Alhiraky Shaher, Konermann Anna, Keilig Ludger, Bourauel Christoph
Oral Technology, University Hospital Bonn, 53111 Bonn, Germany.
Department of Orthodontics, University Hospital Bonn, 53111 Bonn, Germany.
J Pers Med. 2024 Sep 17;14(9):988. doi: 10.3390/jpm14090988.
It was the scope of this study to explore the biomechanical implications of retraction force application point modifications in lingual orthodontics, aiming to mitigate the bowing effect and enhance anchorage stability in the anterior teeth.
Using the FE method on an idealized maxillary model, en masse retraction was simulated using a modified lingual fixed appliance including edgewise lingual brackets, a 0.017″ × 0.025″ mushroom-shaped archwire, and power arms between lateral incisors and canines, with a transpalatal arch (TPA) connecting the first molars. Applying bilateral retraction forces of 1.5 N at twelve positions, initial tooth displacements during space closure were evaluated.
Shifting power arms gingivally did not effectively counteract palatal tipping of incisors but reduced posterior and palatal tipping of canines with a power arm length of 11.3 mm preventing posterior tipping. Apically displacing the TPA retraction force increased mesiobuccal rotation while preventing mesial molar tipping for retraction forces applied 12.6 mm from the archwire.
Apically shifting retraction forces can mitigate vertical bowing effects in lingual orthodontics, yet it also highlights the challenges in maintaining torque in the anterior teeth. Further research and clinical validation are essential in order to confirm these results, emphasizing the complexity and need for advanced biomechanical strategies in personalized lingual orthodontic treatments.
本研究旨在探讨舌侧正畸中牵引着力点改变的生物力学影响,以减轻弯曲效应并增强前牙的支抗稳定性。
在理想化的上颌模型上采用有限元方法,使用改良的舌侧固定矫治器模拟整体内收,该矫治器包括方丝弓舌侧托槽、0.017″×0.025″蘑菇形弓丝,以及侧切牙和尖牙之间的加力臂,并用横腭杆(TPA)连接第一磨牙。在十二个位置施加1.5 N的双侧牵引力,评估关闭间隙期间的初始牙齿位移。
将加力臂向龈方移动并不能有效对抗切牙的腭向倾斜,但在加力臂长度为11.3 mm时可减少尖牙的远中及腭向倾斜,防止远中倾斜。将TPA牵引力向根尖方向移位会增加近中颊向旋转,同时在距弓丝12.6 mm处施加牵引力时可防止磨牙近中倾斜。
在舌侧正畸中,将牵引力向根尖方向移位可减轻垂直弯曲效应,但也凸显了维持前牙转矩的挑战。为了证实这些结果,进一步的研究和临床验证至关重要,这强调了个性化舌侧正畸治疗中复杂且需要先进生物力学策略的必要性。