CN108542519B - Device based on micro-implant anchorage moves molar to far and middle - Google Patents

Device based on micro-implant anchorage moves molar to far and middle Download PDF

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Publication number
CN108542519B
CN108542519B CN201810427573.0A CN201810427573A CN108542519B CN 108542519 B CN108542519 B CN 108542519B CN 201810427573 A CN201810427573 A CN 201810427573A CN 108542519 B CN108542519 B CN 108542519B
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buccal tube
square
hole
buccal
arch wire
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CN108542519A (en
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刘钧
夏恺
邹玲
孙闻天
余丽媛
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Sichuan University
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Sichuan University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/12Brackets; Arch wires; Combinations thereof; Accessories therefor
    • A61C7/28Securing arch wire to bracket
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61CDENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C7/00Orthodontics, i.e. obtaining or maintaining the desired position of teeth, e.g. by straightening, evening, regulating, separating, or by correcting malocclusions
    • A61C7/12Brackets; Arch wires; Combinations thereof; Accessories therefor
    • A61C7/28Securing arch wire to bracket
    • A61C7/282Buccal tubes
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02ATECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

Abstract

The invention discloses a device for remotely moving molar based on micro-implant anchorage, which comprises: the device comprises a main arch wire, a bracket, an auxiliary arch wire, a buccal tube, an anchorage element and a force application element; the buccal tube has three, the first buccal tube is attached to the first premolars, the second buccal tube is attached to the first molars; the auxiliary arch wire is used for connecting the first buccal tube and the second buccal tube, and is positioned above the second premolars bracket; a third buccal tube is also attached to the first molar; the first buccal tube is closely attached to the distal intermediate end of the first premolars bracket and the second buccal tube is closely attached to the proximal intermediate end of the third buccal tube; the main arch wire passes through the first buccal tube, the second buccal tube and the third buccal tube and is fixed in the buccal tubes; the force application element is connected with the anchorage element and applies traction force parallel to the main arch wire to the auxiliary arch wire; the traction force is directed in the distal direction. The technical scheme provided by the invention can simply and effectively move the molar to the far and middle, and saves time and economic cost for clinical operation.

