国际口腔医学杂志

国际口腔医学杂志 ›› 2025, Vol. 52 ›› Issue (1): 69-75.doi: 10.7518/gjkq.2025016

• 论著 • 上一篇    下一篇

隐形拔牙矫治不同垂直骨面型上颌前牙移动特征的三维有限元研究

李汪儒(),杨璞()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 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:2024-04-09 修回日期:2024-08-20 出版日期:2025-01-01 发布日期:2025-01-11
  • 通讯作者: 杨璞
  • 作者简介:李汪儒，硕士，Email：507071944@qq.com
  • 基金资助:
    中国牙病防治基金会科研项目(A2021-143)

Movement characteristics of upper anterior teeth in clear aligner therapy with tooth extraction orthodontics with different vertical facial patterns in finite element analysis

Wangru Li(),Pu Yang()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-04-09 Revised:2024-08-20 Online:2025-01-01 Published:2025-01-11
  • Contact: Pu Yang
  • Supported by:
    Scientific Research Project of China Oral Health Foundation(A2021-143)

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摘要：

目的 通过三维有限元分析，探讨不同垂直骨面型患者在无托槽隐形拔牙矫治过程中上颌前牙的移动特征。 方法 采集1例正畸患者的上颌骨锥形束CT数据和上颌牙列口内扫描数据，使用Mimics、Geomagic Studio、HyperMesh等软件，建立3种不同垂直骨面型（高角组、均角组、低角组）拔除上颌第一前磨牙的三维有限元模型，模拟透明矫治器内收上颌前牙，分析上颌前牙的移动趋势，分析各向位移量、转矩变化及牙周膜等效应力。 结果 各垂直骨面型组均表现为牙齿向拔牙侧移动，移动方式为倾斜移动，根位移量小于冠位移量；中切牙和侧切牙的垂直向及矢状向位移量、牙周膜等效应力和转矩变化均表现为低角组、均角组、高角组依次增多；尖牙的垂直向及矢状向位移量、牙周膜等效应力和转矩变化则表现为均角组最多，低角组最小。 结论 在进行无托槽隐形拔牙矫治设计时，应充分考虑不同垂直骨面型的前牙移动特征，制订个性化设计方案。

关键词: 无托槽隐形矫治, 拔牙矫治, 生物力学, 垂直骨面型, 有限元分析

Abstract:

Objective This study aims to investigate the movement dynamics of maxillary anterior teeth during extraction and correction utilizing clear aligner therapy among patients exhibiting distinct vertical facial patterns. Methods Oral and cone beam computed tomography data of the patient’s maxillary anatomy and oral scan data of maxillary dentition were collected. By employing software such as Mimics, Geomagic Studio, and HyperMesh, three vertical facial patterns were established via a three-dimensional finite element model. This model simulated clear aligner adduction of the upper anterior teeth, facilitating analysis of movement trends, sagittal and vertical displacements, alterations in anterior tooth torque, and periodontal ligament equivalent stress. Results Across all vertical facial pattern groups, the teeth exhi-bited migration towards the extraction site, with root displacement inferior to crown displacement and concurrent oblique movement. Vertical and sagittal displacements of maxillary incisors and periodontal ligament effects demonstrated progressive increment from the brachyfacial group to the mesofacial and dolichofacial groups. Conversely, vertical and sagittal displacements of canines, periodontal ligament equiva-lent stress, and torque changes remained consistent. Notably, the dolichofacial group exhibited the highest magnitude, whereas the brachyfacial group displayed the lowest. Conclusion Clear aligner therapy with tooth extraction and correction induces a clockwise moment on the anterior teeth, intensifying sequentially across the brachyfacial, mesofacial, and dolichofacial groups.

Key words: clear aligner, tooth extraction therapy, biomechanics, vertical facial pattern, finite element analysis

中图分类号: 

  • R783

图1

不同垂直骨面型的三维有限元模型设计SN：前颅底平面；U1：上颌中切牙轴；OP：平面。"

表 1

不同垂直骨面型三维有限元模型相关参数"

参数低角组均角组高角组
∠U1-SN102.4102.4102.4
∠OP-SN9.213.822.4
∠U1-OP68.463.855.2

图2

拔除第一前磨牙的不同垂直骨面型的三维有限元模型A：低角组；B：均角组；C：高角组。"

表 2

材料参数"

材料弹性模量（E/MPa）松柏比（v）
上颌骨24 0000.3
透明矫治器5280.36
牙周膜0.690.45
牙齿19 6000.3

图3

坐标系的设定A：全局坐标系；B：局部坐标系。"

图4

上颌前牙位移方向A：低角组；B：均角组；C：高角组；A1、B1、C1：3组牙列切面观；A2、B2、C2：3组牙列舌面观。"

表 3

不同垂直骨面型上颌前牙矢状向位移"

牙齿低角组均角组高角组
牙冠牙根冠根位移差值牙冠牙根冠根位移差值牙冠牙根冠根位移差值
中切牙4.033 5L1.441 5B2.592 0L5.847 5L2.054 0B3.793 5L6.552 0L2.194 5B4.357 5L
侧切牙2.954 5L1.090 5B1.864 0L5.979 0L2.181 5B3.797 5L7.774 0L2.682 0B5.092 0L
尖牙6.715 0L2.758 0B3.957 0L9.200 0L3.838 0B5.362 0L7.461 0L3.196 0B4.265 0L

图 5

上颌前牙位移等高线图A：低角组；B：均角组；C：高角组；A1、B1、C1：３组牙列切面观；A2、B2、C2：３组牙列唇面观。"

表 4

不同垂直骨面型上颌前牙垂直向位移"

牙齿低角组均角组高角组
牙冠牙根冠根位移差值牙冠牙根冠根位移差值牙冠牙根冠根位移差值
中切牙1.275 0E0.571 6I0.703 4E2.190 0E1.012 0I1.178 0E3.445 0E1.128 0I2.317 0E
侧切牙0.908 0E0.343 3I0.564 7E2.207 0E0.944 4I1.263 0E4.360 0E1.910 0I2.450 0E
尖牙1.432 0E2.727 0I1.295 0I1.608 0E3.732 0I2.124 0I1.300 0E2.870 0I1.569 0I

表 5

不同垂直骨面型上颌前牙的转矩变化 (×0.01°)"

牙齿低角组均角组高角组
中切牙7.014 610.901 512.402 4
侧切牙5.331 610.813 614 371 2
尖牙9.122 512 470 410.498 2

图6

牙周膜等效应力图A：低角组；B：均角组；C：高角组；A1、B1、C1：3组牙列唇面观；A2、B2、C2：3组牙列切面观。"

表 6

不同垂直骨面型上颌前牙最大牙周膜主应力值 (MPa)"

牙齿低角组均角组高角组
中切牙1.3251.7341.842
侧切牙1.9012.0022.192
尖牙2.1233.3242.746
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