拔牙区域不同形式连接桥体在隐形矫治远移尖牙过程中的三维有限元分析

doi:10.11958/20251185

天津医药 ›› 2025, Vol. 53 ›› Issue (7): 741-746.doi: 10.11958/20251185

拔牙区域不同形式连接桥体在隐形矫治远移尖牙过程中的三维有限元分析

郭子源¹^,²^,³(), 李嘉辉¹^,³, 张锡忠¹^,³^,^△(), 王一凡¹^,³

1 天津市口腔医院正畸科，南开大学医学院（邮编300041）
2 天津医科大学口腔临床学院（邮编300041）
3 天津市口腔功能重建重点实验室（邮编300041）

收稿日期:2025-03-25 修回日期:2025-05-13 出版日期:2025-07-15 发布日期:2025-07-21
通讯作者: ^△E-mail：Zhangxizhong9999@hotmail.com
作者简介:郭子源（1995），女，医师，主要从事口腔正畸学方面研究。E-mail：15122282102@163.com
基金资助:
天津市医学重点学科（专科）建设项目(TJYXZDXK-024A)

Three-dimensional finite element analysis of different pontic designs in the extraction area of clear aligners during the distalization of canine

GUO Ziyuan¹^,²^,³(), LI Jiahui¹^,³, ZHANG Xizhong¹^,³^,^△(), WANG Yifan¹^,³

1 Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
2 School of Clinical Stomatology, Tianjin Medical University
3 Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction

Received:2025-03-25 Revised:2025-05-13 Published:2025-07-15 Online:2025-07-21
Contact: ^△E-mail：Zhangxizhong9999@hotmail.com

郭子源, 李嘉辉, 张锡忠, 王一凡. 拔牙区域不同形式连接桥体在隐形矫治远移尖牙过程中的三维有限元分析[J]. 天津医药, 2025, 53(7): 741-746.

GUO Ziyuan, LI Jiahui, ZHANG Xizhong, WANG Yifan. Three-dimensional finite element analysis of different pontic designs in the extraction area of clear aligners during the distalization of canine[J]. Tianjin Medical Journal, 2025, 53(7): 741-746.

摘要/Abstract

摘要：

目的探究三维有限元方法在无托槽隐形矫治器拔牙区域建立不同形式的连接桥体降低应力中断效应、抵抗过山车现象的作用。方法建立拔牙区域不同形式连接桥体的无托槽隐形矫治器模型，分为无空泡连接式、常规空泡连接式、半实心桥体连接式及全实心桥体连接式无托槽隐形矫治器模型，将4种矫治器模型分别与牙列模型进行装配。有限元分析工况均设计为模拟尖牙远移0.2 mm，观察4个工况中尖牙及第二前磨牙的初始位移情况及最大主应力分布情况。结果牙齿初始位移趋势图显示，所有工况中尖牙及第二前磨牙均表现为倾斜移动，但不同连接设计的初始位移存在差异。全实心桥体连接式无托槽隐形矫治器模型初始最大位移量、根尖点及颊侧牙尖点的位移值均表现出最高值，且装配该种矫治器模型时牙齿移动方式更接近于整体移动，表现出最优的牙齿控制能力。牙周膜最大主应力分布图显示，装配全实心桥体连接式无托槽隐形矫治器模型时，牙周膜最大主应力表现为最大值。结论在无托槽矫治器拔牙区域设计全实心桥体连接能在一定程度上减少矫治器形变，降低应力中断效应，抵抗过山车现象。

关键词: 牙畸形, 正畸矫正器, 有限元分析, 隐形矫治

Abstract:

Objective To explore the effect of different pontic designs in resisting stress interruption effect and roller coaster phenomenon through three-dimensional finite element analysis, providing clinical guidance for the application of clear aligners in extraction cases. Methods Four three-dimensional finite element models of different pontic designs in the extraction area of clear aligners were established, including the pontic-free connection design, the conventional hollow pontic design, the partially solid-filled pontic design and the fully solid-filled pontic design. All four aligner models were individually assembled with the dental arch model. A 0.2 mm distal movement of the canine was simulated to observe the initial displacement and periodontal ligament stress distribution of canine and second premolar in each group of models. Results The initial displacement tendency diagram revealed that in all experimental conditions, both the canine and second premolar exhibited tipping movement patterns. However, significant variations in initial displacement magnitudes were observed across different pontic designs. The fully solid-filled pontic-connected clear aligner model exhibited the greatest initial displacement values (both crown and root) and the maximum initial displacement magnitude. Notably, this kind of design displayed movement characteristics closer to bodily movement, indicating superior control efficacy in tooth positioning. Periodontal ligament stress analysis revealed that the fully solid-filled pontic-connected clear aligner model generated the highest maximum principal stress in the periodontal ligament.Conclusion This three-dimensional finite element study reveals that the application of solid-filled pontic in clear aligner therapy could improve biomechanical control at extraction sites by minimizing aligner distortion, reducing stress interruption effect and preventing the roller coaster phenomenon.

Key words: tooth abnormalities, orthodontic appliances, finite element analysis, clear aligner technology

中图分类号:

R783.5

图/表 9

图1 含附件的上颌牙列及牙周膜模型 A：上颌牙列模型；B：上颌牙周膜模型。

Fig.1 Maxillary dentition model with attachments and periodontal ligament model

图2 含不同形式连接桥体的无托槽隐形矫治器模型 A：无空泡连接式无托槽隐形矫治器模型；B：常规空泡连接式无托槽隐形矫治器模型；C：半实心桥体连接式无托槽隐形矫治器模型；D：全实心桥体连接式无托槽隐形矫治器模型。

Fig.2 Clear aligner models with different types of connected pontics

图3 最终组合的三维有限元模型 A：组合模型1；B：组合模型2；C：组合模型3；D：组合模型4。

Fig.3 The final assembled 3D finite element model

表1 各组合模型的节点数与单元数

Tab.1 The number of nodes and units in each group of 3D model

组别	节点数	单元数
组合模型1	205 195	333 679
组合模型2	206 254	335 767
组合模型3	212 213	361 155
组合模型4	216 416	381 990

表2 各材料的力学性能参数

Tab.2 Material properties of each material

材料	弹性模量/MPa	泊松比
牙列及附件	19 600	0.30
牙周膜	0.05	0.49
无托槽隐形矫治器	528	0.40

图4 尖牙及第二前磨牙初始位移的三维有限元分析 A：尖牙初始位移分析；B：第二前磨牙初始位移分析。

Fig.4 Initial displacement analysis of canine and second premolar teeth

表3 尖牙及第二前磨牙初始位移分析

Tab.3 Initial displacement analysis of canine and second premolar teeth

牙位	工况	最大位移量/mm	根尖点位移/mm	颊侧牙尖点位移/mm	R/C 比值
尖牙	工况1	0.128	0.056	-0.121	-0.462
	工况2	0.119	0.052	-0.112	-0.467
	工况3	0.128	0.056	-0.120	-0.464
	工况4	0.134	0.058	-0.125	-0.461
第二前磨牙	工况1	0.053	-0.018	0.036	-0.490
	工况2	0.046	-0.016	0.031	-0.498
	工况3	0.055	-0.018	0.038	-0.479
	工况4	0.058	-0.019	0.042	-0.460

图5 尖牙及第二前磨牙牙周膜应力分布图 A：尖牙牙周膜应力分布；B：第二前磨牙牙周膜应力分布。

Fig.5 Periodontal ligament stress distribution of canine and second premolar

表4 尖牙及第二前磨牙牙周膜最大主应力

Tab.4 Periodontal ligament stress of canine and second premolar

牙位	工况	最大主应力/MPa
尖牙	工况1	0.155
	工况2	0.145
	工况3	0.154
	工况4	0.160
第二前磨牙	工况1	0.061
	工况2	0.052
	工况3	0.065
	工况4	0.070

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拔牙区域不同形式连接桥体在隐形矫治远移尖牙过程中的三维有限元分析

Three-dimensional finite element analysis of different pontic designs in the extraction area of clear aligners during the distalization of canine

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