微種植體支抗遠(yuǎn)中移動下頜磨牙的三維有限元分析
發(fā)布時(shí)間：2019-06-26 15:33
【摘要】：目的：遠(yuǎn)移下頜磨牙是正畸矯治的一個(gè)重要方法。傳統(tǒng)正畸治療用組牙支抗推磨牙遠(yuǎn)移。近年來微種植體被廣泛應(yīng)用，，微種植體支抗也被應(yīng)用于遠(yuǎn)移下頜磨牙。本研究通過建立包含牙列、牙周膜、下頜骨、標(biāo)準(zhǔn)MBT直絲弓托槽、弓絲、微種植體的三維有限元模型，研究分析將微種植體植入不同位置、采用不同牙齒移動方式以及拔牙創(chuàng)不同愈合期遠(yuǎn)移下頜磨牙時(shí)牙齒所受應(yīng)力和初始位移情況，探討遠(yuǎn)移下頜磨牙的適宜方式，為臨床遠(yuǎn)中移動下頜磨牙提供生物力學(xué)參考。 方法：1.選擇一名牙列完整的健康女青年志愿者行頭顱螺旋CT掃描，利用有限元建模軟件建立包含牙列、牙周膜、下頜骨、標(biāo)準(zhǔn)MBT直絲弓托槽、弓絲、微種植體的三維有限元模型。2.在所建三維有限元模型上，設(shè)置三組工況。工況一在下頜第一與第二磨牙間直接置鎳鈦推簧，模擬鎳鈦推簧加載150g力，遠(yuǎn)移下頜第二磨牙；工況二在工況一的基礎(chǔ)上將同側(cè)中切牙至第一磨牙整體連扎；工況三在工況一的基礎(chǔ)上將微種植體植入于下頜第一與第二磨牙牙根間，微種植體與第一磨牙相連。觀察各支抗牙與第二磨牙應(yīng)力分布及初始位移情況。3.在所建三維有限元模型上，將微種植體植入于下頜第二前磨牙與第一磨牙牙根間，微種植體與第二前磨牙相連，第二前磨牙與第一磨牙間置鎳鈦推簧同時(shí)遠(yuǎn)移下頜第一與第二磨牙，模擬鎳鈦推簧分別加載150g、200g、250g、300g力，觀察支抗牙與磨牙應(yīng)力分布。4.將微種植體植入于雙側(cè)第二磨牙遠(yuǎn)中頰側(cè)，直接用鎳鈦拉簧牽拉雙側(cè)側(cè)切牙與尖牙間牽引鉤遠(yuǎn)移整個(gè)下頜牙列，模擬鎳鈦拉簧分別加載200g、300g、400g力。觀察微種植體、磨牙與各支抗牙應(yīng)力分布及初始位移情況。5.在所建三維有限元模型上，將微種植體植入于雙側(cè)第二磨牙遠(yuǎn)中頰側(cè)，直接牽拉遠(yuǎn)移下頜牙列。將一側(cè)第二磨牙遠(yuǎn)中設(shè)置為第三磨牙拔牙窩，將拔牙窩內(nèi)組織分別設(shè)置為肉芽組織、結(jié)締組織、不成熟骨組織、成熟骨組織，模擬拔牙創(chuàng)不同愈合期，觀察拔牙創(chuàng)不同愈合期遠(yuǎn)移下頜牙列時(shí)牙齒應(yīng)力分布及初始位移情況。 結(jié)果：1.建立了精確度較高的，包含牙列、牙周膜、下頜骨、標(biāo)準(zhǔn)MBT直絲弓托槽、弓絲、微種植體的三維有限元模型。2.三種工況下頜第二磨牙牙周膜最大Von-mises應(yīng)力值分別為24.03kPa、24.03kPa、23.75kPa、低于牙周膜可承受的最大應(yīng)力水平26kPa。工況二支抗牙牙周膜Von-mises應(yīng)力值、牙齒Von-mises應(yīng)力值及初始位移值都比工況一減小，但相差不大。工況三較工況一第二磨牙初始位移值增大，第一磨牙牙周膜最大Von-mises應(yīng)力值增大，近中向傾斜趨勢增大，其余支抗牙牙周膜Von-mises應(yīng)力值、牙齒Von-mises應(yīng)力值與初始位移值均明顯減小。3.隨著加載力值的增加，牙周膜Von-mises應(yīng)力值呈現(xiàn)逐漸上升趨勢。當(dāng)加載300g時(shí)，第二前磨牙與第一磨牙牙周膜最大Von-mises應(yīng)力值分別為27.85kPa、28.01kPa，均超過26kPa；加載250g力時(shí)，第二前磨牙與第一磨牙牙周膜最大Von-mises應(yīng)力值分別為23.21kPa、23.34kPa，均未超過26kPa。4.當(dāng)加載400g力時(shí)，側(cè)切牙與尖牙牙周膜最大Von-mises應(yīng)力值分別為27.50kPa、20.67kPa，側(cè)切牙牙周膜最大Von-mises應(yīng)力值超過26kPa；加載300g力時(shí)，側(cè)切牙與尖牙牙周膜最大Von-mises應(yīng)力值分別為20.62kPa、15.50kPa，均未超過26kPa。下頜第二磨牙在受150g推力后，遠(yuǎn)中傾斜伴舌向旋轉(zhuǎn)運(yùn)動；下頜第一與第二磨牙在受250g推力后，遠(yuǎn)中傾斜運(yùn)動。下頜牙列在受300g拉力遠(yuǎn)移后，第一磨牙接近整體遠(yuǎn)移、第二磨牙遠(yuǎn)中傾斜趨勢減小。這三種工況微種植體最大初始位移值分別為0.27um、0.35um和0.46um，微種植體骨界面皮質(zhì)骨最大Von-mises應(yīng)力值分別為3.41GPa、6.07GPa和14.69GPa。5.在拔牙創(chuàng)不同愈合期遠(yuǎn)移下頜牙列，牙周膜Von-mises應(yīng)力值均低于26kPa。早期移動牙齒位移有增大的趨勢，且相比前牙，磨牙最大初始位移值增大幅度較大。 結(jié)論:1.在推下頜第二磨牙遠(yuǎn)移時(shí)，將支抗牙“8”字整體結(jié)扎并未能明顯增強(qiáng)支抗，微種植體間接支抗能夠有效的增強(qiáng)支抗，但支抗牙仍向近中移動，仍有支抗丟失。2.250g力為同時(shí)遠(yuǎn)移下頜第一與第二磨牙的適宜力值。3.300g力為遠(yuǎn)移整個(gè)下頜牙列的適宜力值。4.當(dāng)需要遠(yuǎn)移多顆牙齒時(shí)，成組牙齒移動較逐個(gè)牙齒移動有利于磨牙整體移動，有利于縮短矯治時(shí)間。5.可以考慮在下頜第三磨牙拔牙創(chuàng)愈合早期遠(yuǎn)移下頜牙列。
[Abstract]:Objective: To remove the mandibular molar is an important method of orthodontic treatment. In the traditional orthodontic treatment, the anti-thrust molar is far removed. Microimplant has been widely used in recent years, and the anti-implant of micro-implant is also applied to the long-distance mandibular molar. The three-dimensional finite element model of the dental arch, the periodontal ligament, the mandible, the standard MBT straight wire, the archwire and the micro-implant was established, and the micro-implant was implanted into different positions. In order to provide the biomechanics reference for the movement of the mandibular molar in the clinic, the proper way to move the lower molar is discussed by using the different tooth movement methods and the stress and initial displacement of the teeth in the different healing period of the tooth extraction. Method: 1. The three-dimensional finite element model of the tooth column, the periodontal ligament, the mandible, the standard MBT straight-wire archwire bracket, the arch wire and the micro-implant was established by using the finite element modeling software. 