He Xin, Zhuang Wei-Hang, Zhang Dong-Liang
Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, 100050, People's Republic of China.
Department of Stomatology, Beijing Rytime Dental Hospital, Beijing, 100024, People's Republic of China.
Int J Gen Med. 2021 Nov 18;14:8455-8461. doi: 10.2147/IJGM.S337212. eCollection 2021.
To analyze the movement of anterior teeth by changing the height of the power-arm and changing the force application points during whole maxillary dentition distalization with the aid of micro-implants in lingual orthodontics to set a biomechanical reference for effective clinical use of lingual orthodontic appliance.
A three-dimensional finite element model of the maxillary teeth with lingual appliance and the associated support tissue was established. Maxillary dentition with the force of 200g was distalized using implant as anchorage, then the movement of anterior teeth was analyzed by changing the length of power-arm (1mm, 3mm, 6mm, 9mm) and by changing the force location from lingual side to buccal side.
During whole maxillary dentition distalization with aid of the implants in lingual orthodontics: when the height of power arm was 1mm, the anterior teeth rotated clockwise, with the increasing of the height of power-arm, the anterior teeth rotated counterclockwise gradually. When the height of power-arm was 9mm, all anterior teeth rotated counterclockwise. Central incisor and lateral incisor rotated counterclockwise and canine rotated clockwise when the buccal side force was applied.
With the increase of the height of the power-arm, the movement pattern of the upper anterior teeth is different. The canine is more sensitive to the height of the power-arm than the central incisor and the lateral incisor. When the height of the power-arm reaches 9mm, the upper anterior teeth are displayed as crown tipping buccally movement. Compare with lingual side force, the buccal side force do better in preventing the loss of anterior tooth torque. If the upper anterior teeth are up-right or lingually tipped before treatment, it is preferable to use longer power-arm or buccal side traction force. If the anterior teeth are already tipped buccally, then short power-arm or lingual side force is advised.
通过在舌侧正畸中借助微型种植体改变力臂高度和力的作用点来分析上颌全牙列远移过程中前牙的移动情况,为舌侧正畸矫治器的有效临床应用建立生物力学参考。
建立带有舌侧矫治器的上颌牙齿及相关支持组织的三维有限元模型。以种植体为支抗,施加200g力使上颌牙列远移,然后通过改变力臂长度(1mm、3mm、6mm、9mm)以及将力的作用位置从舌侧改为颊侧来分析前牙的移动情况。
在舌侧正畸借助种植体进行上颌全牙列远移过程中:当力臂高度为1mm时,前牙顺时针旋转,随着力臂高度增加,前牙逐渐逆时针旋转。当力臂高度为9mm时,所有前牙均逆时针旋转。当施加颊侧力时,中切牙和侧切牙逆时针旋转,尖牙顺时针旋转。
随着力臂高度增加,上前牙的移动模式不同。尖牙比中切牙和侧切牙对力臂高度更敏感。当力臂高度达到9mm时,上前牙表现为冠向颊侧倾斜移动。与舌侧力相比,颊侧力在防止前牙转矩丧失方面效果更好。如果治疗前上前牙直立或舌倾,最好使用较长力臂或颊侧牵引力。如果前牙已经颊倾,则建议使用短力臂或舌侧力。