不同牙槽骨高度的磨牙压低时牙周膜应力分析

上海口腔医学 ›› 2013, Vol. 22 ›› Issue (3): 247-251.

不同牙槽骨高度的磨牙压低时牙周膜应力分析

王晖¹，吴建勇²，周铨³，刘剑²

(1.杭州口腔医院正畸中心，浙江杭州 310006；2.南昌大学医学院附属口腔医院正畸科，江西南昌 330006；3.杭州口腔医院牙周科，浙江杭州 310006)

收稿日期:2012-12-13 修回日期:2013-01-22 出版日期:2013-06-10 发布日期:2013-06-10
通讯作者: 吴建勇， E-mail：wjyyrx@163.com
作者简介:王晖(1978-)，男，硕士，主治医师，E-mail：wangh78@foxmail.com
基金资助:
江西省自然科学基金(0540091)

Initial stress in the periodontal membrane of maxillary first molar with different alveolar bone height by intrusion: 3-dimensional finite element analysis

WANG Hui¹, WU Jian-Yong², ZHOU Quan³, LIU Jian²

1.Department of Orthodontics, Hangzhou Stomatological Hospital. Hangzhou 310006, Zhejiang Province; 2.Department of Orthodontics, Affiliated Stomatological Hospital of Nanchang University. Nanchang 330006, Jiangxi Province; 3.Department of Periodontics, Hangzhou Stomatological Hospital. Hangzhou 310006, Zhejiang Province, China

Received:2012-12-13 Revised:2013-01-22 Online:2013-06-10 Published:2013-06-10
Supported by:
Supported by Natural Science Foundation of Jiangxi Province (0540091).

摘要/Abstract

摘要： 目的：通过建立具有不同牙槽骨高度的上颌第一磨牙三维有限元模型，在压力载荷下，计算分析其牙周膜应力的大小和分布，为正畸治疗提供力学参考。方法：采用CT对上颌第一磨牙进行扫描，建立牙槽骨发生不均衡水平吸收的上颌第一磨牙的三维有限元数字模型，计算加载垂直向的压低力时，牙周膜应力的大小和分布。结果：当牙槽骨从正常高度降低3.5 mm时，加载产生的牙周膜应力增加平缓，高应力集中部位在根分叉处；而牙槽骨降低超过6.0 mm，根分叉部分暴露时，牙周膜应力明显增加，应力集中的部位转移至根尖及根1/3处。结论：当牙槽骨高度降低未超过6 mm时(牙槽骨吸收未超过根长的48%)，应根据牙槽骨的丧失程度来减小矫治力值；当牙槽骨高度降低6 mm以上时(牙槽骨吸收超过根长48%)，磨牙的根分叉完全暴露，则应显著减小矫治力值。

关键词: 上颌第一磨牙, 有限元分析法, 牙槽骨降低, 应力分布

Abstract: PURPOSE: To establish the 3-D finite element models of maxillary first molar, and calculate the stress magnitude and distribution within the PDL of maxillary first molar when loaded with intrusion force. METHODS: Date from CT scanning image of the maxillary first molar was used to establish the 3-D finite element model of maxillary first molar. By simulating the horizontal unbalanced bone resorption model sequentially, the magnitude and distribution of PDL stress at these models were calculated under intrusion force. RESULTS: The 3-D finite element models of maxillary first molar were constructed. With constant decrease of alveolar bone height, stress of the PDL increased non-linearly. The stress in PDL changed slowly when alveolar bone height reduced from normal level to 3.5 mm, but it increased dramatically when the height of alveolar bone resorption exceeded 6.0 mm and root furcation was exposed. The high-stress concentrated in root furcation of maxillary first molar when root furcation had not been exposed, and it would be transfered to apex or one third of root length when root furcation had been exposed. CONCLUSIONS: With the sustained decrease of alveolar bone height (less than 6 mm), orthodontic force value should be reduced according to the degree of periodontal bone loss. When the alveolar bone loss reduces to more than 6 mm and the root furcation exposes completely, orthodontic force value should be reduced significantly.

Key words: Maxillary first molar, 3-D finite element method, Alveolar bone loss, Stress distribution

中图分类号:

783.5

王晖, 吴建勇, 周铨, 刘剑. 不同牙槽骨高度的磨牙压低时牙周膜应力分析[J]. 上海口腔医学, 2013, 22(3): 247-251.

WANG Hui, WU Jian-Yong, ZHOU Quan, LIU Jian. Initial stress in the periodontal membrane of maxillary first molar with different alveolar bone height by intrusion: 3-dimensional finite element analysis[J]. Shanghai Journal of Stomatology, 2013, 22(3): 247-251.

参考文献

[1] Proffit WR, Fields HW, Sarver DM. Contemporary orthodontics[M]. 4th Ed. St.Louis: Mosby Elsevier, 2007: 331-343.
[2] ?ifter M, Sara? M. Maxillary posterior intrusion mechanics with mini-implant anchorage evaluated with the finite element method[J]. Am J Orthod Dentofacial Orthop, 2011, 140(5): e233-241.
[3] 陈文静, 许文翠, 郑仕中, 等. 牙周支持骨高度对垂直向力下牙周应力分布的有限元分析[J].口腔正畸学,2004,11(4):151-153.
[4] 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.
[5] 孔亮, 胡开进, 赵海涛, 等. 利用薄层CT技术和Matlab软件辅助建立下颌骨三维有限元模型[J]. 实用口腔医学杂志, 2004, 20(2): 175-177.
[6] 高翔, 王景云, 赵云刚, 等. 不同牙周支持条件下下颌固定义齿三维有限元模型建立[J]. 临床口腔医学杂志, 2004, 20(11): 664-666.
[7] 曾琳, 胡玲玲, 兰泽栋. 上颌组牙三维有限元模型的建立及Carrière Distalizer矫治器的力学分析[J]. 北京口腔医学, 2009, 17(1): 27-30.
[8] 周学军, 赵志河, 赵美英, 等. 下颌骨三维有限元模型的边界约束设计[J]. 华西口腔医学杂志, 1999, 17(1): 29-32.
[9] 苏杰华, 张端强, 许潾于, 等. 上颌前牙段阻抗中心的三维有限元研究[J]. 上海口腔医学, 2010, 19(5): 534-540.
[10] 李志华.有限元法在牙齿及其支持组织应力分布研究中的应用[J]. 实用临床医学, 2001, 2(2): 118-120.
[11] 潘燕环, 唐亮, 马达. 用子模型方法进行牙周膜应力分析[J]. 实用口腔医学杂志, 2005, 21(4): 445-447.
[12] Tanne K, Yoshida S, Kawata T, et al. An evaluation of the biomechanical response of the tooth and periodontium to orthodontic forces in adolescent and adult subjects[J]. Br J Orthod, 1998, 25(2): 109-115.
[13] 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.
[14] Burr DB, Milgrom C, Fyhrie D, et al. In vivo measurement of human tibial strains during vigorous activity[J].Bone,1996,18(5): 405-410.
[15] 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.
[16] Cobo J, Argüelles J, Puente M, et al. Dentoalveolar stress from bodily tooth movement at different levels of bone loss[J]. Am J Orthod Dentofacial Orthop, 1996, 110(3): 256-262.