2. On the three-dimensional finite element model, set the three-group work in that condition, a nickel-titanium push-spring is directly arranged between the first and the second molar of the mandibular first and the second molar, the simulated nickel-titanium push-spring is used for loading 150g of force, and the second molar of the lower jaw is far removed; the working condition 2, on the basis of the working condition 1, And the micro-implant is implanted between the first and the second molar roots of the lower jaw and the micro-implant and the first molar phase on the basis of the working condition 3 under the working condition 1. The stress distribution and initial displacement of each bearing and the second molar were observed. 3. on the three-dimensional finite element model, the micro-implant is implanted between the second premolar and the first molar root of the lower jaw, the micro-implant is connected with the second premolar, the second premolar and the first molar are arranged between the second premolar and the first molar, 150 g,200 g,250 g, and 300 g of the Ni-Ti push-spring were loaded to observe the stress distribution of the teeth and the molar. 4. The micro-implant is implanted on the distal buccal side of the bilateral second molar, and the bilateral side incisor and the interdental traction hook are directly pulled by the nickel-titanium tension spring to move the whole lower jaw row, and the simulated nickel-titanium tension spring is respectively loaded with 200g, 300g, 400g, Force. Observe the stress distribution and initial displacement of micro-implant, bruxism and each branch. 5. On the three-dimensional finite element model, the micro-implant was implanted on the distal buccal side of the bilateral second molar, and the submandibular tooth was pulled directly. and the tooth extraction socket inner tissue is respectively arranged as a granulation tissue, a connective tissue, an immature bone tissue, a mature bone tissue, a simulated tooth extraction and a different healing, The stress distribution and initial displacement of the teeth in the submandibular teeth during the different healing period of the tooth extraction condition Fruit:1. The three-dimensional finite element model with higher precision, including the dentition, the periodontal ligament, the mandible, the standard MBT straight-wire archwire bracket, the arch wire and the micro-implant 2. The maximum Von-mises stress of the second molar in the mandibular second molar was 24.03 kPa, 24.03 kPa, 23.75kPa, and the maximum stress level of the periodontal ligament was lower than that of the periodontal ligament. Under the condition of kPa, the stress value of the Von-mises stress and the initial displacement of the tooth Von-mises stress value and the initial displacement are reduced in comparison with the working condition, but the phase The initial displacement value of the second molar increased, the maximum Von-mises stress value of the first molar was increased, and the value of the Von-mises stress and the value of the Von-mises stress and the initial displacement of the tooth were significantly reduced. 