.
[15]Jasoria G,Shamim W,Rathore S,et al.Miniscrew implants as temporary anchorage devices in orthodontics:Acomprehensive review[J].J Contemp Dent Pract,2013,14(5):993-999.
[16]Suzuki H,Moon W,Previdente LH,et al.et al.Miniscrew-assisted rapid palatal expander(MARPE):The quest for pure orthopedic movement[J].Dental Press J Orthod,2016,21(4):17-23.
[17]Lee J,Miyazawa K,Tabuchi M,et al.Midpalatal miniscrews and high-pull headgear for anteroposterior and vertical anchorage control:Cephalometric comparisons of treatment changes[J].Am J Orthod Dentofacial Orthop,2013,144(2):238-250.
[18]Park YC,Chu JH,Choi YJ,et al.Extraction space closure with vacuum-formed splints and miniscrew anchorage[J].JClin Orthod,2005,39(2):76-79.
[19]Womack WR.Four-premolar extraction treatment with Invisalign[J].J Clin Orthod,2006,40(8):493-500.
[20]Park YC,Choi YJ,Choi NC,et al.Esthetic segmental retraction of maxillary anterior teeth with a palatal appliance and orthodontic mini-implants[J].Am J Orthod Dentofacial Orthop,2007,131(4):537-544.
[21]Choi NC,Park YC,Jo YM,et al.Combined use of miniscrews and clear appliances for the treatment of bialveolar protrusion without conventional brackets[J].Am J Orthod Dentofacial Orthop,2009,135(5):671-681.
[22]李丽岩.无托槽隐形矫治与固定矫治技术在拔牙病例中的联合应用[J].中国美容医学,2013,22(13):1416-1421.
[2]Kim T,Suh J,Kim N,et al.Optimum conditions for parallel translation of maxillary anterior teeth under retraction force determined with the finite element method[J].Am JOrthod Dentofacial Orthop,2010,137(5):639-647.
[3]Rossini G,Parrini S,Castroflorio T,et al.Efficacy of clear aligners in controlling orthodontic tooth movement:A systematic review[J].Angle Orthod,2015,85(5):881-889.
[4]Uribe F,Cutrera A,Nanda R.A segmented appliance for space closure followed by Invisalign and fixed appliances[J].Orthodontics(Chic.),2011,12(4):386-395.
[5]唐娜,赵志河,王军,等.无托槽隐形矫治技术生物力学效应的有限元法研究[J].医用生物力学杂志,2010,25(6):399-405.
[6]Zhang N,Bai Y,Li S.Treatment of a Class II Division 1malocclusion with miniscrew anchorage[J].Am J Orthod Dentofacial Orthop,2012,141(6):e85-e93.
[7]Ammar HH,Ngan P,Crout RJ,et al.Three-dimensional modeling and finite element analysis in treatment planning for orthodontic tooth movement[J].Am J Orthod Dentofacial Orthop,2011,139(1):e59-e71.
[8]Kesling HD.Coordinating the predetermined pattern and tooth positioner with conventional treatment[J].Am J Orthod Oral Surg,1946,32:285-293.
[9]Melsen B.Northcroft lecture:How has the spectrum of orthodontics changed over the past decades?[J].J Orthod,2011,38(2):134-143.
[10]Rosvall MD,Fields HW,Ziuchkovski J,et al.Attractiveness,acceptability,and value of orthodontic appliances[J].Am J Orthod Dentofacial Orthop,2009,135(3):276.
[11]潘裕炯,黄盛沛,田杰.双颌前突用无托槽隐形矫治器矫治1例[J].实用口腔医学杂志,2012,28(5):659-661.
[12]郑钰婷,陈琳,吴嘉桦,等.无托槽隐形矫治器整体内收上颌前牙的三维有限元分析[J].实用口腔医学杂志,2017,33(5):621-624.
[13]Linkow LI.The endosseous blade vent[J].Newsl Am Acad Implant Dent,1969,18(2):15-24.
[14]Kim SH,Hwang YS,Ferreira A,et al.Analysis of temporary skeletal anchorage devices used for en-masse retraction:A preliminary study[J].Am J Orthod Dentofacial Orthop,2009,136(2):268-276.
[15]Jasoria G,Shamim W,Rathore S,et al.Miniscrew implants as temporary anchorage devices in orthodontics:Acomprehensive review[J].J Contemp Dent Pract,2013,14(5):993-999.
[16]Suzuki H,Moon W,Previdente LH,et al.et al.Miniscrew-assisted rapid palatal expander(MARPE):The quest for pure orthopedic movement[J].Dental Press J Orthod,2016,21(4):17-23.
[17]Lee J,Miyazawa K,Tabuchi M,et al.Midpalatal miniscrews and high-pull headgear for anteroposterior and vertical anchorage control:Cephalometric comparisons of treatment changes[J].Am J Orthod Dentofacial Orthop,2013,144(2):238-250.
[18]Park YC,Chu JH,Choi YJ,et al.Extraction space closure with vacuum-formed splints and miniscrew anchorage[J].JClin Orthod,2005,39(2):76-79.
[19]Womack WR.Four-premolar extraction treatment with Invisalign[J].J Clin Orthod,2006,40(8):493-500.
[20]Park YC,Choi YJ,Choi NC,et al.Esthetic segmental retraction of maxillary anterior teeth with a palatal appliance and orthodontic mini-implants[J].Am J Orthod Dentofacial Orthop,2007,131(4):537-544.
[21]Choi NC,Park YC,Jo YM,et al.Combined use of miniscrews and clear appliances for the treatment of bialveolar protrusion without conventional brackets[J].Am J Orthod Dentofacial Orthop,2009,135(5):671-681.
[22]李丽岩.无托槽隐形矫治与固定矫治技术在拔牙病例中的联合应用[J].中国美容医学,2013,22(13):1416-1421.