Description

Device based on micro-implant anchorage moves molar to far and middle
Technical Field
The invention relates to the technical field of tooth correction, in particular to a device for remotely moving molar based on micro-implant anchorage.
Background
With the development of economy and the progress of society, more and more people choose to receive orthodontic treatment for aesthetic or functional reasons. In clinical work, an orthodontist applies force to teeth, jawbone or temporomandibular joint through various correction devices, so that the teeth are inclined, integral, root-controlled, vertical (elongated or depressed) or rotationally moved, and the shape and position of the jawbone are reconstructed, thereby achieving the established correction effect and the purposes of balance, attractive appearance and stability.
In the face of complex maxillofacial deformities, orthodontists often need to move molars distally to provide a basis for interproximal alignment, leveling of dentition, adjustment of bite relationships, and the like. However, in conventional fixed appliances, the difficulty of moving the molars distally is greater. In conventional methods, orthodontists are struggled against one or more teeth when applying an orthodontic force to achieve their desired tooth movement, and each movement inevitably involves an equal and opposite reaction force that also displaces the struggling teeth. At this time, the orthodontist needs to consider how to move the teeth desired to be moved to the maximum while minimizing the displacement of the teeth undesired to be moved, a process called anchorage control. The resistance to moving teeth in the far middle is greater than in the near middle, so it is far from sufficient to provide anchorage by other teeth alone. With the advancement of technology, the emergence of micro-implant antigens (micro-implant anchorage, MIA) in jawbone has enabled the control of the antigens to turn over a new page. The principle is to implant tiny titanium screws in the jawbone to provide absolute anchorage, so that the teeth which do not want to move do not generate displacement at all. By means of MIA and some force application elements, a more pronounced pushing and grinding tooth moving in the distal direction than with conventional anchorage can be produced.
The implantation sites of the micro-implant anchorage are divided into two types, which correspond to two correction methods respectively: one is to implant the anchorage nail on the buccal side, utilize the nickel titanium pushing spring on the main arch wire to push the molar tooth to move far, tie the anchorage nail with the cuspid tooth with the ligature wire, but this way needs to dismantle the main arch wire and change the pushing spring to apply force during each re-diagnosis; the other is to implant the anchorage nail in the middle of the palate and bend the improved palate bar to reach about 6mm in the middle of the anchorage nail, the anchorage nail and the improved palate bar are connected and forced by a chain-shaped rubber ring, and the applied far-middle moving force passes through the impedance center of the molar, so that the molar can be moved in a far-middle way integrally, but in this way, the belt ring is arranged on the molar and additional bending welding work is needed.
Disclosure of Invention
The invention aims to provide a device for remotely moving molar based on micro-implant anchorage, which can simply and effectively move molar to the remote center and saves time and economic cost for clinical operation.
In order to achieve the above purpose, the invention adopts the following technical scheme:
a device for moving molars distally based on micro-implant anchorage, comprising: a primary archwire, a wire for guiding tooth movement; a bracket attached to the orthodontic object; the main arch wire sequentially passes through the grooves of the bracket and is fixed in the grooves of the bracket; characterized by further comprising: auxiliary archwire, buccal tube, anchorage element, force application element; the buccal tube has three, the first buccal tube is attached to the first premolars, and the second buccal tube is attached to the first molars; the auxiliary arch wire is used for connecting the first buccal tube and the second buccal tube, and is positioned above the second premolars bracket; a third buccal tube is also attached to the first molar; the first buccal tube is closely attached to the distal intermediate end of the first premolars bracket and the second buccal tube is closely attached to the proximal intermediate end of the third buccal tube; the primary archwire passes through the first, second, and third buccal tubes; the main arch wire is fixed in the first buccal tube, the second buccal tube and the third buccal tube; the force application element is connected with the anchorage element and applies traction force parallel to the main arch wire to the auxiliary arch wire; the traction force is directed in the mesial direction.
Preferably, the first and second buccal tubes are double-bore buccal tubes; the double-hole buccal tube comprises: a square gingival aperture and a square occlusal aperture, the square gingival aperture being inclined to the buccal side relative to the square occlusal aperture; the main arch wire passes through the square hole of the first buccal tube, the square hole of the second buccal tube and the third buccal tube; the auxiliary arch wire passes through the square gingival hole of the first buccal tube and the square gingival hole of the second buccal tube; the auxiliary archwire is fixed in the square gingival aperture of the first buccal tube and the square gingival aperture of the second buccal tube.
Preferably, the auxiliary archwire comprises: a traction hook, a first groove and a second groove; the far middle end of the first groove opening is connected with the near middle end of the second groove opening through a horizontal connecting rod; the proximal end of the opening of the first groove is connected with the traction hook; the traction hook is open towards the middle; the traction hook is higher than the connecting rod; the first groove is fixed in a square gingival hole of the first buccal tube, and the second groove is fixed in a square gingival hole of the second buccal tube; one end of the force application element is connected with the traction hook, and the other end of the force application element is connected with the anchorage element; the anchorage element is planted in the jawbone in the far and middle direction of the traction hook.
Preferably, the traction hook, the first groove, the second groove and the connecting rod are integrally formed.
Preferably, the force application element is a rubber band, or a rubber chain, or a tension spring.