3. The Von-mises stress value of the periodontal ligament is gradually increased with the increase of the loading force value. The maximum Von-mises stress values of the second premolar and the first molar were 27.85 kPa and 28.01 kPa, respectively. The maximum Von-mises stress values of the second premolar and the first molar were 23.21 kPa, 23.34 kPa, no more than 26 kP when the 300g was loaded. A.4. When 400 g of force was loaded, the maximum Von-mises stress value of the side incisor and the apical periodontal ligament was 27.50 kPa, 20.67 kPa, the maximum Von-mises stress value of the side incisor periodontal ligament was more than 26 kPa, and the maximum Von-mises stress value of the side incisor and the apical periodontal ligament was 20.62 kPa and 15.50 kPa, respectively, when the 300 g force was applied, and no more than 26. KPa. The second molar of the lower jaw is inclined with the tongue in the distal direction after receiving 150 g of thrust, and the first and second molars of the lower jaw are in the distal direction after receiving the thrust of 250 g. The first molar approach the whole distal movement and the second molar is inclined toward the distal direction after the 300 g of the pulling force is far removed. The maximum initial displacement of the micro-implant was 0.27 um, 0.35um and 0.46 um, respectively. The maximum Von-mises stress value of the micro-implant bone interface was 3.41 GPa, 6.07 GPa and 14.69 GP respectively. A.5. The stress values of the Von-mises of the periodontal membrane were lower than 26 during the different healing period of the tooth extraction. KPa. The early movement of the teeth has a tendency to increase, and the maximum initial displacement of the molar in comparison with the anterior teeth is increased substantially. The degree is large. Conclusion:1. When the second molar of the mandibular second molar is far removed, the whole ligation of the anti-dental "8" is not obviously enhanced, the indirect anchorage of the micro-implant can be effectively enhanced, but the anti-tooth still 2.250 g is the appropriate force to move the mandibular first and second molar at the same time. Good value.4. When a long distance of multiple teeth is required, the movement of the group of teeth is in favor of the whole movement of the molar, which is beneficial to the shortening of the straightening force. Treatment time.5. It can be considered in the early part of the third molar extraction of the mandibular third molar.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.6
本文編號：2506288
[Abstract]:Objective: To remove the mandibular molar is an important method of orthodontic treatment. In the traditional orthodontic treatment, the anti-thrust molar is far removed. Microimplant has been widely used in recent years, and the anti-implant of micro-implant is also applied to the long-distance mandibular molar. The three-dimensional finite element model of the dental arch, the periodontal ligament, the mandible, the standard MBT straight wire, the archwire and the micro-implant was established, and the micro-implant was implanted into different positions. In order to provide the biomechanics reference for the movement of the mandibular molar in the clinic, the proper way to move the lower molar is discussed by using the different tooth movement methods and the stress and initial displacement of the teeth in the different healing period of the tooth extraction. Method: 1. The three-dimensional finite element model of the tooth column, the periodontal ligament, the mandible, the standard MBT straight-wire archwire bracket, the arch wire and the micro-implant was established by using the finite element modeling software. 