正畸力内收前牙对牙槽骨吸收程度不同后牙的影响
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摘要
目的通过有限元法模拟不同程度的后牙牙槽骨吸收状态,分析骨吸收情况下的牙周应力分布和总位移趋势,以便为临床施加合适的矫治力提供指导。方法在建立正常牙槽骨高度(1号模型)的基础上,通过删减单元格获得后牙牙槽骨高度水平均衡降低2、4、6 mm的2、3、4号模型;在各模型上进行模拟加载,加载力1.47 N,分析在施加矫治力的情况下,各模型后牙组牙的牙周膜初应力及牙齿初始总位移的分布情况。结果随着牙槽骨高度的降低,后牙组牙总位移增加,牙周膜Von Mises应力逐渐增大,当牙槽骨吸收达4 mm时,应力值和牙齿初始总位移值明显增加。结论对于伴有牙槽骨丧失的患者,应当避免受力或显著减小受力,避免造成牙周组织不可逆的损伤和牙根、牙槽骨的持续吸收。
Objective This study applied the direct orthodontic force system to explore the applicability of the finite element method in the simulation of alveolar bone absorption and analyze periodontal stress distribution and the overall displacement trend. Methods The horizontal balanced alveolar bones of model 2, 3 and 4 were reduced by 2, 4, and 6 mm by deleting elements in reference to the established height of the normal alveolar bone model 1. Then, stress distribution on the posterior set of teeth and initial total tooth displacement under the simulated load of 1.47 N of orthodontic force were investigated.Results The total displacement of posterior teeth increased and parodontium Von Mises stress gradually increased as the alveolar bone height decreased. The total displacement trend and parodontium stress drastically increased when alveolar bone absorp tion reached the height of 4 mm. Conclusion When treating patients with alveolar bone loss, stress should be avoided or drasti cally reduced to prevent irreversible damage to periodontal tissue and to improve the quality of medical treatment.
Objective This study applied the direct orthodontic force system to explore the applicability of the finite element method in the simulation of alveolar bone absorption and analyze periodontal stress distribution and the overall displacement trend. Methods The horizontal balanced alveolar bones of model 2, 3 and 4 were reduced by 2, 4, and 6 mm by deleting elements in reference to the established height of the normal alveolar bone model 1. Then, stress distribution on the posterior set of teeth and initial total tooth displacement under the simulated load of 1.47 N of orthodontic force were investigated.Results The total displacement of posterior teeth increased and parodontium Von Mises stress gradually increased as the alveolar bone height decreased. The total displacement trend and parodontium stress drastically increased when alveolar bone absorp tion reached the height of 4 mm. Conclusion When treating patients with alveolar bone loss, stress should be avoided or drasti cally reduced to prevent irreversible damage to periodontal tissue and to improve the quality of medical treatment.
引文
[1]Cattaneo PM, Dalstra M, Melsen B. The transfer of occlusal forces through the maxillary molars:a finite element study[J]. Am J Orthod Dentofacial Orthop, 2003, 123(4):367-373.
[2]TanneKZ,SakudaM,BurstoneCJ. Three-dimensional finite element analysis for stress in the periodontal tissue by orthodontic forces[J]. Am J Orthod Dentofacial Orthop,1987, 92(6):499-505.
[3]Jeon PD, Turley PK, Ting K. Three-dimensional finite element analysis of stress in the periodontal ligament of the maxillary first molar with simulated bone loss[J]. Am J Orthod Dentofacial Orthop, 2001, 119(5):498-504.
[4]金晶.微种植体支抗整体内收及压低上颌前牙的三维有限元分析[D].西安:第四军医大学, 2015:1-55.JinJ. Afiniteelementanalysisofen-massretractionof maxillary anterior teeth with vertical traction[D]. Xi’an:The Fourth Military Medical University, 2015:1-55.
[5]Sung EH, Kim SJ, Chun YS, et al. Distalization pattern of whole maxillary dentition according to force application points[J]. Korean J Orthod, 2015, 45(1):20-28.
[6]Jiang W, Bo H, Yongchun G, et al. Stress distribution in molars restored with inlays or onlays with or without endodontic treatment:a three-dimensional finite element analysis[J]. J Prosthet Dent, 2010, 103(1):6-12.
[7]Ammar HH, Ngan P, Crout RJ, et al. Three-dimensional modeling and finite element analysis in treatment planning for orthodontic tooth movement[J]. Am J Orthod Dentofacial Orthop, 2011, 139(1):e59-e71.
[8]Chatzigianni A, Keilig L, Duschner H, et al. Comparative analysis of numerical and experimental data of orthodontic mini-implants[J]. Eur J Orthod, 2011, 33(5):468-475.
[9]Yoshida N, Koga Y, Peng CL, et al. In vivo measurement of the elastic modulus of the human periodontal ligament[J].Med Eng Phys, 2001, 23(8):567-572.
[10]吕晶晶,米丛波.牙周膜的生物力学性能[J].国际口腔医学杂志, 2014, 41(3):362-364.LüJJ, Mi CB. Research progress on biomechanics of periodontal ligament[J]. Int J Stomatol, 2014, 41(3):362-364.
[11]Geramy A. Initial stress produced in the periodontal membrane by orthodontic loads in the presence of varying loss of alveolar bone:a three-dimensional finite element analysis[J]. Eur J Orthod, 2002, 24(1):21-33.
