Kodi Mungatani Kuti Musalephere Kugwira Ntchito Pachiyambi cha Chithandizo cha Orthodontic?

Chiyambi

Kulephera kwa ma bracket bond ndi vuto lalikulu kuposa kusokoneza pang'ono pa chisamaliro cha mano: kungachedwetse kuyenda kwa dzino, kuwonjezera maulendo adzidzidzi, ndikuwonjezera nthawi yopewera chithandizo. Kupewa kumafuna chisamaliro cha njira zachipatala komanso njira yomatira yomwe imagwiritsidwa ntchito pa sitepe iliyonse, kuyambira kukonzekera enamel ndi kuwongolera chinyezi mpaka kuika ma bracket ndi kuchiritsa. Nkhaniyi ikufotokoza zomwe zimayambitsa kulephera kwa ma bracket, kuchuluka kwa zizindikiro zomwe zimasonyeza vuto, ndi njira zothandiza zomwe zimathandizira kusunga ma bracket tsiku ndi tsiku. Pomaliza, owerenga adzakhala ndi njira yomveka bwino yochepetsera kulephera, kuteteza magwiridwe antchito a chithandizo, komanso kukonza zotsatira za odwala.

Kodi Kulephera kwa Bracket Bond N'chiyani Ndipo N'chifukwa Chiyani Kuli Kofunika?

Kugwirana kodalirika kwa ma bracket ndikofunikira kwambiri pakugwira bwino ntchito kwa chithandizo chamakono cha mano. Ngati bracket ichoka pa dzino msanga, imasokoneza mphamvu za biomechanical zomwe zimafunikira kuti dzino lisunthe, zomwe zimapangitsa kuti zotsatira zake zikhale zovuta komanso nthawi yayitali ya chithandizocho ichedwe.

Mu malo azachipatala omwe amayendetsedwa bwino, muyezo wovomerezeka padziko lonse wa kuchuluka kwa kulephera kwa ma bracket bond nthawi zambiri umakhala pakati pa 5% ndi 10%. Kupitirira malire awa kumasonyeza cholakwika cha dongosolo pakusankha zinthu, njira zachipatala, kapena kasamalidwe kotsatira malamulo a odwala. Kumvetsetsa momwe kulephera kumeneku kumachitikira ndi gawo loyamba pakukhazikitsa njira zowongolera.

Chifukwa chiyani kulephera kwa chigwirizano cha bracket kumawonjezera nthawi yogwiritsira ntchito mpando

Zotsatira zake za kulephera kwa chikole cha bracket ndi kuwonjezeka kwakukulu kwa nthawi yosakonzedweratu ya mpando. Kusintha chikole chimodzi kumafuna kuchotsa zotsalira za composite, kupoperanso, kupatula, kupukuta, kuyikanso, ndikuyikanso chikole chatsopano. Nthawi zambiri izi zimatenga mphindi 10 mpaka 15 za nthawi yachipatala.

Kupatula kusokonezeka kwa nthawi yomweyo pa nthawi yokumana ndi dokotala, kulephera kwa ma bond osakonzedwa kumapita patsogolo mpaka nthawi yayitali ya chithandizo. Kafukufuku wa zachipatala akusonyeza kuti kulephera kulikonse kwa bracket kumatha kuwonjezera nthawi yonse ya chithandizo cha wodwala ndi mwezi umodzi mpaka iwiri. Izi sizimangochepetsa phindu la ntchito powonjezera ndalama zomwe wodwalayo amawononga komanso zimakhudzanso kukhutitsidwa kwa wodwalayo komanso kutsatira malamulo.

Momwe mungatanthauzire bwino kulephera kwa chikole cha bracket

Kulephera kwa chigwirizano cha bracket kumatanthauzidwa mwaluso ngati kuchotsedwa kosayembekezereka kwa chigwirizano cha orthodontic kuchokera pamwamba pa enamel asanafike gawo lokonzekera la chithandizo chochotsera chigwirizano. Kuti adziwe chomwe chimayambitsa vutoli, madokotala ayenera kugawa kulepherako kutengera Adhesive Remnant Index (ARI), yomwe imazindikira komwe kuswekako kunachitikira.