2. On the three-dimensional finite element model, set the three-group work in that condition, a nickel-titanium push-spring is directly arranged between the first and the second molar of the mandibular first and the second molar, the simulated nickel-titanium push-spring is used for loading 150g of force, and the second molar of the lower jaw is far removed; the working condition 2, on the basis of the working condition 1, And the micro-implant is implanted between the first and the second molar roots of the lower jaw and the micro-implant and the first molar phase on the basis of the working condition 3 under the working condition 1. The stress distribution and initial displacement of each bearing and the second molar were observed. 3. on the three-dimensional finite element model, the micro-implant is implanted between the second premolar and the first molar root of the lower jaw, the micro-implant is connected with the second premolar, the second premolar and the first molar are arranged between the second premolar and the first molar, 150 g,200 g,250 g, and 300 g of the Ni-Ti push-spring were loaded to observe the stress distribution of the teeth and the molar. 4. The micro-implant is implanted on the distal buccal side of the bilateral second molar, and the bilateral side incisor and the interdental traction hook are directly pulled by the nickel-titanium tension spring to move the whole lower jaw row, and the simulated nickel-titanium tension spring is respectively loaded with 200g, 300g, 400g, Force. Observe the stress distribution and initial displacement of micro-implant, bruxism and each branch. 5. On the three-dimensional finite element model, the micro-implant was implanted on the distal buccal side of the bilateral second molar, and the submandibular tooth was pulled directly. and the tooth extraction socket inner tissue is respectively arranged as a granulation tissue, a connective tissue, an immature bone tissue, a mature bone tissue, a simulated tooth extraction and a different healing, The stress distribution and initial displacement of the teeth in the submandibular teeth during the different healing period of the tooth extraction condition Fruit:1. The three-dimensional finite element model with higher precision, including the dentition, the periodontal ligament, the mandible, the standard MBT straight-wire archwire bracket, the arch wire and the micro-implant 2. The maximum Von-mises stress of the second molar in the mandibular second molar was 24.03 kPa, 24.03 kPa, 23.75kPa, and the maximum stress level of the periodontal ligament was lower than that of the periodontal ligament. Under the condition of kPa, the stress value of the Von-mises stress and the initial displacement of the tooth Von-mises stress value and the initial displacement are reduced in comparison with the working condition, but the phase The initial displacement value of the second molar increased, the maximum Von-mises stress value of the first molar was increased, and the value of the Von-mises stress and the value of the Von-mises stress and the initial displacement of the tooth were significantly reduced. 