矩形附件厚度与位置变化对矫正尖牙扭转的影响

从隐形数据库中挑选 标 准 左 上 尖牙 ， 3D 打印成实体模型。
收集各应力、位移分布云图 及最大应力、位移值，探讨 附件的厚度及放置位置对 矫正扭转尖牙的影响。
建立矫治器-附件-尖牙-牙周膜-松质骨皮质骨有限元模型
建立矫治器-尖牙牙周膜-松质骨-皮 质骨有限元模型
附件厚度：0.5，0.75， 1.0，1.5 mm。
Chen Zhouyan, Master, Attending physician, Department of Stomatology, Yaan People's Hospital, Yaan 625000, Sichuan Province, China
Corresponding author: Huang Yue, Professor, MD, Affiliated Stomatology Hospital of Jinan University School of Stomatology, Foshan 528000, Guangdong Province, China
《中国组织工程研究》 Chinese Journal of Tissue Engineering Research
矩形附件厚度与位置变化对矫正尖牙扭转的影响
来自百度文库
·研究原著·
陈周艳1，周 容2，何 淞3，吴定丹3，吴 稀3，白 蕊3，黄 跃4(1雅安市人民医院口腔科，四川省雅安市 625000；2绵阳市中医医
院口腔科，四川省绵阳市 621000；3西南医科大学附属口腔医院，四川省泸州市 646000；4暨南大学口腔医学院•附属口腔医院，广
东省佛山市 528000)
DOI:10.3969/j.issn.2095-4344.2262
ORCID: 0000-0001-9902-8967(陈周艳)
文章快速阅读：
文章特点— (1)目前无托槽隐形矫治技术已大量应用于临床，但牙齿移动效率问题尚未得到解决。目前主要通过
联合使用邻面去釉、增加附件及过矫治来提高扭转牙的矫治效率，但临床上附件的选择及放置等 往往依靠医师经验和习惯，其产生的效果是否不同目前暂无相关报道； (2)通过有限元分析法探讨附件的存在与否、附件放置位置及厚度对矫治效果的影响及规律。
附件位置：近中、远中、 合方、正中、龈方。
将不同厚度及放置位置的有附件模 型及无附件模型模拟远中扭转移动
陈周艳，女，1984 年生， 四川省内江市人，汉族， 2014 年西南医科大学毕 业，硕士，主治医生，主 要从事三维有限元的建模 及其在口腔正畸中力学性 能的研究。
通讯作者：黄跃，教授， 博士，暨南大学口腔医学 院•附属口腔医院，广东省 佛山市 528000
Chen Zhouyan1, Zhou Rong2, He Song3, Wu Dingdan3, Wu Xi3, Bai Rui3, Huang Yue4 (1Department of Stomatology, Yaan People's Hospital, Yaan 625000, Sichuan Province, China; 2Department of Stomatology, Mianyang City Hospital of Traditional Chinese Medicine, Mianyang 621000, Sichuan Province, China; 3Hospital of Stomatology, Southwest Medical University, Luzhou 646000, Sichuan Province, China; 4Affiliated Stomatology Hospital of Jinan University School of Stomatology, Foshan 528000, Guangdong Province, China)
Abstract BACKGROUND: Using interproximal enamel reduction, adding attachments and over-correction are major methods to improve the efficiency of correcting tooth torsion when using clear aligners in the clinic. However, the choice and placement of attachments depend on the experience and habits of orthodontists, and whether the effects are different has not been reported. OBJECTIVE: To explore the effects of rectangular attachment with different thicknesses and locations on the left maxillary canine tooth torsion in clear aligner by three-dimensional finite element analysis. METHODS: The finite element models of the clear aligner-attachment-maxillary canine-periodontal ligament-spongy bone-cortical bone and the clear aligner-maxillary canine-periodontal ligament-spongy bone-cortical bone were established according to the scanning data of in vitro maxillary canine. The models with attachments were divided into four groups based on different thicknesses of attachment, namely 0.5, 0.75, 1.0, and 1.5 mm groups. The placement positions were divided into five areas: mesial, distal, occlusal, median, and gingival of canine. 