Kulephera kungachitike pa malo olumikizirana ndi enamel (kusonyeza kusakhazikika bwino kapena kuipitsidwa ndi chinyezi), mkati mwa guluu lokha (kulephera kugwirizana, kusonyeza kuti silikutha kapena zinthu zomwe zatha ntchito), kapena pa malo olumikizirana ndi guluu (kusonyeza kuti maukonde sakulowa bwino kapena kuipitsidwa ndi maziko). Kuti ntchito ikhale yabwino, mphamvu ya shear bond (SBS) iyenera kukhala mkati mwa zenera linalake lochiritsira: 6 mpaka 8 Megapascals (MPa) nthawi zambiri imafunika kuti ipirire mphamvu zopukutira ndi zodulira mano, pomwe kupitirira 14 MPa kumawonjezera kwambiri chiopsezo cha kusweka kwa enamel panthawi yopatukana.

Zomwe Zimayambitsa Kulephera kwa Bracket Bond Pa Chithandizo cha Orthodontic

Kugawikana kwa mabulaketi nthawi zambiri sikuchitika chifukwa cha cholakwika chimodzi; nthawi zambiri chimakhala vuto la zinthu zambiri zokhudzana ndi kuchitidwa kwachipatala, sayansi ya zinthu, ndi zinthu zina zomwe odwala amakumana nazo. Kuzindikira chomwe chimayambitsa vutoli kumafuna kuwunikanso bwino malo olumikizirana ndi mphamvu zakuthupi zomwe zimagwiritsidwa ntchito pabulaketi.

Mwa kusiyanitsa zinthu monga kulamulira chinyezi, makina omatira, ndi kusokoneza kwa occlusal, akatswiri amatha kuzindikira komwe njira yawo yolumikizirana ikuwonongeka.

Momwe mkhalidwe wa enamel ndi chinyezi zimakhudzira mphamvu ya mgwirizano

Mkhalidwe wa enamel ndi kukhalapo kwa chinyezi ndizomwe zimapangitsa kuti mgwirizano ukhale wautali. Kuipitsidwa kwa malovu, magazi, kapena madzi am'mimba panthawi yolumikizana ndi chifukwa chachikulu cha kulephera, zomwe zimatha kuchepetsa mphamvu ya mgwirizano ndi 30% mpaka 50%. Ngakhale chinyezi chozungulira kuchokera ku kupuma kwa wodwala chikhoza kusokoneza kusungidwa kwa micro-mechanical komwe kumachitika ndi etchant.

Kukonzekera enamel kumatanthauzanso kupambana. Njira yokhazikika imafuna masekondi 15 mpaka 30 odula ndi 37% phosphoric acid kuti pakhale microporosity yokwanira. Komabe, mikhalidwe ya enamel yosazolowereka, monga fluorosis, hypomineralization, kapena kukhalapo kwa mano odula, imakhala ndi zigawo za enamel zosasinthika zomwe zimakana kudula kokhazikika, zomwe zimapangitsa kuti nthawi yayitali yodula kapena microabrasion ifike kuti mphamvu ya 6 MPa bond ikhale yoyambira.

Momwe kapangidwe ka mabulaketi ndi kusankha zomatira zimakhudzira kulephera

Makhalidwe enieni a maziko a bracket amachita gawo lofunika kwambiri pakusunga makina. Maziko a foil-mesh, makamaka omwe amagwiritsa ntchito maukonde a 80-gauge, amapereka malo abwino kwambiri olumikizirana ndi guluu. Ngati maukondewo ndi abwino kwambiri, zinthu zokhuthala sizingalowe; ngati ndi zolimba kwambiri, guluu umafooka.

