【摘要】：目的:1、通過建立雙鑰匙曲內(nèi)收伴有牙槽骨喪失的上頜前牙的三維有限元模型,為本實(shí)驗(yàn)的后續(xù)生物力學(xué)分析奠定基礎(chǔ)。2、通過結(jié)扎雙鑰匙曲頂部使前牙段弓絲形變,探討不同程度形變的弓絲控制前牙轉(zhuǎn)矩的效能,并分析該力系系統(tǒng)對(duì)伴有不同程度牙槽骨喪失的前牙牙周膜的影響。方法:1、選擇一名個(gè)別正常牙合且牙周健康的志愿者,通過CBCT掃描獲得上頜骨及上牙列的數(shù)據(jù)信息,利用軟件調(diào)整閾值,提取牙頜各種組織結(jié)構(gòu)的數(shù)據(jù)從而構(gòu)建3D初步模型。經(jīng)Geomagic Studio軟件設(shè)定各組織材料屬性,并分別將牙槽骨降低0mm、1mm、2mm、3mm獲得伴有不同程度牙槽骨喪失的上頜前牙的三維有限元模型。2、結(jié)扎絲向遠(yuǎn)中加力打開遠(yuǎn)中曲,近遠(yuǎn)中鑰匙曲頂部結(jié)扎絲連扎,可使得前牙段弓絲平面與牙合平面成1°、3°、5°、7°,分別將弓絲作用于牙槽骨降低0mm、1mm、2mm、3mm的上頜骨和牙列的模型中,利用三維有限元法模擬整體內(nèi)收上頜前牙,分析前牙相對(duì)移動(dòng)趨勢(shì)及牙周膜應(yīng)力變化趨勢(shì)。結(jié)果:1、本研究建立的上頜骨、上頜全牙列、雙鑰匙曲三維有限模型精確度較高,幾何相似性好。2、前牙在雙鑰匙曲作用下均發(fā)生傾斜移動(dòng),尖牙傾斜度最大。3、近遠(yuǎn)中鑰匙曲頂部結(jié)扎加力越大,在各工況矢狀向上前牙牙冠舌傾趨勢(shì)均減弱,垂直向伸長相對(duì)位移量減少。4、沒有發(fā)生骨吸收的情況下,側(cè)切牙隨雙鑰匙曲形變程度增大而發(fā)生壓入運(yùn)動(dòng),其余工況,側(cè)切牙發(fā)生伸長移動(dòng)。5、尖牙在雙鑰匙曲內(nèi)收前牙時(shí),發(fā)生了扭轉(zhuǎn),且其三維方向上發(fā)生的相對(duì)位移在三個(gè)前牙中最大。6、隨著牙槽骨降低,相同加載力值下前牙牙冠及牙根運(yùn)動(dòng)趨勢(shì)均相應(yīng)增大,前牙伸長趨勢(shì)及根舌向轉(zhuǎn)矩運(yùn)動(dòng)趨勢(shì)增加,骨吸收1mm時(shí)尖牙牙周膜等效應(yīng)力達(dá)3.01E-02MPa,而骨吸收達(dá)3mm時(shí)側(cè)切牙處牙周膜等效應(yīng)力達(dá)3.41E-02MPa,均超過牙周膜生理極限。結(jié)論:1、作為連續(xù)唇弓,雙鑰匙曲產(chǎn)生的力影響牙弓每一顆牙,近遠(yuǎn)中鑰匙曲結(jié)扎加力,均能增加前牙整體內(nèi)收時(shí)牙冠唇向轉(zhuǎn)矩,加力的程度越大,冠唇向轉(zhuǎn)矩的趨勢(shì)也越明顯。轉(zhuǎn)矩增加的同時(shí),牙頸部牙周膜應(yīng)力增大。2、雙鑰匙曲對(duì)切牙的控制效果優(yōu)于尖牙。3、隨著牙槽骨降低,相同加載力值下的前牙牙冠及牙根運(yùn)動(dòng)趨勢(shì)相應(yīng)增大,前牙伸長趨勢(shì)及根舌向轉(zhuǎn)矩運(yùn)動(dòng)趨勢(shì)增加。牙槽骨降低一定程度時(shí),前牙牙周膜等效應(yīng)力超過生理極限,可能會(huì)引起牙周組織進(jìn)一步喪失。
[Abstract]:Objective: 1. To establish a three-dimensional finite element model of maxillary anterior teeth with alveolar bone loss in double key curvature, and to lay the foundation for further biomechanical analysis of the experiment. 2. To deform the arch wire of anterior segment by ligating the top of double key curve. To investigate the effect of different deformed arch wires on the torque control of anterior teeth, and to analyze the effect of the force system on the periodontal membrane of anterior teeth with different degrees of alveolar bone loss. Methods: 1. An individual volunteer with normal occlusion and periodontal health was selected, and the data of maxilla and upper dentition were obtained by CBCT scan, and the data of various tissue structures of dentin were extracted by software adjusting threshold to construct 3D preliminary model. The material properties of each tissue were set up by Geomagic Studio software, and the alveolar bone was reduced by 0 mm to 1 mm and 2 mm to 3 mm respectively to obtain the three-dimensional finite element model of maxillary anterior teeth with different degrees of alveolar bone loss. 2, the ligation wire was applied to the distal center to open the distal curve, and the three dimensional finite element model of the maxillary anterior teeth with different degrees of alveolar bone loss was obtained. The ligation of wire at the top of the proximal key bend can make the plane