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牙周膜最大正畸力评估(完整和减少的牙周组织)(第一部分)。

Assessment of the Maximum Amount of Orthodontic Force for PDL in Intact and Reduced Periodontium (Part I).

机构信息

Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania.

Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania.

出版信息

Int J Environ Res Public Health. 2023 Jan 19;20(3):1889. doi: 10.3390/ijerph20031889.

Abstract

This study examines 0.6 N and 1.2 N as the maximum orthodontic force for periodontal ligament (PDL) at multiple levels of periodontal breakdown, and the relationships with the ischemic, necrotic, and resorptive risks. Additionally, this study evaluates if Tresca failure criteria is more adequate for the PDL study. Eighty-one 3D models (from nine patients; nine models/patients) with the 2nd lower premolar and different degrees of bone loss (0-8 mm) where subjected to intrusion, extrusion, rotation, translation, and tipping movements. Tresca shear stress was assessed individually for each movement and bone loss level. Rotation and translation produced the highest PDL stresses, while intrusion and extrusion determined the lowest. Apical and middle third PDL stresses were lower than the cervical stress. In intact periodontium, the amount of shear stress produced by the two investigated forces was lower than the 16 KPa of the maximum physiological hydrostatic pressure (MHP). In reduced periodontium (1-8 mm tissue loss), the apical amount of PDL shear stress was lower than MHP for both applied forces, while cervically for rotation, translation and tipping movements exceeded 16 KPa. Additionally, 1.2 N could be used in intact periodontium (i.e., without risks) and for the reduced periodontium only in the apical and middle third of PDL up to 8 mm of bone loss. However, for avoiding any resorptive risks, in the cervical third of PDL, the rotation, translation, and tipping movements require less than 0.2-0.4 N of force after 4 mm of loss. Tresca seems to be more adequate for the study of PDL than other criteria.

摘要

本研究考察了 0.6N 和 1.2N 作为牙周韧带(PDL)在多个牙周破坏水平的最大正畸力,以及与缺血、坏死和吸收风险的关系。此外,本研究还评估了 Tresca 失效准则是否更适合 PDL 研究。对 9 名患者的 81 个 3D 模型(每个患者 9 个模型)的第 2 下前磨牙进行了内收、外展、旋转、平移和倾斜运动。分别评估了每种运动和骨丧失水平下的 Tresca 剪切应力。旋转和平移产生的 PDL 应力最高,而内收和外展产生的 PDL 应力最低。根尖和中间三分之一的 PDL 应力低于颈段的 PDL 应力。在完整的牙周组织中,两种研究力产生的剪切应力低于最大生理静水压力(MHP)的 16KPa。在减少的牙周组织(1-8mm 组织丧失)中,对于两种应用力,根尖 PDL 剪切应力低于 MHP,而对于旋转、平移和倾斜运动,颈段超过 16KPa。此外,1.2N 可用于完整的牙周组织(即无风险),以及减少的牙周组织,在 PDL 的根尖和中间三分之一,骨丧失不超过 8mm。然而,为了避免任何吸收风险,在 PDL 的颈段三分之一,在骨丧失 4mm 后,旋转、平移和倾斜运动需要的力小于 0.2-0.4N。与其他准则相比,Tresca 似乎更适合 PDL 的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb0e/9914466/4595b5ad42d9/ijerph-20-01889-g001.jpg

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