Preferably, the bronchial antigen element is mbia.
Preferably, the primary and secondary archwires are both stainless steel square wires; the square gingival holes are square holes matched with the auxiliary archwires, and the square gingival holes are square holes matched with the main archwires.
Preferably, the sizes of the gingival square hole and the combined square hole are 0.56 x 0.69mm; the angle of inclination of the square gingival aperture to the buccal side is 65 deg.
Preferably, the inner diameter of the traction hook is 1-1.5 mm, and the radian is 200 degrees.
According to the device for remotely moving the molar based on the micro-implant anchorage, provided by the embodiment of the invention, the first buccal tube positioned in the first premolars is connected with the second buccal tube positioned in the first molar through the auxiliary archwire, and the force application element is used for applying the traction force parallel to the main archwire and pointing to the far-middle direction to the auxiliary archwire, so that the first premolars can be continuously applied with force, and the first premolars can be effectively pushed to move distally. Moreover, the technical scheme provided by the embodiment of the invention can be carried out simultaneously with full-mouth fixing correction, and the correction effect of the original bracket is not affected; the auxiliary arch wire adopted in the invention has simple structure and easy manufacture. Therefore, the technical scheme provided by the invention can simply and effectively move the molar to the far center, and saves time and economic cost for clinical operation.
Drawings
FIG. 1 is a state diagram of the use of an embodiment of the present invention;
FIG. 2 is an assembly view of a primary archwire, a secondary archwire, and a dual-hole buccal tube in an embodiment of the present invention;
FIG. 3 is a side view of a dual bore buccal tube in accordance with an embodiment of the present invention;
FIGS. 4 to 9 are views showing a process of manufacturing the auxiliary bow according to the embodiment of the present invention;
in the figure, 1 is a main arch wire, 2 is a bracket, 3 is an auxiliary arch wire, 41 is a first buccal tube, 42 is a second buccal tube, 43 is a third buccal tube, 5 is an anchorage element, 6 is a force application element, 7 is a first premolars tooth, 8 is a first molar tooth, 9 is a second premolars tooth, 10 is a gingival square hole of a double-hole buccal tube, 11 is a square hole of the double-hole buccal tube, 31 is a traction hook, 32 is a first groove, 33 is a second groove, and 34 is a connecting rod.
Detailed Description
The present invention will be described in further detail with reference to the accompanying drawings, in order to make the objects, technical solutions and advantages of the present invention more apparent.
FIG. 1 is a state diagram of the use of an embodiment of the present invention, including: a main archwire 1, a wire for guiding tooth movement; a bracket 2 attached to the orthodontic object; the main archwire 1 sequentially passes through the grooves of the bracket 2 and is fixed in the grooves of the bracket 2; further comprises: auxiliary archwire 3, buccal tube, anchorage element 5, force application element 6.
Three of the buccal tubes are provided, a first buccal tube 41 being attached to the first premolars 7 and a second buccal tube 42 being attached to the first molars 8; the auxiliary archwire 3 is used for connecting the first buccal tube 41 and the second buccal tube 42, and the auxiliary archwire 3 is positioned above the second premolars 9 bracket; a third buccal tube 43 is also attached to the first molar 8; the first buccal tube 41 is attached to the distal intermediate end of the first premolar 7 bracket and the second buccal tube 42 is attached to the proximal intermediate end of the third buccal tube 43; the primary archwire 1 passes through the first, second, and third buccal tubes 41, 42, 43; the main archwire 1 is fixed in the first buccal tube 41, the second buccal tube 42 and the third buccal tube 43; the force application element 6 is connected to the anchorage element 5 and applies a traction force to the auxiliary archwire 3 parallel to the primary archwire 1; the traction force is directed in the mesial direction.
In order to obtain better traction effect, the first buccal tube 41 and the second buccal tube 42 are double-hole buccal tubes; the double-hole buccal tube comprises: a square gingival aperture 10 and a square occlusal aperture 11, the square gingival aperture 10 being inclined to the cheek with respect to the square occlusal aperture 11; the main archwire 1 passes through the square holes of the first buccal tube 41, the square holes of the second buccal tube 42 and the third buccal tube 43; the auxiliary archwire 3 passes through the square gingival aperture of the first buccal tube 41 and the square gingival aperture of the second buccal tube 42; the auxiliary archwire 3 is fixed in the square gingival aperture of the first buccal tube 41 and in the square gingival aperture of the second buccal tube 42.
For convenient use and better traction, the auxiliary archwire 3 comprises: a traction hook 31, a first groove 32, a second groove 33; the open distal end of the first groove 32 is connected with the open proximal end of the second groove 33 through a horizontal connecting rod 34; the proximal end of the opening of the first groove 32 is connected with the traction hook 31; the traction hook 31 is open towards the middle; the traction hook 31 is higher than the connecting rod 34; the first groove 32 is fixed in the square gingival hole of the first buccal tube 41, and the second groove 33 is fixed in the square gingival hole of the second buccal tube 42; one end of the force application element 6 is connected with the traction hook 31, and the other end of the force application element 6 is connected with the anchorage element 5; the anchorage element 5 is implanted in the jawbone in the distal direction of the towing hook 31.
In this embodiment, the force application element 6 is a rubber band, or a rubber chain, or a tension spring; the anchorage element 5 is M IA; the main arch wire 1 and the auxiliary arch wire 3 are stainless steel square wires; the square gingival hole 10 is a square hole matched with the auxiliary arch wire 3, and the square hole 11 is a square hole matched with the main arch wire 1. Specifically, the dimensions of the square gingival hole 10 and the square gingival hole 11 are 0.56×0.69mm; the square gingival hole 10 and the square gingival hole 11 are angled on the coronal plane, and the angle of inclination of the square gingival hole 10 to the buccal side relative to the square gingival hole 11 is 65 degrees, so that the traction hook 31 and the force application element 6 are far away from the oral mucosa, and the oral mucosa is prevented from being crushed.