3. The Von-mises stress value of the periodontal ligament is gradually increased with the increase of the loading force value. The maximum Von-mises stress values of the second premolar and the first molar were 27.85 kPa and 28.01 kPa, respectively. The maximum Von-mises stress values of the second premolar and the first molar were 23.21 kPa, 23.34 kPa, no more than 26 kP when the 300g was loaded. A.4. When 400 g of force was loaded, the maximum Von-mises stress value of the side incisor and the apical periodontal ligament was 27.50 kPa, 20.67 kPa, the maximum Von-mises stress value of the side incisor periodontal ligament was more than 26 kPa, and the maximum Von-mises stress value of the side incisor and the apical periodontal ligament was 20.62 kPa and 15.50 kPa, respectively, when the 300 g force was applied, and no more than 26. KPa. The second molar of the lower jaw is inclined with the tongue in the distal direction after receiving 150 g of thrust, and the first and second molars of the lower jaw are in the distal direction after receiving the thrust of 250 g. The first molar approach the whole distal movement and the second molar is inclined toward the distal direction after the 300 g of the pulling force is far removed. The maximum initial displacement of the micro-implant was 0.27 um, 0.35um and 0.46 um, respectively. The maximum Von-mises stress value of the micro-implant bone interface was 3.41 GPa, 6.07 GPa and 14.69 GP respectively. A.5. The stress values of the Von-mises of the periodontal membrane were lower than 26 during the different healing period of the tooth extraction. KPa. The early movement of the teeth has a tendency to increase, and the maximum initial displacement of the molar in comparison with the anterior teeth is increased substantially. The degree is large. Conclusion:1. When the second molar of the mandibular second molar is far removed, the whole ligation of the anti-dental "8" is not obviously enhanced, the indirect anchorage of the micro-implant can be effectively enhanced, but the anti-tooth still 2.250 g is the appropriate force to move the mandibular first and second molar at the same time. Good value.4. When a long distance of multiple teeth is required, the movement of the group of teeth is in favor of the whole movement of the molar, which is beneficial to the shortening of the straightening force. Treatment time.5. It can be considered in the early part of the third molar extraction of the mandibular third molar.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R783.6
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 吳忠榮,葉翁三杰,劉平先;鄰面去釉在口腔正畸中的應(yīng)用[J];廣東牙病防治;2000年02期
2 張新宇;翦新春;;自攻型微螺釘遠(yuǎn)中移動下頜磨牙的臨床運(yùn)用[J];廣東牙病防治;2010年10期
3 魏惺;趙立星;許楨睿;唐娜;趙志河;;關(guān)于中國人正畸支抗用微種植釘牙槽骨植入安全區(qū)的研究[J];國際口腔醫(yī)學(xué)雜志;2010年02期
4 袁曉,羅頌椒,沈剛,陳振琦,朱慶黨;鄰牙向拔牙區(qū)移動最佳時(shí)機(jī)選擇的實(shí)驗(yàn)研究[J];華西口腔醫(yī)學(xué)雜志;2003年04期
5 王穎;熊國平;汪麟;;拔牙創(chuàng)愈合對正畸牙移動的影響[J];華西口腔醫(yī)學(xué)雜志;2006年03期
6 周潔;唐國華;;下頜第二磨牙阻生的病因及治療方法[J];口腔材料器械雜志;2009年04期
7 趙計(jì)林,劉月華,陳揚(yáng)熙;下牙弓后段可用間隙與下后牙槽高度關(guān)系研究[J];口腔正畸學(xué);2002年03期
8 姜世同,王作君,田洪深,鐘明紅,張盧瑞;雙軌式磨牙遠(yuǎn)移器矯治牙列擁擠[J];口腔醫(yī)學(xué);2004年03期
9 蔡思嘉;易新;張揚(yáng);;成人下頜第三磨牙與下前牙擁擠的相關(guān)性研究[J];口腔醫(yī)學(xué);2012年01期
10 張棟梁,王銳,李業(yè)東;應(yīng)用Tip-back裝置直立后牙的臨床研究[J];口腔醫(yī)學(xué)研究;2004年06期
本文編號：2506288
本文鏈接：http://sikaile.net/yixuelunwen/kouq/2506288.html
最近更新
教材專著
