Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil.
Department of Orthodontics, University of Guarulhos, Guarulhos, Brazil.
J Orthod. 2023 Dec;50(4):344-351. doi: 10.1177/14653125231166437. Epub 2023 Apr 12.
To compare two methods of maxillary molar distalisation with skeletal anchorage using finite element analysis (FEA).
Two digitised models were created: the miniscrew-anchored distaliser, which consisted of a distalisation method anchored in a buccal miniscrew between the first molar and second premolar (Model 1), and the miniscrew-anchored palatal appliance, which consisted of a distalisation method anchored in a miniscrew on the anterior region of the palate (Model 2). FEA was used to simulate both methods, assessing teeth displacements and stress concentration.
The miniscrew-anchored distaliser showed greater buccal than distal displacement of the first molar, while the opposite was observed in the miniscrew-anchored palatal appliance. The second molar responded similarly in the transverse and anteroposterior perspectives with both appliances. Greater displacements were observed at crown level than in apical regions. Greater stress concentration was observed at the buccal and cervical regions of the crown in the miniscrew-anchored distaliser and the palatal and cervical regions in the palatal appliance. The stress progressively spread in the buccal side of the alveolar bone for the miniscrew-anchored distaliser and in the palatal root and alveolar bone for the palatal appliance.
FEA assumes that both appliances would promote maxillary molar distalisation. A skeletally anchored palatal distalisation force seems to provide a greater molar bodily movement with less undesirable effects. Greater stress is expected at the crown and cervical regions during distalisation, and the stress concentration in the roots and alveolar bone depends directly on the region the force was applied.
通过有限元分析(FEA)比较两种带有骨骼锚固的上颌磨牙远移方法。
创建了两个数字化模型:颊侧微型螺钉远移器,由第一磨牙和第二前磨牙之间的颊侧微型螺钉固定的远移方法组成(模型 1);和微型螺钉锚固的腭部矫治器,由腭部前区的微型螺钉固定的远移方法组成(模型 2)。FEA 用于模拟这两种方法,评估牙齿位移和应力集中。
颊侧微型螺钉远移器使第一磨牙颊向移动大于远移,而微型螺钉锚固的腭部矫治器则相反。两种矫治器在横向和前后方向上对第二磨牙的反应相似。牙冠处的位移大于根尖区。微型螺钉锚固的远移器的牙冠颊侧和颈侧以及腭部矫治器的腭侧和颈侧观察到更大的应力集中。应力在颊侧牙槽骨中逐渐扩散,对于颊侧微型螺钉远移器,而在腭侧根和牙槽骨中对于腭部矫治器。
FEA 假设两种矫治器都能促进上颌磨牙远移。带有骨骼锚固的腭部远移力似乎提供了更大的磨牙整体移动,而不良影响较小。在远移过程中,牙冠和颈区预计会承受更大的压力,而根和牙槽骨的应力集中则直接取决于力施加的区域。