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Informationen aus Orthodontie & Kieferorthopädie 2012; 44(03): 199-206
DOI: 10.1055/s-0032-1323751
Übersichtsartikel
© Georg Thieme Verlag KG Stuttgart · New York

Die initiale Phase der Mesialisierung eines unteren Molaren in einem patientenbezogenen Finite-Elemente-Modell

The Initial Phase of Mesialization of a Lower Molar in a Patient-Oriented Finite Element Model
B. Ludwig
1   Kieferorthopädische Fachpraxis, Traben-Trarbach
3   Poliklinik für Kieferorthopädie, Universität des Saarlandes, Homburg/Saar
,
A. Geringer
2   Lehrstuhl für Technische Mechanik, Universität des Saarlandes, Saarbrücken
,
B. Glasl
1   Kieferorthopädische Fachpraxis, Traben-Trarbach
,
S. Diebels
2   Lehrstuhl für Technische Mechanik, Universität des Saarlandes, Saarbrücken
,
J. Lisson
3   Poliklinik für Kieferorthopädie, Universität des Saarlandes, Homburg/Saar
,
T. Lietz
4   Zahnarzt, Neulingen
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
18. Oktober 2012 (online)

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Zusammenfassung

Zielsetzung:

Bei fehlenden Seitenzähnen ist der singuläre Lückenschluss durch Mesialisation der Molaren mithilfe skelettaler Verankerungen eine sehr häufige Indikation geworden. Angestrebt wird dabei die körperliche Translation eines Zahnes, von der man annimmt, dass in der Initialphase der Bewegung der im Parodont entstehende Druck gleichmäßig verteilt ist. Es war zu prüfen, ob mithilfe eines patientenbezogenen Finite-Elemente-Modells die optimalen biomechanischen Parameter bestimmt werden können.

Material und Methode:

Basierend auf dem CT-Bild eines Patienten wurde ein Finite-Elemente-Modell erstellt und zur Simulation der initialen Zahnbewegung bei der Mesialisation eines unteren Molars anhand von 4 Lastsituationen genutzt. Die nach mesial gerichtete Kraft betrug 1N. In der ersten Simulation erfolgte die Belastung nur von vestibulär im Bereich der Krone. In der zweiten Simulation wurde bilateral, vestibulär und oral im Bereich der Krone belastet. In der dritten Simulation erfolgte der Kraftansatz nur vestibulär in Höhe des Widerstandszentrums. In der vierten Simulation wurde die Kraft bilateral auf Höhe des Widerstandszentrums appliziert.

Ergebnisse:

In den ersten 3 Simulationen war der Druck im Parodont ungleichmäßig verteilt und lag deutlich über dem definierten Richtwert. Nur bei der vierten Simulation entstand ein annähernd gleichmäßig verteilter Druck, der im Bereich des Richtwertes lag und eine reine Translation bewirken könnte.

Schlussfolgerungen:

Das aus Patientendaten gewonnene Finite-Elemente-Modell kann dazu dienen, patienten- und therapiebezogene Kraftapplikationen zu definieren und unerwünschte Nebenwirkungen zu reduzieren.

Abstract

Objective:

In case of missing premolars and molars, space closure by mesialization of molars has become a very common indication. The aim is a bodily translation of the posterior tooth, which needs a biomechanically uniformly distributed pressure in the periodontium in the initial phase of tooth movement. It was necessary to determine whether a patient-specific finite element model could be used, to determine the optimal biomechanical parameters.

Materials and methods:

Based on the CT image of a patient, a finite element model to simulate the initial tooth movement in a lower molar mesialization was used and 4 different load situations were created. The mesially directed force was 1 N. In the first simulation, the load was only in the vestibular site of the crown. In the second simulation the force was applied bilateral of the crown. In the third simulation the buccal force was applied at the center of resistance. In the fourth simulation, the force was applied bilaterally at the level of the center of resistance.

Results:

In the first 3 simulations, the pressure was unevenly distributed in the periodontal tissues and was significantly higher than the defined benchmark. Only the fourth simulation resulted in a nearly evenly distributed pressure that was in the range of the standard value and could cause a pure translation.

Conclusions:

Patients’ specific data designing a finite element model can be used to define a patient as well as treatment-related force application and to reduce unwanted side effects.

Schlüsselwörter

CT - Finite-Elemente-Modell - parodontales Ligament - initiale Zahnbewegung - orthodontische Kräfte - Molarenlückenschluss

Key words

CT - finite-element model - periodontal ligament - initial tooth movement - orthodontic forces - molar space closure
 

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