Liu Jia-Rong, Xu Xin-Ran, Wang Xing-Yue, Zhang Yan, Wang Xiao-Ming
Key Laboratory of Dental Maxillofacial Reconstruction and Biological Intelligence Manufacturing (No.: 20JR10RA653-ZDKF20210401), School of Stomatology, Lanzhou University, No. 199 Donggang West Road, 730000, Lanzhou, Gansu Province, China.
Department of Orthodontics, School of Stomatology, Lanzhou University, 730000, Lanzhou, Gansu Province, China.
J Orofac Orthop. 2024 Oct 8. doi: 10.1007/s00056-024-00554-x.
Precise root torque adjustment of anterior teeth is indispensable for optimizing dental esthetics and occlusal stability in orthodontics. The efficiency of traditional rectangular archwire manipulation within bracket slots seems to be limited. The crimpable gate spring, a novel device, has emerged as a promising alternative. Yet, there is a paucity of guidelines for its optimal clinical application. This study used finite element analysis (FEA) to investigate the biomechanical impact of the gate spring on torque adjustment of individual anterior teeth and to elucidate the most effective application strategy.
A FEA model was constructed by a maxillary central incisor affixed with an edgewise bracket featuring a 0.022 × 0.028 inch (in) slot. A range of stainless steel rectangular archwires, in conjunction with a gate spring, were modeled and simulated within the bracket slots. A control group utilized a conventional rectangular wire devoid of a gate spring. Palatal root moments were standardized to 9, 18, and 36 Nmm for both experimental and control groups.
The gate spring significantly amplified palatal root movement, notably with the 0.019 × 0.025 in archwire. However, this was accompanied by an increase in stress on the tooth and periodontal ligament, particularly in the cervical regions. The synergistic use of a 0.019 × 0.025 in rectangular archwire with a gate spring in a 0.022 × 0.028 in bracket slot was identified as most efficacious for torque control of individual anterior teeth.
The gate spring is a viable auxiliary device for enhancing torque adjustment on individual teeth. However, caution is advised as excessive initial stress may concentrate in the cervical and apical regions of the periodontal ligament and tooth.
在正畸治疗中，精确调整前牙牙根转矩对于优化牙齿美观和咬合稳定性至关重要。传统的矩形弓丝在托槽槽沟内的操作效率似乎有限。可压接式门形弹簧作为一种新型装置，已成为一种有前景的替代方法。然而，关于其最佳临床应用的指南却很少。本研究采用有限元分析（FEA）来研究门形弹簧对单个前牙转矩调整的生物力学影响，并阐明最有效的应用策略。
构建一个上颌中切牙的有限元分析模型，该牙附着有一个具有0.022×0.028英寸（in）槽沟的方丝弓托槽。一系列不锈钢矩形弓丝与一个门形弹簧一起在托槽槽沟内进行建模和模拟。对照组使用不含门形弹簧的传统矩形弓丝。实验组和对照组的腭根力矩均标准化为9、18和36 Nmm。
门形弹簧显著放大了腭根移动，特别是在使用0.019×0.025英寸弓丝时。然而，这伴随着牙齿和牙周膜应力的增加，尤其是在颈部区域。在0.022×0.028英寸托槽槽沟中，将0.019×0.025英寸矩形弓丝与门形弹簧协同使用被确定为对单个前牙转矩控制最有效。
门形弹簧是增强单个牙齿转矩调整的可行辅助装置。然而，建议谨慎使用，因为过大的初始应力可能集中在牙周膜和牙齿的颈部及根尖区域。
