口腔医学 ›› 2023, Vol. 43 ›› Issue (2): 104-109.doi: 10.13591/j.cnki.kqyx.2023.02.002

• 基础研究 • 上一篇    下一篇

无托槽隐形矫治拔牙病例的后牙不同轴倾度对牙齿三维力学影响

樊永杰(),寇雅婷   

  1. 内蒙古医科大学第四附属医院口腔正畸科,内蒙古包头(014030)
  • 修回日期:2022-10-27 出版日期:2023-02-28 发布日期:2023-03-02
  • 通讯作者: 樊永杰 E-mail:13947240089@163.com
  • 基金资助:
    2021年包头市卫生健康科技计划项目(wsjkkj014)

Effect of different tips of posteriors in extraction treatment on three-dimensional forces of teeth with clear aligners

FAN Yongjie(),KOU Yating   

  1. Department of Stomatology, Fourth Affiliated Hospital of Inner Mongolia Medical University, Baotou 014030, China
  • Revised:2022-10-27 Online:2023-02-28 Published:2023-03-02
  • Contact: FAN Yongjie E-mail:13947240089@163.com

摘要:

目的 研究无托槽隐形矫治技术拔除双侧上颌第一前磨牙病例整体内收前牙,后牙不同轴倾度时,各个牙齿的瞬时受力情况。方法 设置4组后牙不同轴倾度的上颌牙列,T1组后牙为正常牙合轴倾度,T2组后牙在T1组基础上后倾5°,T3组后牙在T1组基础上前倾5°,T4组后牙在T1组基础上前倾10°。拔除双侧第一前磨牙,整体内收前牙0.25 mm,在矫治器六轴力传感器测试平台上测量4组牙列中各个牙齿在三维方向的瞬时力。每组牙列设计12副隐形矫治器。结果 与T1组相比,T2组切牙伸长力减小,尖牙远中向力增加,后牙近中向力减小,磨牙颊向和伸长力增大,差异均有统计学意义(P<0.05)。与T1组相比,T3和T4组切牙舌向力和伸长力增大,尖牙远中向力增大,后牙近中向力也增大,磨牙颊向和伸长力增大,差异均有统计学意义(P<0.05)。结论 后牙后倾时利于前牙转矩的表达,有助于保护后牙支抗,但增加了磨牙的颊向力和伸长力。后牙前倾时,前牙更容易出现转矩丢失,覆牙合加深的现象。后牙越前倾,覆牙合越容易加深,后牙支抗容易丢失。

关键词: 正畸, 无托槽隐形矫治, 拔牙矫治, 后牙轴倾度, 三维受力

Abstract:

Objective To investigate the three-dimensional forces in real-time at different tips of the posteriors created by clear aligners on maxillary teeth during en-masse retraction of anteriors after 2 first premolars extraction treatment. Methods Four groups of maxillary models with different tips of posteriors(T1-upright of posteriors, T2-posteriors with distal inclination of 5°, T3-posteriors with mesial inclination of 5°, T4-posteriors with mesial inclination of 10°) undergoing 0.25 mm en-masse retraction treatment using clear aligners were simulated on a multi-axis force/torque transducer measurement system. When each clear aligner was inserted, a computer connected to the transducer collected and recorded the three-dimensional force of every tooth in real-time. Each group included 12 aligners. Results Incisors received smaller lingual and extrusive forces; canines received greater distal forces; smaller mesial forces were observed on the posteriors, and molars received greater buccal and extrusive forces in T2,compared with T1,which showed statistically significant differences(P<0.05). Incisors received smaller lingual and extrusive forces; canines received greater distal forces; greater mesial forces were observed on the posteriors, and molars received greater buccal and extrusive forces in T3 and T4,compared with T1,which showed statistically significant differences(P<0.05). Conclusion Posteriors with distal inclination contributed to the torque of the anterior and anchorage of posteriors. In group T2 posterior teeth experienced larger buccal forces and extrusive forces than in group T1. When the posteriors crown inclined mesially, the anterior teeth were more prone to lingual tip and caused overbite. The more mesially inclined the posterior teeth were, the more serious overbite was, and the posterior teeth were more prone to anchorage loss.

Key words: orthodontics, clear aligner, extraction, tips of posteriors, three-dimensional forces

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