山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (11): 48-58.doi: 10.6040/j.issn.1671-7554.0.2022.1397
• • 上一篇
韩迪1,2,3,郭泾1,2,3,4
HAN Di1,2,3, GUO Jing1,2,3,4
摘要: 目的 利用电磁感应加热式Typodont 结合扫描仪,观察关闭间隙时使用滑动法和双钥匙曲法牙列的三维变化,并探索在同一加力方式下,加载不同力值对牙列的影响。 方法 在拔除第一前磨牙的标准Typodont上颌模型上黏接托槽,滑动组采用滑动直丝弓技术关闭拔牙间隙,分为平弓组和摇椅组;双钥匙组采用双钥匙曲法关闭间隙,分为前倾组和后倾组。设置250 g和300 g两种加载力值。重叠初始和实验后数字模型,分析牙冠标志点三维位移变化。 结果 (1)矢状向上,平弓组在250 g力值下与摇椅组U1、前倾组U1、后倾组U3、U7差异有统计学意义(P<0.05);300 g力值下与摇椅组U7、后倾组U1~U6差异有统计学意义(P<0.05)。力值增加,各实验组的前牙后退量无明显增加;后牙前移量均相应增加,除摇椅组U6、后倾组U7外(P<0.05),其他后牙变化差异无统计学意义(P>0.05)。(2)在冠唇(颊)舌倾度上,平弓组前牙区冠舌倾程度大于摇椅组,力值增加两组冠舌倾程度均增加。两力值下,所有实验组仅前倾组前牙表现冠唇倾,后倾组前牙在250 g力值时接近整体后退。加载250 g时仅摇椅组后牙区冠舌倾,其他3组后牙均冠颊倾。300 g时滑动组的U5、U6牙冠舌倾,U7牙冠颊倾,双钥匙组后牙均冠颊倾。(3)垂直向上,平弓组在250 g力值时除U7牙压入外前后牙都伸长,300 g力值时后牙伸长量明显增加(U6、U7:P<0.05)。摇椅组在250 g力值时前后牙少量压入,300 g时前牙表现伸长而后牙压入减少。前倾组可明显压低前牙,少量伸长后牙,力值增加前牙压低量减少,后牙伸长量明显增加(P<0.05)。后倾组可明显压低后牙,少量伸长前牙,力值增加前后牙变化差异无统计学意义(P>0.05)。 结论 (1)预置摇椅可在一定程度上减少滑动法前牙冠舌倾程度、后牙前移及伸长量。双钥匙曲法预置后倾弯可获得较强的后牙支抗,预置前倾弯可获得较强的前牙支抗,前、后倾可差异性地压低前、后牙,并利于内收过程中前牙冠舌倾的控制。(2)使用较大的力值并未见前牙内收量增加,但对后牙支抗及前牙转矩的控制有不利影响。
中图分类号:
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