[不同移动设计下使用透明矫治器进行磨牙远移时上颌牙列的三维分析:一项实验]

[Three-dimensional analysis of maxillary dentition during molar distalization with clear aligners under different movement designs: an experiment].

作者信息

Hu Y R, Song B L, Li B, Shi R Y, Liu S Y, Gu Z X

机构信息

Department of Orthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Xi'an 710032, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2023 Feb 28;58(3):265-270. doi: 10.3760/cma.j.cn112144-20220731-00431.

Abstract

To investigate the three-dimensional force in the maxillary dentition under different movement designs for molar distalization with clear aligners Three groups were designed: simultaneous movement group (simultaneous distalization of maxillary first and second molars), second molar movement group (distalization of maxillary second molars) and first molar movement group (distalization of maxillary first molars). Ten clear aligners were made in each group, and the displacement was designed to be 0.2 mm. A force sensing device was established to measure the three-dimensional force on the upper dentition with the clear aligner. The device contained a model of the maxillary dentition consisting of 14 teeth, each tooth connected to an individual sensor. After the clear aligner was fitted, the data of 14 sensors were collected and analyzed using computer analysis software. The moving teeth were taken as the target teeth, and the rest of the teeth were anchorage. The data of the three-dimensional force in the three groups in each tooth position were measured and compared. The sagittal forces on the first and second molars in the simultaneous movement group were (5.61±0.94) and (5.81±1.08) N, respectively, which were significantly smaller than those of the target teeth in the same position in other groups (<0.05). The second molars in the first molar movement group received a sagittal reaction force, which was (-6.73±1.99) N. The anterior teeth in the three groups were all subjected to sagittal reaction force, and the force value was in a range of (-3.33 to 0.46) N. In the coronal direction, the second premolars of the simultaneous movement group received the reaction force in the palatal direction, and the force value was (-2.17±1.06) N. The first molars in the second molar movement group were also subjected to palatal reaction force of (-1.99±0.70) N. The second molars and second premolars in the first molar movement group were also subjected to palatal reaction force, which were (-2.85±0.57) and (-1.85±0.74) N, respectively. Compared with the sagittal and coronal forces, the target teeth and anchorage teeth in the three groups were less stressed in the vertical direction. The first and second molars distalized simultaneously, the correction force in the sagittal direction was relatively small. When first molar was moved distally alone, a greater reaction force in the sagittal direction was exerted on the second molar. Buccal displacement of the adjacent anchorage teeth should be designed to counteract the palatal reaction force on the anchorage teeth as the molars moved distally.

摘要

为研究使用透明矫治器进行磨牙远移不同移动设计时上颌牙列的三维力,设计了三组:同时移动组(上颌第一和第二磨牙同时远移)、第二磨牙移动组(上颌第二磨牙远移)和第一磨牙移动组(上颌第一磨牙远移)。每组制作10副透明矫治器,位移设计为0.2mm。建立一个力传感装置来测量使用透明矫治器时上颌牙列上的三维力。该装置包含一个由14颗牙齿组成的上颌牙列模型,每颗牙齿连接到一个单独的传感器。佩戴透明矫治器后,使用计算机分析软件收集并分析14个传感器的数据。将移动的牙齿作为目标牙,其余牙齿作为支抗。测量并比较三组中每个牙位的三维力数据。同时移动组中第一和第二磨牙的矢状向力分别为(5.61±0.94)N和(5.81±1.08)N,明显小于其他组相同位置目标牙的矢状向力(<0.05)。第一磨牙移动组中的第二磨牙受到矢状向反作用力,为(-6.73±1.99)N。三组中的前牙均受到矢状向反作用力,力值在(-3.33至0.46)N范围内。在冠向,同时移动组的第二前磨牙受到腭向反作用力,力值为(-2.17±1.06)N。第二磨牙移动组中的第一磨牙也受到(-1.99±0.70)N的腭向反作用力。第一磨牙移动组中的第二磨牙和第二前磨牙也受到腭向反作用力,分别为(-2.85±0.57)N和(-1.85±0.74)N。与矢状向和冠向力相比,三组中的目标牙和支抗牙在垂直方向上受力较小。第一和第二磨牙同时远移时,矢状向的矫治力相对较小。当单独移动第一磨牙向远中时,第二磨牙受到更大的矢状向反作用力。随着磨牙向远中移动,应设计相邻支抗牙的颊向位移以抵消支抗牙上的腭向反作用力。

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