The method for manufacturing the auxiliary archwire and the method for assembling the auxiliary archwire and the double-hole buccal tube are specifically described below, and the tools used are as follows: filament forming pliers, cutting pliers, marker pens, compasses or straightedge. As shown in fig. 4 to 9.
Step one, a section of stainless steel square wire with the length of 5-7 cm and the size of 0.019 x 0.025 inches (namely 0.4826 x 0.635 mm) is cut, and a thin wire forming clamp is adopted to bend one end of the stainless steel square wire to manufacture a traction hook. The inner diameter of the traction hook is 1-1.5 mm, and the radian is 200 degrees. As shown in fig. 4.
Step two, bending the stainless steel square wire to the far middle by 90 degrees by adopting a filament forming clamp at the position about 5mm below the circular arc of the traction hook, and penetrating a double-hole buccal tube from the other end of the stainless steel square wire to enable the stainless steel square wire to be positioned in a gingival square hole of the double-hole buccal tube; the 5mm value can be changed, and finally the traction hook and the anchorage element M IA can be leveled. As shown in fig. 5.
And thirdly, in the oral cavity of the patient, the other end of the stainless steel square wire is propped against the near middle end of the third buccal tube, a marking point is marked by a marking pen which is clung to the far middle end of the first premolaring bracket, the distance between the marking point and the other end of the stainless steel square wire is measured, and the distance is marked as x (mm).
And step four, bending the stainless steel square wire at the far and middle ends of the double-hole buccal tube by 90 degrees towards the gingival direction to form a first groove, and enabling the first groove to resist the double-hole buccal tube. As shown in fig. 6.
And fifthly, bending the stainless steel square wire in a distal direction, wherein the length of the gingival vertical section is about 3mm, so that the auxiliary arch wire bypasses the second premolaring bracket from the gingival side. As shown in fig. 7.
And step six, marking points at the middle (x-5) mm of bending by using a compass or a ruler.
And seventhly, bending the stainless steel square wire to the square at the standard point of the step six by 90 degrees, wherein the length of the vertical section is about 3mm. And then continuously bending 90 degrees in the far and middle direction, penetrating another double-hole buccal tube from the other end of the stainless steel square wire, and enabling the stainless steel square wire to be positioned in the gingival square hole of the double-hole buccal tube. As shown in fig. 8.
And step eight, bending the stainless steel square wire at the far and middle ends of the other double-hole buccal tube by 90 degrees towards the gingival direction to form a second groove, wherein the second groove withstands the double-hole buccal tube, and cutting off the tail end of the stainless steel square wire (namely the other end of the stainless steel square wire) at the 4mm position of the turning gingival direction by adopting cutting pliers. As shown in fig. 9.
Step nine, threading the primary archwire into the square holes of two double-hole buccal tubes and installing into the patient's mouth as shown in fig. 1. The anchorage element MIA and the traction hook are applied with force by continuous rolling through a tension spring or a rubber chain.
The device assembled by the auxiliary arch wire and the two double-hole buccal tubes is called an auxiliary arch, and the using method of the auxiliary arch is as follows: inserting a main arch wire into square holes of two double-hole buccal tubes; the mesial double-hole buccal tube (first buccal tube) was placed against the distal intermediate end of the first premolars bracket and the mesial double-hole buccal tube (second buccal tube) was placed against the mesial end of the third buccal tube. The MIA is then tied with the traction hook of the secondary archwire using a rubber chain. When the device is used for moving the molar, if the far middle end of the near middle double-hole buccal tube does not reach the near middle end of the second premolars bracket, a patient only needs to replace the rubber chain during each re-diagnosis; if the distal intermediate end of the mesial double-hole buccal tube reaches the mesial end of the second premolars bracket while the distance of movement of the first premolars remains short of the treatment target, the dentist is required to bend the auxiliary arch again as described above. The method can be simultaneously carried out with full-mouth fixation correction, is simple and convenient to manufacture (can be manufactured beside a chair), has small foreign body sensation, is simple and convenient to apply force during re-diagnosis, does not need repeated disassembly, has high efficiency of pushing and grinding teeth to the far and middle, and does not need the cooperation of patients.
According to the device for remotely moving the molar based on the micro-implant anchorage, provided by the embodiment of the invention, the double-hole buccal tube positioned in the first premolars is connected with the double-hole buccal tube positioned in the first molar through the auxiliary archwire, the double-hole buccal tube is used as a linkage device, and the force application element is used for applying the traction force parallel to the main archwire and pointing to the far-middle direction to the auxiliary archwire, so that the first premolars can be continuously forced, and the first premolars can be effectively pushed to remotely move. Clinical application shows that the scheme can efficiently push and grind teeth to the middle distance of 1-1.5 mm/month. In addition, the technical scheme provided by the embodiment of the invention can be simultaneously carried out with full-mouth fixing correction, the correction effect of the original bracket is not affected, and the tooth grinding belt ring is not required to be adhered or complicated steel wire bending is not required to be carried out; the auxiliary arch wire adopted in the invention has simple structure and easy manufacture, is manufactured according to the use and the follow-up of each patient, does not need to repeatedly disassemble the steel wire or replace the nickel-titanium spring when the patient is re-diagnosed, and saves time and economic cost for clinical operation.
The foregoing is merely illustrative of the present invention, and the present invention is not limited thereto, and any person skilled in the art will readily recognize that variations or substitutions are within the scope of the present invention.

