The displacement of teeth and stress distribution on periodontal ligament under different upper incisors proclination with clear aligner in cases of extraction: a finite element study.

IF 4.8 2区 医学 Q1 Dentistry Progress in Orthodontics Pub Date : 2023-11-20 DOI:10.1186/s40510-023-00491-2
Fujia Kang, Yumiao Wu, Yuchen Cui, Jiamin Yuan, Zhiqiang Hu, Xianchun Zhu
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Abstract

Objectives: To investigate the displacement of dentition and stress distribution on periodontal ligament (PDL) during retraction and intrusion of anterior teeth under different proclination of incisors using clear aligner (CA) in cases involving extraction of the first premolars.

Methods: Models were constructed, consisting of the maxilla, PDLs, CA and maxillary dentition without first premolars. These models were then imported to finite element analysis (FEA) software. The incisor proclination determined the division of the models into three groups: Small torque (ST) with U1-SN = 100°, Middle torque (MT) with U1-SN = 110°, and High torque (HT) with U1-SN = 120°. Following space closure, a 200 g intrusion force was applied at angles of 60°, 70°, 80°, and 90° to the occlusal plane, respectively.

Results: CA therapy caused lingual tipping and extrusion of incisors, mesial tipping and intrusion of canines, and mesial tipping of posterior teeth in each group. As the proclination of incisors increased, the incisors presented more extrusion and minor retraction, and the teeth from the canine to the second molar displayed an increased tendency of intrusion. The peak Von Mises equivalent stress (VMES) value successively decreased from the central incisor to the canine and from the second premolar to the second molar, and the VMES of the second molar was the lowest among the three groups. When the angle between the intrusion force and occlusal plane got larger, the incisors exhibited greater intrusion but minor retraction.

Conclusions: The "roller coaster effect" usually occurred in cases involving premolar extraction with CA, especially in patients with protruded incisors. The force closer to the vertical direction were more effective in achieving incisor intrusion. The stress on PDLs mainly concentrated on the cervix and apex of incisors during the retraction process, indicating a possibility of root resorption.

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不同上切牙前倾时牙体位移及牙周韧带应力分布的有限元研究。
目的:研究在不同前牙前倾情况下,使用CA矫正器(clear aligner, CA)拔除第一前磨牙时,前牙收缩时牙列位移及牙周韧带应力分布情况。方法:建立上颌牙列、前牙列、前牙列和不含第一前磨牙的上颌牙列模型。然后将这些模型导入到有限元分析软件中。切牙的前倾决定了模型分为三组:小扭矩(ST), U1-SN = 100°,中扭矩(MT), U1-SN = 110°,高扭矩(HT), U1-SN = 120°。封闭空间后,分别在咬合面60°、70°、80°和90°角度施加200 g的侵入力。结果:CA治疗引起各组切牙舌尖和牙外突,犬齿近端尖和牙内突,后牙近端尖。随着切牙前倾的增加,切牙呈现出更多的挤压和轻微的内缩,从犬齿到第二磨牙的牙齿呈现出增加的侵入趋势。Von Mises等效应力(VMES)峰值从中切牙到犬齿依次递减,从第二前磨牙到第二磨牙依次递减,其中第二磨牙的VMES最低。压入力与咬合平面夹角越大,切牙压入程度越大,后缩程度越小。结论:前磨牙CA拔牙常发生“过山车效应”,尤其是门牙突出的患者。靠近垂直方向的力对切牙的侵入效果更好。在后缩过程中,对pdl的应力主要集中在切牙的子宫颈和尖端,表明牙根有吸收的可能。
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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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