Biomechanical effects of different staging and attachment designs in maxillary molar distalization with clear aligner: a finite element study.

IF 4.8 2区 医学 Q1 Dentistry
Jie Gao, Donghui Guo, Xu Zhang, Yuxun Cheng, Hao Zhang, Yuerong Xu, Zuolin Jin, Yanning Ma
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Abstract

Background: In the present study, the effects of distalizations of one and two molars with different step distances and attachment designs have been analyzed.

Methods: A 3D finite element analysis model has been developed in order to determine the tendency of tooth displacement and stress distribution with clear aligner treatment.

Results: Under the condition of single-molar distalization, when the step distance was set to 0.25 mm, the total displacement was 0.086 mm for central incisors, 0.080 mm for lateral incisors, 0.084 mm for canines, 0.102 mm for the first premolar and 0.076 mm for the second premolar. The von Mises stress of roots and the principal stress of the periodontal ligament was slightly lower than in the control group when the step distance was set to 0.130 mm. Under the condition of two-molar distalization, when the step distance was set to 0.130 mm, the total displacements for central incisors, lateral incisors and canines as well as both the first and second maxillary molars were basically the same as with a distance of 0.250 mm for one-molar distalization. In addition, when the step distance was 0.130 mm with two-molar distalization, the rotation center of the first and second molar was closer to the apex of the root indicating that the smaller step distance led to more bodily movement during the two-molar distalization. However, displacement tendencies of the first molar and the second molar were basically the same whether horizontal or vertical rectangular attachments were added.

Conclusions: A step distance of moving two molars to 0.130 mm can achieve the same reaction force on the anterior teeth as moving one molar 0.250 mm without effects on horizontal or vertical rectangular attachments.

Clinical relevance: Our results provide a theoretical basis and guidance for simultaneously moving two molars backward in clinical practice using a clear aligner.

不同阶段和附着体设计对上颌磨牙远端清除矫正器的生物力学影响:有限元研究。
背景:本研究分析了不同步距和附着体设计对单磨牙和双磨牙离体的影响。方法:建立三维有限元分析模型,以确定牙体位移和应力分布的趋势。结果:在单磨牙远端条件下,当步距设置为0.25 mm时,中切牙位移量为0.086 mm,侧切牙位移量为0.080 mm,犬齿位移量为0.084 mm,第一前磨牙位移量为0.102 mm,第二前磨牙位移量为0.076 mm。当步距为0.130 mm时,牙根von Mises应力和牙周膜主应力均略低于对照组。在两磨牙远距条件下,当步距设置为0.130 mm时,中切牙、侧切牙、犬齿以及上颌第一、第二磨牙的总位移与一磨牙远距设置为0.250 mm时的总位移基本相同。此外,当两磨牙远端步距为0.130 mm时,第一磨牙和第二磨牙的旋转中心更靠近根尖,说明两磨牙远端步距越小,身体运动越多。然而,无论添加水平或垂直矩形附着体,第一磨牙和第二磨牙的位移趋势基本相同。结论:移动2颗磨牙至0.130 mm的步距与移动1颗磨牙至0.250 mm的步距对前牙的反作用力相同,且不影响水平或垂直矩形附着体。临床意义:我们的结果为临床实践中使用透明矫正器同时向后移动两磨牙提供了理论依据和指导。
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来源期刊
Progress in Orthodontics
Progress in Orthodontics Dentistry-Orthodontics
CiteScore
7.30
自引率
4.20%
发文量
45
审稿时长
13 weeks
期刊介绍: Progress in Orthodontics is a fully open access, international journal owned by the Italian Society of Orthodontics and published under the brand SpringerOpen. The Society is currently covering all publication costs so there are no article processing charges for authors. It is a premier journal of international scope that fosters orthodontic research, including both basic research and development of innovative clinical techniques, with an emphasis on the following areas: • Mechanisms to improve orthodontics • Clinical studies and control animal studies • Orthodontics and genetics, genomics • Temporomandibular joint (TMJ) control clinical trials • Efficacy of orthodontic appliances and animal models • Systematic reviews and meta analyses • Mechanisms to speed orthodontic treatment Progress in Orthodontics will consider for publication only meritorious and original contributions. These may be: • Original articles reporting the findings of clinical trials, clinically relevant basic scientific investigations, or novel therapeutic or diagnostic systems • Review articles on current topics • Articles on novel techniques and clinical tools • Articles of contemporary interest
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