Kusankha zabwino kwambiriorthodontics yomatira yolumikizira pa bulaketiZimaonetsetsa kuti utomoni wophatikizika uli ndi kukhuthala koyenera kuti ulowe pansi pa bracket pamene ukukana kusunthika koyambirira. Zomatira zokhala ndi zodzaza zambiri zitha kukhala ndi mphamvu zambiri zokanikiza koma sizimatha kuyenda bwino kuti zinyowetse maukonde a bracket kwathunthu, zomwe zimapangitsa kuti ma interface a bracket-adhesive alephereke.

Momwe khalidwe la wodwala ndi mphamvu zobisika zimathandizira

Ngakhale mutapatula bwino komanso mutakhala ndi zinthu zabwino kwambiri, mphamvu zakunja zimatha kugonjetsa mgwirizano. Mphamvu zoluma zomwe zimayabwa m'magawo akumbuyo zimatha kupitirira 200 mpaka 500 Newtons. Odwala akanyalanyaza malamulo oletsa zakudya ndikudya zakudya zolimba, zopyapyala, kapena zomata, kudulidwa kwa ndulu ndi kukoka komwe kumachitika kumaphwanya guluu.

Kusokonezeka kwa occlusal kumathandiziranso kwambiri kulephera koyambirira. Pakakhala kuluma kwambiri kapena kukakamizidwa kwambiri, mano otsutsana nawo angakhudze mabulaketi atsopano panthawi yogwira ntchito. Ngati bulaketi ikuvutika nthawi zonse ndi occlusal over the 8 MPa threshold ya guluu, kuchotsedwa sikungapeweke pokhapokha ngati ma bite turbos kapena ma bite plates atayikidwa kuti atseke mano.

Ndi Ma Adhesive ndi Ma Protocol Otani Omwe Amachepetsa Kulephera kwa Bracket Bond

Kusankha njira yoyenera yomatira ndi chisankho chofunikira chomwe chimalamulira momwe ntchito yachipatala imayendera komanso kudalirika kwa ma bond. Msikawu umapereka mitundu yosiyanasiyana ya mankhwala, iliyonse yopangidwa kuti ithane ndi mavuto enaake azachipatala monga kuwongolera chinyezi, nthawi yogwira ntchito, komanso kuteteza enamel.

Kusintha kwaorthodontics yomatira yolumikizira pa bulaketiyaika patsogolo kupeza mgwirizano wabwino pakati pa kusunga bwino mkati mwa chithandizo ndi kuchotsedwa kwa bond kotetezeka komanso kodziwikiratu kumapeto kwa chithandizo.

Momwe njira zoyeretsera kuwala, kudzichiritsa wekha, kudzichiritsa kawiri, ndi magalasi zimafananira

Ma resini opangidwa ndi kuwala amakhalabe muyezo wa makampani, ndipo amapereka nthawi yayitali yogwirira ntchito yomwe imalola malo okhazikika bwino a bracket asanayambe kuunika kwa masekondi 10 mpaka 20. Izi nthawi zambiri zimapereka mphamvu yolimba ya shear bond ya 8 mpaka 10 MPa. Ma glue odzipangira okha amadalira njira ya mankhwala ya magawo awiri ndipo makamaka amasungidwa kuti azilumikiza pamalo owonekera bwino pomwe kuwala sikungalowe, monga ma molar bands kapena korona zachitsulo.

Simenti ya ionomer yagalasi yosinthidwa ndi resin (RMGI) imapereka mwayi wapadera m'malo omwe ali ndi chinyezi. Chifukwa chakuti ndi yofewa ndi madzi, imagwira ntchito bwino kuposa zinthu zopangidwa m'minda yosiyana pang'ono, monga mizere yachiwiri yophulika pang'ono. Komabe, kulekerera chinyezi kumeneku kumabweretsa ndalama zochepa pakusunga konse, ndipo ma RMGI nthawi zambiri amapereka SBS yotsika ya 5 mpaka 7 MPa.