Claims (7)

1. A device for moving molars distally based on micro-implant anchorage, comprising: a main archwire (1) for guiding the movement of teeth; a bracket (2) attached to the orthodontic object; the main arch wire (1) sequentially passes through the grooves of the bracket (2) and is fixed in the grooves of the bracket (2); characterized by further comprising: an auxiliary arch wire (3), a buccal tube, an anchorage element (5) and a force application element (6);
three buccal tubes, a first buccal tube (41) being attached to the first premolars (7) and a second buccal tube (42) being attached to the first molars (8); the auxiliary arch wire (3) is used for connecting the first buccal tube (41) and the second buccal tube (42), and the auxiliary arch wire (3) is positioned above the bracket of the second premolars (9); a third buccal tube (43) is also attached to the first molar (8); the first buccal tube (41) is clung to the far middle end of the bracket of the first premolars (7), and the second buccal tube (42) is clung to the near middle end of the third buccal tube (43); the main arch wire (1) passes through the first buccal tube (41), the second buccal tube (42) and the third buccal tube (43); the main arch wire (1) is fixed in the first buccal tube (41), the second buccal tube (42) and the third buccal tube (43); the force application element (6) is connected with the anchorage element (5) and applies traction force parallel to the main archwire (1) to the auxiliary archwire (3); the traction force points in a far-middle direction;
the anchorage element (5) is MIA;
the force application element (6) is a rubber band, a rubber chain or a tension spring.
2. The microplant-anchorage-based distal movement molar device of claim 1, wherein the first buccal tube (41) and the second buccal tube (42) are double-hole buccal tubes; the double-hole buccal tube comprises: a square gingival aperture (10) and a square occlusal aperture (11), the square gingival aperture (10) being inclined to the buccal side relative to the square occlusal aperture (11); the main arch wire (1) passes through the square hole (11) of the first buccal tube (41), the square hole (11) of the second buccal tube (42) and the third buccal tube (43); the auxiliary arch wire (3) passes through the square gingival hole (10) of the first buccal tube (41) and the square gingival hole (10) of the second buccal tube (42); the auxiliary arch wire (3) is fixed in the square gingival hole (10) of the first buccal tube (41) and the square gingival hole (10) of the second buccal tube (42).
3. The device for distal movement of molars based on micro-implant anchorage according to claim 2, wherein the auxiliary archwire (3) comprises: a traction hook (31), a first groove (32), a second groove (33); the far middle end of the opening of the first groove (32) is connected with the near middle end of the opening of the second groove (33) through a horizontal connecting rod (34); the proximal and middle ends of the openings of the first grooves (32) are connected with the traction hooks (31); -said towing hook (31) opens towards the middle; the traction hook (31) is higher than the connecting rod (34); the first groove (32) is fixed in a square gingival hole of the first buccal tube (41), and the second groove (33) is fixed in a square gingival hole of the second buccal tube (42); one end of the force application element (6) is connected with the traction hook (31), and the other end of the force application element (6) is connected with the anchorage element (5); the anchorage element (5) is planted in the jawbone in the far and middle direction of the traction hook (31).
4. A device for moving molars in the distal direction based on micro-implant anchorage according to claim 3, wherein the traction hook (31), the first groove (32), the second groove (33) and the connecting rod (34) are integrally formed.
5. A device for distal movement of molar based on micro-implant anchorage according to claim 3, characterized in that the primary archwire (1) and the secondary archwire (3) are both stainless steel square wires; the square gingival hole (10) is a square hole matched with the auxiliary arch wire (3), and the square closing hole (11) is a square hole matched with the main arch wire (1).
6. The device for distal movement of molar based on microplant anchorage according to claim 5, characterized in that the dimensions of the square gingival aperture (10) and of the square occlusal aperture (11) are both 0.56 x 0.69mm; the angle of inclination of the square gingival hole (10) relative to the square occlusal hole (11) is 65 degrees.
7. A device for moving molars in the distal direction based on micro-implant anchorage according to claim 3, wherein the traction hook (31) has an inner diameter of 1-1.5 mm and an arc of 200 °.
CN201810427573.0A 2018-05-07 2018-05-07 Device based on micro-implant anchorage moves molar to far and middle Active CN108542519B (en)

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