[12]陈凤山,杨陆一,梁傥.矫治力作用于不同高度牙槽骨其牙周组织的应力分析[J].口腔正畸学, 1999, 6(3):106-108.Chen FS, Yang LY, Liang T. The orthodontic force was used to analyze the stress of periodontal tissue of alveolar bone with different height[J]. Chin J Orthod, 1999, 6(3):106-108.
[13]李世清,舒昶.材料力学[M].重庆:重庆大学出版社, 1998:124-156.Li SQ, Shu C. Mechanics of materials[M]. Chongqing:Chongqing University Press, 1998:124-156.
[14]傅晓峰,王林,浦广益.不同牙槽骨高度条件下上颌牙列牙周组织应力分布的三维有限元分析[J].口腔医学, 2006,26(6):434-436.Fu XF, Wang L, Pu GY. Three-dimensional finite element analyses of stress distribution on periodontal tissue of maxillary dentition under various alveolar bone altitude conditions[J]. Stomatology, 2006, 26(6):434-436.
[15]Lee BW. Relationship between tooth-movement rate and estimated pressure applied[J]. J Dent Res, 1965, 44(5):1053.
[16]钟先瑜,徐佳蕊,张理红.牙周吸收情况下上颌切牙的三维有限元分析[J].广东牙病防治, 2015, 23(12):647-650.Zhong XY, Xu JR, Zhang LH. Three dimensional finite element analysis of upper incisors under reduced perio dontal supporting[J]. J Dent Prev Treat, 2015, 23(12):647-650.
[2]TanneKZ,SakudaM,BurstoneCJ. Three-dimensional finite element analysis for stress in the periodontal tissue by orthodontic forces[J]. Am J Orthod Dentofacial Orthop,1987, 92(6):499-505.
[3]Jeon PD, Turley PK, Ting K. Three-dimensional finite element analysis of stress in the periodontal ligament of the maxillary first molar with simulated bone loss[J]. Am J Orthod Dentofacial Orthop, 2001, 119(5):498-504.
[4]金晶.微种植体支抗整体内收及压低上颌前牙的三维有限元分析[D].西安:第四军医大学, 2015:1-55.JinJ. Afiniteelementanalysisofen-massretractionof maxillary anterior teeth with vertical traction[D]. Xi’an:The Fourth Military Medical University, 2015:1-55.
[5]Sung EH, Kim SJ, Chun YS, et al. Distalization pattern of whole maxillary dentition according to force application points[J]. Korean J Orthod, 2015, 45(1):20-28.
[6]Jiang W, Bo H, Yongchun G, et al. Stress distribution in molars restored with inlays or onlays with or without endodontic treatment:a three-dimensional finite element analysis[J]. J Prosthet Dent, 2010, 103(1):6-12.
[7]Ammar HH, Ngan P, Crout RJ, et al. Three-dimensional modeling and finite element analysis in treatment planning for orthodontic tooth movement[J]. Am J Orthod Dentofacial Orthop, 2011, 139(1):e59-e71.
[8]Chatzigianni A, Keilig L, Duschner H, et al. Comparative analysis of numerical and experimental data of orthodontic mini-implants[J]. Eur J Orthod, 2011, 33(5):468-475.
[9]Yoshida N, Koga Y, Peng CL, et al. In vivo measurement of the elastic modulus of the human periodontal ligament[J].Med Eng Phys, 2001, 23(8):567-572.
[10]吕晶晶,米丛波.牙周膜的生物力学性能[J].国际口腔医学杂志, 2014, 41(3):362-364.LüJJ, Mi CB. Research progress on biomechanics of periodontal ligament[J]. Int J Stomatol, 2014, 41(3):362-364.
[11]Geramy A. Initial stress produced in the periodontal membrane by orthodontic loads in the presence of varying loss of alveolar bone:a three-dimensional finite element analysis[J]. Eur J Orthod, 2002, 24(1):21-33.
[12]陈凤山,杨陆一,梁傥.矫治力作用于不同高度牙槽骨其牙周组织的应力分析[J].口腔正畸学, 1999, 6(3):106-108.Chen FS, Yang LY, Liang T. The orthodontic force was used to analyze the stress of periodontal tissue of alveolar bone with different height[J]. Chin J Orthod, 1999, 6(3):106-108.
[13]李世清,舒昶.材料力学[M].重庆:重庆大学出版社, 1998:124-156.Li SQ, Shu C. Mechanics of materials[M]. Chongqing:Chongqing University Press, 1998:124-156.
[14]傅晓峰,王林,浦广益.不同牙槽骨高度条件下上颌牙列牙周组织应力分布的三维有限元分析[J].口腔医学, 2006,26(6):434-436.Fu XF, Wang L, Pu GY. Three-dimensional finite element analyses of stress distribution on periodontal tissue of maxillary dentition under various alveolar bone altitude conditions[J]. Stomatology, 2006, 26(6):434-436.
[15]Lee BW. Relationship between tooth-movement rate and estimated pressure applied[J]. J Dent Res, 1965, 44(5):1053.
[16]钟先瑜,徐佳蕊,张理红.牙周吸收情况下上颌切牙的三维有限元分析[J].广东牙病防治, 2015, 23(12):647-650.Zhong XY, Xu JR, Zhang LH. Three dimensional finite element analysis of upper incisors under reduced perio dontal supporting[J]. J Dent Prev Treat, 2015, 23(12):647-650.