2°clockwise rotation of the tooth axis (X axis) was applied to the clear aligner. The action of the appliance and the canine were calculated by MSC.Marc.Mentat software. Then, the nephograms of stress and displacement, and the maximum stress and displacement values were collected. RESULTS AND CONCLUSION: (1) Whether the rectangular attachment was used or not, the two models’ distribution of canine’s displacement and periodontal stress were the same. The stress values of periodontal ligament were all higher than those without rectangular attachment. (2) With the thickness of rectangular attachment increasing, the maximum displacement values of the canine increased gradually, which were 42.94, 49.32, 52.52 and 59.39 µm, respectively. (3) When the rectangular attachment was placed in different positions, the maximal displacement of canine teeth the attachment of which was placed on the median was almost the same with that of the gingival side. While the changes in the mesial and distal directions were irregular. (4) The use of rectangular attachments makes no effect on the movement of instant canines, which only plays a synergistic role in the control of canine tooth torsion. The thickness of the attachment has a certain effect on the torsion of appliance. When the thickness increases, the maximum displacement of the canine tooth and the stress of the periodontal ligament are increased. In the vertical direction, the closer of the placement is to the crown, the better the control of the rotated canine is. Key words: bracketless invisible appliance; attachment; canine tooth; torsion; three-dimensional finite element analysis; oral biomaterials; thickness of attachments; placement position of attachments Funding: the National Natural Science Foundation of China (Youth Program), No. 81300903 (to HY)
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陈周艳，周容，何淞，吴定丹，吴稀，白蕊，黄跃. 矩形附件厚度与位置变化对矫正尖牙扭转的影响[J]. 中国组织工程研究，2020，24(16):2513-2519. DOI:10.3969/j.issn.2095-4344.2262
Effects of the changes of thickness and placement position of rectangular attachment on canine tooth torsion correction
文献标识码:A 投稿日期：2019-09-09 送审日期：2019-09-10 采用日期：2019-10-15 在线日期：2019-12-27
文题释义： 附件：在无托槽隐形矫治中为了提高隐形矫治器的固位、更好地控制牙齿三维方向上的移动及支抗设计等， 常需要在牙齿上设计及粘接相应的附件，但附件的放置及选择常常仅依靠医生的个人经验及习惯，附件变化 对牙齿三维移动的生物力学影响尚有待进一步的研究及证实。 扭转力学：即正畸中的旋转移动，指在正畸治疗过程中牙体围绕其牙体长轴的转动。实验通过将各组矫治器 以尖牙牙体长轴为旋转轴，将矫治器远中扭转 2°以模拟矫治中的尖牙远中扭转，探讨附件的变化对扭转力学 的影响。
摘要 背景：临床上采用无托槽隐形矫治器矫治扭转牙时，主要通过联合使用邻面去釉、增加附件及过矫治来提高 矫治效率，但附件的选择及放置等仅依靠医师经验和习惯而定，其产生的效果是否不同目前暂无相关报道。 目的：通过三维有限元法探究矩形附件的存在及厚度和放置位置对隐形矫治器矫正左上颌尖牙扭转的影响。 方法：通过离体牙扫描数据分别建立矫治器-附件-尖牙-牙周膜-松质骨-皮质骨(有附件组)与矫治器-尖牙-牙 周膜-松质骨-皮质骨(无附件组)有限元模型。其中有附件组中的附件厚度又分为 0.5，0.75，1.0，1.5 mm(附 件的放置位置、垂直高度、水平宽度和放置方向均设为一致)，放置位置又分为近中、远中、合方、正中、龈 方 5 个区域(附件的厚度、垂直高度、水平宽度和放置方向均设为一致)。将各组的矫治器以尖牙牙体长轴(X 轴)为旋转中心轴，将矫治器远中扭转 2°，在 MSC.Marc.Mentat 软件中模拟运算，收集各应力、位移分布云 图及最大应力、位移值。 结果与结论：①无论是否使用矩形附件，模型最终状态时尖牙均发生了不同程度的顺时针扭转，无附件组与 有附件组模型尖牙位移及牙周膜应力分布趋势一致，但有附件组模型中尖牙位移值及牙周膜各种应力值均不 同程度的大于无附件组；②随着矩形附件厚度的增加，尖牙的最大位移随之增大，分别为 42.94，49.32，52.52， 59.39 µm；③当矩形附件放于尖牙牙冠唇面不同位置时，尖牙的最大位移值变化规律为正中与龈方差别不大， 但两者均明显大于合方，而近中、远中向的变化不规律；④结果表明，附件的使用不会改变初戴矫治器瞬间 尖牙的移动方式，其仅在矫正扭转尖牙时起到了协同作用；附件厚度对矫治器扭转表达有一定的影响，当厚 度增大时尖牙所发生的最大位移及牙周膜受力越大；矩形附件在牙冠唇面合、龈方向的粘接位置越靠近牙冠 外形高点处，越有利于矫治器对扭转尖牙的控制。 关键词： 无托槽隐形矫治器；附件；尖牙；扭转；三维有限元分析；口腔生物材料；附件厚度，附件放置位置 中图分类号：R459.9；R783.5；R311 基金资助： 国家自然科学基金青年基金(81300903)，项目负责人：黄跃