of anterior arch wire and occlusal plane become 1 擄, 3 擄, 5 擄and 7 擄respectively. The arch wire acts on the maxillary bone and dentition model with the alveolar bone reduced by 0 mm to 1 mm and 2 mm to 3 mm, respectively. The three-dimensional finite element method is used to simulate the whole maxillary anterior teeth. The relative movement trend of anterior teeth and the change trend of periodontal ligament stress were analyzed. Results: 1. The 3D finite model of maxilla, maxillary total dentition, double key curved 3D finite model established in this study has high accuracy and good geometric similarity. 2. The anterior teeth are inclined to move under the action of double key curvature. The canine inclination was the largest. 3. The greater the ligation force at the top of the proximal middle key curve, the lower the tendency of sagittal upward anterior crown and tongue inclination, the lower the relative displacement of vertical elongation, and the less bone resorption. The lateral incisors were pressed into the teeth with the increase of the deformation degree of the double keys. In other cases, the lateral incisors were elongated and moved. 5. When the canine teeth received the anterior teeth in the double key curvature, the torsion occurred. The relative displacement in the three dimensional direction was the largest in the three anterior teeth. 6. With the reduction of alveolar bone, the movement trend of the crown and root of the anterior teeth increased correspondingly under the same loading force, and the trend of the extension of the anterior teeth and the movement trend of the root tongue torque increased. When bone resorbed to 1mm, the isogenic force of periodontal membrane reached 3.01E-02MPa, while that of lateral incisor reached 3.41E-02MPa when bone resorption reached 3mm, which exceeded the physiological limit of periodontal ligament. Conclusion: 1. As a continuous labial arch, the force produced by double key curvature affects every tooth of dental arch, and the ligation force in the near and far distance can increase the crown lip torque when the whole anterior tooth is in adduction. The greater the degree of applied force is, the more obvious the trend of crown lip torque is. With the increase of torque, the stress of periodontal membrane in the neck of tooth increased. 2. The control effect of double key bend on incisor was better than that of canine. 3. With the decrease of alveolar bone, the movement trend of anterior crown and root increased with the same loading force. The trend of anterior tooth elongation and the movement of root tongue torque increased. When alveolar bone decreases to a certain extent, the effect force of anterior periodontal ligament exceeds the physiological limit, which may cause further loss of periodontal tissue.
【學(xué)位授予單位】：廣州醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R783.5

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