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根据牙齿形态和托槽位置的扭矩差异:一项有限元研究。

Torque differences according to tooth morphology and bracket placement: a finite element study.

作者信息

Papageorgiou Spyridon N, Sifakakis Iosif, Keilig Ludger, Patcas Raphael, Affolter Stefan, Eliades Theodore, Bourauel Christoph

机构信息

Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Switzerland.

Department of Oral Technology, School of Dentistry, University of Bonn, Germany.

出版信息

Eur J Orthod. 2017 Aug 1;39(4):411-418. doi: 10.1093/ejo/cjw074.

Abstract

INTRODUCTION

Torque of the maxillary incisors is essential in esthetics and proper occlusion, while torque expression is influenced by many factors. The aim of this finite element study was to assess the relative effect of tooth morphology, bracket prescription, and bracket positioning on tooth displacement and developed stresses/strains after torque application.

METHODS

A three-dimensional upper right central incisor with its periodontal ligament (PDL) and alveolus was modelled. The tooth varied in the crown-root angle (CRA) between 156°, 170°, and 184°. An 0.018-inch slot discovery® (Dentaurum, Ispringen, Germany) bracket with a rectangular 0.018 × 0.025-inch β-titanium wire was modelled. Bracket torque prescription varied between 0°, 12°, and 22°, with bracket placement at the centre of the middle, gingival or incisal third of the crown. A total of 27 models were generated and a buccal root torque of 30° was applied. Afterwards, crown and apex displacement, strains in the PDL, and stresses in the bracket were calculated and analysed statistically.

RESULTS

The palatal crown displacement was significantly affected by bracket positioning (up to 94 per cent), while the buccal apex displacement was significantly affected by bracket prescription (up to 42 per cent) and bracket positioning (up to 23 per cent). Strains in the PDL were affected mainly by CRA (up to 54 per cent), followed by bracket positioning (up to 45 per cent). Finally, bracket prescription considerably affected the stresses in the bracket (up to 144 per cent).

LIMITATIONS

These in silico results need to be validated in vivo before they can be clinically extrapolated.

CONCLUSION

Tooth anatomy and the characteristics of the orthodontic appliance should be considered during torque application.

摘要

引言

上颌切牙的转矩对于美观和正常咬合至关重要,而转矩表达受多种因素影响。本有限元研究的目的是评估牙齿形态、托槽处方和托槽定位对施加转矩后牙齿位移以及产生的应力/应变的相对影响。

方法

建立了一个包含右上中切牙及其牙周膜(PDL)和牙槽骨的三维模型。该牙齿的冠根角(CRA)在156°、170°和184°之间变化。模拟了一个带有0.018×0.025英寸矩形β钛丝的0.018英寸槽沟Discovery®(德国登泰克公司,伊斯普林根)托槽。托槽转矩处方在0°、12°和22°之间变化,托槽放置在牙冠中部、龈方或切方三分之一的中心位置。共生成27个模型,并施加30°的颊侧牙根转矩。之后,计算并统计分析牙冠和根尖位移、牙周膜中的应变以及托槽中的应力。

结果

腭侧牙冠位移受托槽定位的影响显著(高达94%),而颊侧根尖位移受托槽处方(高达42%)和托槽定位(高达23%)的影响显著。牙周膜中的应变主要受冠根角的影响(高达54%),其次是托槽定位(高达45%)。最后,托槽处方对托槽中的应力有相当大的影响(高达144%)。

局限性

这些计算机模拟结果在能够进行临床推断之前需要在体内进行验证。

结论

在施加转矩时应考虑牙齿解剖结构和正畸矫治器的特性。

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