Nthawi yoti musinthe njira zokoka, zokonzera, ndi zophikira

Kulumikiza kwachikhalidwe kumafuna magawo atatu osiyana: kukumba ndi asidi, kugwiritsa ntchito choyambira cha hydrophilic, ndikuyika phala lomatira. Ngakhale izi zimapangitsa kuti pakhale mphamvu yayikulu yolumikizana, imakhala yotetezeka kwambiri ku kuipitsidwa kwa malovu pakati pa masitepe. Kusintha njira iyi pogwiritsa ntchito Self-Etching Primers (SEPs) kumaphatikiza magawo okumba ndi omatira, zomwe zimachepetsa kwambiri kuipitsidwa kwa chinyezi.

Pogwiritsa ntchito ma SEP, madokotala ayenera kuonetsetsa kuti kuwala kothira ndi kokwanira, chifukwa kuphatikiza kwa mankhwala kumadalira kwambiri kulowa kwa photon mozama. Mphamvu yothira yocheperako ya 1,000 mW/cm² ndiyofunikira kwambiri. Ngati mphamvu ya kuwala yatsika, nthawi yothira pa bulaketi iliyonse iyenera kuwonjezeredwa kuchokera pa masekondi 10 mpaka masekondi 20 kuti tipewe kulephera kwa mgwirizano mkati mwa utomoni wosapangidwa.

Zinthu zomwe ziyenera kuyikidwa patebulo loyerekeza la zomatira

Kuti asankhe zinthu zomwe zili mu chipatala, madokotala ayenera kuwunika zomatira kutengera momwe zimagwiritsidwira ntchito. Kuyerekeza kokonzedwa bwino kumatsimikizira kuti zinthu zomwe zasankhidwa zikugwirizana ndi zosowa za wodwalayo komanso liwiro la ntchito ya dokotala.

Kodi Makhalidwe Angatani Kuti Asalepheretse Kulephera kwa Chigwirizano cha Bracket

Kupewa kulephera kwa chigwirizano cha bracket kumafuna kusintha kuchoka pa sayansi ya zinthu kupita ku ntchito zachipatala zokhwima komanso zobwerezabwereza. Kusintha kwa momwe othandizira amakonzera mano kapena momwe zinthu zimasungidwira kungayambitse zofooka zobisika mu mawonekedwe a chigwirizano.

Mwa kugwiritsa ntchito njira zokhazikika zogwirira ntchito, magulu ochizira mano amatha kuchotsa zolakwika zazing'ono zomwe zimapangika kukhala zolephera zazikulu, motero kukhazikika kwa ndalama zowonjezera ndikusunga chithandizo pa nthawi yake.

Ndi njira iti yolumikizirana pang'onopang'ono yomwe imawongolera kusinthasintha

Njira yolumikizirana pang'onopang'ono komanso yosasinthika ndiyo njira yodzitetezera kwambiri ku kulephera. Izi zimayamba ndi kupewa mano; mano ayenera kupukutidwa pogwiritsa ntchito slurry wamba. Kugwiritsa ntchito ma prophy phala okhala ndi fluoride, mafuta onunkhira, kapena glycerin kungasiye zotsalira zazing'ono zomwe zimachepetsa mphamvu ya mgwirizano ndi 15%.

Pambuyo popewa, muyenera kudzipatula kwathunthu pogwiritsa ntchito zochotsera masaya, zoteteza lilime, ndi kuyamwa kwambiri. Chotsukiracho chiyenera kugwiritsidwa ntchito kwa masekondi 30, kutsukidwa bwino kwa masekondi 10, ndikuumitsidwa ndi mpweya wopanikizika wopanda mafuta, wopanda chinyezi mpaka enamel iwoneke yoyera ngati choko. Chotsukiracho chiyenera kugwiritsidwa ntchito ngati wosanjikiza woonda, wofanana, kutsatiridwa ndi malo olimba a bulaketi kuti atulutse kuwala, komwe kuyenera kuchotsedwa mosamala musanachire.

