口腔医学 ›› 2025, Vol. 45 ›› Issue (9): 675-680.doi: 10.13591/j.cnki.kqyx.2025.09.006

• 基础与临床研究 • 上一篇    下一篇

不同牙槽骨高度下内收并压低上前牙的三维有限元研究

薛姣姣, 王晓旭, 樊明月()   

  1. 上海市徐汇区口腔医院口腔正畸科,上海(200032)
  • 收稿日期:2024-10-08 出版日期:2025-09-28 发布日期:2025-09-11
  • 通讯作者: 樊明月 E-mail: 13918158162@163.com
  • 基金资助:
    徐汇区医学科研项目(SHXYF202101)

3D finite element analysis of retraction and intrusion of maxillary anterior teeth at different alveolar bone heights

XUE Jiaojiao, WANG Xiaoxu, FAN Mingyue()   

  1. Department of Orthodontics, Shanghai Xuhui District Stomatological Hospital, Shanghai 200032, China
  • Received:2024-10-08 Online:2025-09-28 Published:2025-09-11

摘要:

目的 通过三维有限元分析法,构建正常牙周以及轻度牙槽骨吸收的上颌骨-牙周膜-牙列三维有限元模型,研究不同加力模式下种植支抗辅助内收和压低上前牙的生物力学效应。方法 获取一名凸面型伴露龈笑患者的锥形束CT数据,使用Mimics、Geomagic、SolidWorks和Ansys软件构建微种植体支抗-直丝弓整体内收上颌前牙的三维有限元模型构建。根据牙槽骨高度以及后牙微种植支抗的植入高度,分为6个实验组。A1,A2和A3为牙周健康组,B1,B2和B3为轻度牙槽骨吸收组,后牙种植支抗位于第一磨牙与第二前磨牙之间,植入高度分别为4、6和8 mm,加载200 g内收力。前牙种植支抗位于中切牙与侧切牙之间,加载50 g压低力。对各组进行受力分析,比较前牙转矩的改变、运动趋势以及应力分布。结果 在不同加力模式下,轻度牙槽骨吸收组前牙转矩变化均大于健康牙周组;后牙微种植支抗植入高度不同,中切牙、侧切牙以及尖牙的表现存在差异;轻度牙槽骨吸收组前牙阻抗中心更偏向根方,在压低内收上前牙时,更易出现伸长和转矩丢失。结论 牙槽骨吸收组较正常牙周组前牙转矩更易失控,当后牙微种植支抗高度增加时,中切牙更趋向于整体移动,可以在一定程度上减轻“过山车”效应。

关键词: 三维有限元, 微种植支抗, 牙槽骨吸收, 生物力学

Abstract:

Objective To investigate the biomechanical effects of implant-anchored retraction and intrusion of maxillary anterior teeth under different force systems using three-dimensional finite element analysis (3D-FEA), by constructing models simulating both normal periodontium and mild alveolar bone resorption. Methods Cone-beam computed tomography (CBCT) data from a patient with skeletal protrusion and gummy smile was utilized. 3D finite element models integrating micro-implants anchorage(MIA) and a straight-wire appliance for en-mass retraction of maxillary anterior teeth were established using Mimics, Geomagic, SolidWorks, and Ansys software. Six experimental groups were designed based on alveolar bone height and vertical positioning of posterior MIA. Groups A1, A2, A3:Normal alveolar bone height. Groups B1, B2, B3: Mild alveolar bone resorption. Posterior MIA were placed between the first molar and second premolar at vertical heights of 4, 6, and 8 mm (relative to the cementoenamel junction), respectively, each loaded with 200 g retraction force. Anterior MIA between the central and lateral incisors delivered 50 g intrusion force. Stress distribution, anterior tooth displacement patterns, and torque changes were analyzed and compared across all groups. Results Under varying force conditions, greater torque loss was observed in the anterior teeth of the mild alveolar bone resorption group compared to the periodontally healthy group. Differential displacement patterns emerged among central incisors, lateral incisors, and canines when posterior MIA were placed at different vertical heights. The center of resistance in the resorption group shifted apically, resulting in undesirable extrusion and compromised torque control during intrusion-retraction of maxillary anterior teeth. Conclusion Anterior torque control is more challenging in the alveolar bone resorption group than in the periodontally normal group. Elevating posterior MIA height promotes bodily movement of central incisors, thereby mitigating the "bowing effect" to a clinically relevant extent.

Key words: finite element analysis(FEA), micro-implant anchorage(MIA), alveolar bone resorption, biomechanics

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