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3种不同类型Twin-block矫治器对前牙应力分布和位移的影响

The Impact of Three Different Types of Twin-Block on Stress Distribution and Displacement of Anterior Teeth
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摘要 目的 研究3种不同类型Twin-block矫治器对前牙、牙周膜及牙槽骨应力及位移的影响。方法 构建上下颌骨、关节盘、牙列及牙周膜的三维有限元模型。3组不同类型Twin-block矫治器的有限元模型分别为传统Twin-block矫治器、带切牙帽Twin-block矫治器、改良隐形Twin-block矫治器(clear twin-block aligner, CTBA)。所有类型矫治器的斜面角度均为70°,双侧分别加载200 N垂直于斜面的力。利用有限元方法分析前牙的应力分布与位移差异。结果 3种不同类型Twin-block矫治器均会导致上前牙舌倾及下前牙唇倾。CTBA组上前牙舌向位移及应力最大,最大应力为30.6 MPa,而下前牙唇向位移及应力最小,位移约为0.02 mm。同时CTBA组下前牙、牙周膜及牙槽骨所受等效应力在3组中最低,而传统Twin-block矫治器组最高。结论 在使用传统Twin-block矫治器治疗安氏Ⅱ类错[牙合]时,无论有无切牙帽,均会导致下前牙的唇倾;而与传统Twin-block矫治器相比,CTBA可减少对下前牙、牙槽骨、牙周膜应力和位移的影响,进而减小下前牙的牙周风险,但需注意上前牙舌向位移带来的舌倾效应。 Objective To investigate the effects of three types of twin-block(TB)appliances on the stress and displacement of anterior teeth,periodontal ligaments,and alveolar bone.Methods A three-dimensional(3D)finite element model was constructed,including maxillofacial bones,articular discs,teeth,and periodontal ligaments.Three types of twin-block appliances were designed:classic twin-block(classic-TB),twin-block with acrylic capping(capping-TB),and clear twin-block aligner(CTBA).All appliances had an inclination angle of 70°,and a masticatory force of 200 N was applied to their inclined planes.The finite element method was used to analyze the stress distribution and displacement differences of anterior teeth.Results All three types of TB appliances induced lingual tilting of maxillary anterior teeth and labial tilting of mandibular anterior teeth.The CTBA group showed the greatest lingual displacement and stress of maxillary anterior teeth,with a maximum stress of 30.6 MPa,while the mandibular anterior teeth in this group exhibited the smallest labial displacement(approximately 0.02 mm)and stress.Additionally,the CTBA group had the lowest compressive stress in mandibular anterior teeth,periodontal ligaments,and alveolar bone,whereas the classic-TB group had the highest.Conclusions In the treatment of Angle Class II malocclusion,classic-TB(with or without acrylic capping)causes labial inclination of mandibular anterior teeth.Compared with classic-TB,CTBA effectively reduces the compressive stress and displacement of mandibular anterior teeth,potentially minimizing adverse periodontal risks.However,attention should be paid to the lingual displacement of maxillary anterior teeth.
作者 李星雨 张春艳 李希贝 黄文莉 于少洋 杨文科 张映玥 郭骏 阎潇 张强 袁晓 LI Xingyu;ZHANG Chunyan;LI Xibei;HUANG Wenli;YU Shaoyang;YANG Wenke;ZHANG Yingyue;GUO Jun;YAN Xiao;ZHANG Qiang;YUAN Xiao(Department of Orthodontics,the Affiliated Hospital of Qingdao University,Qingdao 266003,Shandong,China;School of Stomatology,Qingdao University,Qingdao 266003,Shandong,China;Department of Stomatology,Qingdao Municipal Hospital,Qingdao 266000,Shandong,China)
出处 《医用生物力学》 北大核心 2025年第4期844-850,共7页 Journal of Medical Biomechanics
基金 国家自然科学基金项目(32171303) 山东省自然科学基金项目(ZR2019MH007)。
关键词 TWIN-BLOCK矫治器 功能矫治 隐形矫治器 安氏Ⅱ类错[牙合] 前牙 twin-block appliance functional orthodontic treatment clear aligners classⅡmalocclusion anterior teeth
作者简介 通信作者:袁晓,教授,博士生导师,E-mail:yuanxiaoqd@qdu.edu.cn。
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