Momwe magulu angagwirizanitsire ntchito zosungira, zosungiramo zinthu, ndi zowunikira magetsi

Kuwonongeka kwa zinthu kumabweretsa kulephera kwa mgwirizano. Ma glue ndi ma primer ali ndi zinthu zosinthika zomwe zimawonongeka zikagwiritsidwa ntchito kutentha kapena kuwala kozungulira. Makhalidwe ayenera kutsatiridwamalamulo okhwima osungira zinthu zomwe zili m'sitolo, nthawi zambiri imafuna kutentha kozizira pakati pa 2°C ndi 8°C. Komabe, composite yozizira imakhala yolimba kwambiri ndipo ingalephere kulowa mu ukonde wa bracket; chifukwa chake, zipangizo ziyenera kusungidwa kutentha kwa chipinda kwa ola limodzi musanayambe nthawi yolumikizirana.

Kusamalira zida n'kofunika kwambiri. Ma diode omwe ali mu magetsi oyeretsera a LED amachepa pakapita nthawi, zomwe zimapangitsa kuti mphamvu yotulutsa ichepetsedwe mosazindikira. Magulu azachipatala ayenera kuyesa magetsi oyeretsera sabata iliyonse pogwiritsa ntchito radiometer ya mano kuti atsimikizire kuti mphamvu yotulutsa ikupitirira 1,000 mW/cm². Ngati zida zalephera kapena zipangizo zitatha ntchito, akatswiri ayenera kugwiritsa ntchito ogulitsa.Lumikizanani nafeMa portals kuti ateteze mwachangu zinthu zina ndikupewa kugwiritsa ntchito zinthu zomwe zawonongeka.

Ndi ziti zomwe ziyenera kutsatiridwa kuti ziwunikire kuchuluka kwa zolephera

Kuti azitha kuyang'anira bwino khalidwe, machitidwe ayenera kutsatira miyezo yeniyeni ya kulephera m'malo modalira kuwona zochitika zakale. Kutsata kuchuluka kwa kulephera kumathandiza woyang'anira zachipatala kuzindikira njira—monga ngati kulephera kumagawidwa pa chigawo china, wothandizira zachipatala, kapena gulu linalake la gulu la zomatira.

Mayeso abwino ayenera kukhala ndi chiŵerengero cha kulephera kosakwana 5%. Ngati deta ikuwonetsa kuti ma leather a second second ali ndi chiŵerengero cha kulephera cha 12%, mayeserowa akhoza kulunjika makamaka ku njira zowongolera chinyezi m'dera limenelo.

Kodi Madokotala Ayenera Kusankha Bwanji Njira Yoyenera Yomatira

Kusankha njira yoyenera yomatira sikuti ndi kupeza guluu wolimba kwambiri, koma kupeza chinthu choyenera chomwe chingathandize kuti khungu lisungike bwino panthawi ya chithandizo ndi kuchotsa bwino pambuyo pake. Madokotala ayenera kusintha njira yawo kutengera zomwe wodwala aliyense akufuna.

Ndondomeko yokhazikika, yofanana ndi zonse imabweretsa mgwirizano, pomwe njira yolunjika, yokhazikika pa mfundo imatsimikizira kuti odwala amatha kudziwiratu zomwe zikuchitika.

Ndi mfundo ziti zomwe ziyenera kutsogolera kusankha guluu ndi njira zotsatirira

Zinthu zofunika kwambiri zomwe zimatsogolera kusankha guluu ndi zinthu zomangira, pamwamba pa dzino, ndi malo omwe wodwalayo ali. Mwachitsanzo, mabulaketi a polycrystalline ceramic alibe kusinthasintha ngati chitsulo chosapanga dzimbiri. Ngati atalumikizidwa ndi chinthu cholimba kwambiri (chomwe chimapereka >14 MPa), chiopsezo cha kung'ambika kwa enamel kapena kusweka kwa guluu panthawi yopatukana chimawonjezeka kwambiri. Pazochitikazi, madokotala nthawi zambiri amasankha guluu wopangidwira makamaka zomangira, zomwe zimasweka modziwikiratu pamalo olumikizirana ndi guluu.

