Department of Orthodontics, First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Orthodontics, First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Orthodontics, School of Stomatology, Jinan University, Guangzhou, China.
Am J Orthod Dentofacial Orthop. 2019 Aug;156(2):210-219. doi: 10.1016/j.ajodo.2018.08.025.
More patients are choosing customized orthodontic appliances because of their excellent esthetics. It is essential that clinicians understand the biomechanics of the tooth movement tendency in customized lingual orthodontics. This study aimed to evaluate the tooth movement tendency during space closure in maxillary anterior teeth with the use of miniscrew anchorage in customized lingual orthodontics with various power arm locations.
Three-dimensional finite element models of the maxilla were created with miniscrews and power arms; the positions were varied to change the force directions. A retraction force (1.5 N) was applied from the top of the miniscrews to the selected points on the power arm, and the initial displacements of the reference nodes of the maxillary teeth were analyzed.
After applying force in different directions, power arms located at the distal side of the canines led to larger initial lingual crown tipping and occlusal crown extrusion of the maxillary incisors compared with power arms located at the midpoint between the lateral incisors and canines, and caused a decreasing trend of the intercanine width.
In customized lingual orthodontic treatment, power arms located at the distal side of the canines are unfavorable for anterior teeth torque control and intercanine width control. Power arms located at the midpoint between the lateral incisors and canines can get better torque control, but still cannot achieve excepted torque without extra torque control methods, no matter whether its force application point is higher than, lower than, or equal to the level of the top of the miniscrews.
由于美观效果出色,越来越多的患者选择定制式矫正器。临床医生必须了解定制式舌侧矫正中牙齿移动趋势的生物力学。本研究旨在评估使用微型种植体支抗在定制式舌侧矫正中,不同动力臂位置对关闭上颌前牙间隙时牙齿移动趋势的影响。
通过微型种植体和动力臂建立上颌的三维有限元模型;改变位置以改变力的方向。从微型种植体顶部向动力臂的选定点施加 1.5N 的回收力,分析上颌牙齿参考节点的初始位移。
在不同方向施力后,与位于侧切牙和尖牙之间中点的动力臂相比,位于尖牙远中侧的动力臂导致上颌切牙初始舌倾和牙冠唇倾更大,并导致尖牙间宽度减小。
在定制式舌侧矫正治疗中,位于尖牙远中侧的动力臂不利于前牙转矩控制和尖牙间宽度控制。位于侧切牙和尖牙之间中点的动力臂可以获得更好的转矩控制,但无论其施力点高于、低于还是等于微型种植体顶部,仍不能实现预期的转矩,除非使用额外的转矩控制方法。