Pansi pa nthaka ndi pomwe pamafunika njira yogwirira ntchito. Kulumikizana ndi enamel yoyera kumathandizama resini ophatikizika wamba, koma kugwirizana ndi makorona a porcelain, kukonzanso golide, kapena amalgam kumafuna kukonza pamwamba pa zinthu mwapadera—monga hydrofluoric acid etching kapena silane coupling agents—ndipo nthawi zambiri kumapindula ndi ma resin odzazidwa kwambiri komanso otsukidwa ndi mankhwala kuti atsimikizire kukhazikika.

Momwe mungagwirizanitsire kudalirika kwa ma bond, chitetezo cha enamel, komanso magwiridwe antchito a nthawi

Pomaliza pake, cholinga chake ndikupeza mphamvu yabwino kwambiri yolumikizirana ya 6

Kuwerenga kwina:

• orthodontics yomatira yolumikizira pa bulaketi
• orthodontics yomatira yolumikizira pa bulaketi
• orthodontics yomatira yolumikizira pa bulaketi

Mfundo Zofunika Kwambiri

• Zofunikira kwambiri ndi zifukwa zogwiritsira ntchito orthodontics ya bracket adhesive
• Mafotokozedwe, kutsata malamulo, ndi macheke owopsa oyenera kutsimikiziridwa musanachite izi
• Njira zotsatila zogwira mtima komanso machenjezo omwe owerenga angagwiritse ntchito nthawi yomweyo

Mafunso Ofunsidwa Kawirikawiri

Kodi ndi chifukwa chiyani nthawi zambiri ma brackets amatuluka panthawi ya chithandizo?

Kuipitsidwa ndi chinyezi ndiye chifukwa chachikulu. Malovu, magazi, kapena madzi a m'mitsempha panthawi yocheka kapena kulumikiza zitha kuchepetsa kwambiri mphamvu ya mgwirizano ndikupangitsa kuti bracket itayike msanga.

Kodi madokotala angachepetse bwanji kulephera kwa bracket bond mu ntchito ya tsiku ndi tsiku?

Gwiritsani ntchito njira yodzipatula mosamala, yeretsani ndi kuumitsa enamel bwino, pukutani bwino, ikani primer mofanana, ndipo ikani chivundikirocho popanda kuipitsidwa musanachiume bwino.

Kodi kusankha guluu kumakhudza kudalirika kwa chigwirizano cha bracket?

Inde. Guluu wopangidwa bwino wa orthodontic uyenera kulowa mu ukonde wa bracket, kuuma kwathunthu, ndikupereka mphamvu zokwanira popanda kupangitsa kuti kusweka kwa enamel kukhale koopsa.

Kodi ndi mphamvu yotani yolumikizira shear yomwe nthawi zambiri imaonedwa kuti ndi yotetezeka pa mabulaketi a orthodontic?

Mphamvu yogwira ntchito ndi pafupifupi 6 mpaka 8 MPa. Izi nthawi zambiri zimapirira mphamvu zochizira komanso zimachepetsa chiopsezo cha kuwonongeka kwa enamel panthawi yochotsa bracket.

Kodi malo ochitira opaleshoni angapeze kuti zinthu zomatira zomatira zogwiritsidwa ntchito pakhungu?

Madokotala amatha kuwonanso njira zomatira zomatira pogwiritsa ntchito kabukhu ka zinthu za DenRotary pa denrotary.com kuti ayerekezere zipangizo zomangira nthawi zonse.