Momwe Mungasankhire Mabracket Oyenera Odzipangira Okha Chithandizo cha Orthodontic

Mabulaketi odzimanga okha asintha chithandizo cha mano m'zaka makumi awiri zapitazi. Mosiyana ndi mabulaketi achikhalidwe omwe amafunikira ma ligature otanuka kapena a waya kuti ateteze waya wa arch, mabulaketi odzimanga okha amakhala ndi chipata chomangidwa mkati kapena njira yotsetsereka. Kapangidwe kameneka kamachepetsa kukangana, kamachepetsa nthawi yokumana, komanso kumawonjezera chitonthozo cha wodwala. Malinga ndi American Association of Orthodontists (AAO), odwala pafupifupi 4 miliyoni ku United States amalandira chithandizo cha mano chaka chilichonse, ndipo machitidwe odzimanga okha ndi omwe amachititsa kuti milandu ikule kwambiri. Machitidwe ogwiritsa ntchito mabulaketi odzimanga okha amanena kuti amachepetsa nthawi yomwe wodwala ali pampando ndi mphindi 15-20 paulendo uliwonse.

Bukuli likufotokoza zinthu zofunika kwambiri zomwe madokotala a mano ndi akatswiri a mano ayenera kuzifufuza posankha mabulaketi odzipangira okha, kuphatikizapo kusiyana kwa kapangidwe ka makina, deta ya magwiridwe antchito azachipatala, kufotokozera za zinthu, komanso kuganizira za momwe mtengo wake ungagwiritsidwire ntchito.

Kodi Mabaketi Odzilimbitsa Ndi Chiyani Ndipo Amagwira Ntchito Motani?

Mabulaketi odzigwirizanitsa okha ndi zida zogwirira ntchito za orthodontic zomwe zili ndi njira yolumikizirana yomwe imagwirira mwachindunji waya wa arch popanda kugwiritsa ntchito ma ligature akunja. Thupi la bulaketi lili ndi chogwirira chosunthika, chipata, kapena kasupe yemwe angatsegulidwe kuti aike waya kenako nkutsekedwa kuti aikemo m'malo mwake.

Pali magulu awiri akuluakulu a makina:

Mabulaketi odziyimitsa okhaIli ndi kutseka kolimba komanso kosasuntha komwe sikugwiritsa ntchito mphamvu yogwira ntchito pa waya wa arch. Njira yotsetserekayi imasunga kulumikizana kosasunthika ndi waya, zomwe zimachepetsa kukana kukangana panthawi yosuntha mano. Kapangidwe kameneka ndi koyenera makamaka pa magawo obweza mano ndi zikwama zomwe zimafuna makina otsetsereka bwino.

Mabulaketi odzigwira okha ogwira ntchitoIkani chitseko kapena kasupe wodzaza ndi kasupe womwe umagwiritsa ntchito mphamvu yolumikizana pang'ono pa waya wa arch. Pamene wayayo ndi wocheperako kuposa kukula kwa malo olumikizirana, kasupeyo amalumikizana ndi wayayo, zomwe zimapangitsa kuti wayayo ikhale yolumikizana bwino kwambiri kumayambiriro kwa chithandizo.

Ndemanga ya dongosolo ya 2019 yofalitsidwa muKupita Patsogolo kwa Ma OrthodonticsMagaziniyi inapeza kuti makina osasunthika nthawi zonse amatulutsa mphamvu zochepa zokangana (nthawi zambiri 50–200gf yotsika poyerekeza ndi waya/mabulaketi oyesedwa) pomwe makina ogwirira ntchito adawonetsa kulinganiza koyambirira mwachangu m'malo ocheperako mpaka ocheperako.

Chifukwa Chake Mabracket Odzimanga Amachepetsa Nthawi Yochizira ndi Kupita Kumipando

Chimodzi mwa zabwino zomwe zatchulidwa kwambiri za mabulaketi odziyimitsa okha ndi kuchepetsa nthawi yonse ya chithandizo komanso kuchuluka kwa nthawi yokumana ndi dokotala. Maphunziro azachipatala amapereka zambiri zokhutiritsa:

• Kafukufuku woyembekezeredwa mwachisawawa adanenanso kuti nthawi ya chithandizo yafupika pafupifupi miyezi 6 kwa odwala onse omwe amagwiritsa ntchito njira zodzigwirira okha poyerekeza ndi mabulaketi a mapasa wamba.
• Nthawi zambiri nthawi yokumana imatha kupitilira milungu inayi mpaka milungu isanu ndi umodzi mpaka isanu ndi itatu chifukwa cha mphamvu yogwira ntchito komanso kuchepa kwa kukangana.
• Kuchotsa malo olumikizirana mafupa ndi kuchotsa mafupa kumapulumutsa pafupifupi mphindi 5-8 pa nthawi iliyonse yokumana, malinga ndi kafukufuku wokhudza nthawi yomwe yachitika m'masukulu a mano aku yunivesite.

Njira yoyendetsera kusinthaku imayang'ana kwambiri kuchepetsa kukangana. Mu machitidwe achikhalidwe, ma ligature otanuka amapanga kulumikizana pakati pa malo olumikizirana ndi waya wa archwire, makamaka panthawi yoyenda. Machitidwe odziyimitsa okha amachepetsa kukangana kumeneku ndi 60–80%, zomwe zimathandiza kuti mphamvu zopepuka zopitilira zisunthe mano bwino kudzera mu fupa la alveolar.

Zinthu Zofunika: 17-4 Chitsulo Chosapanga Dzimbiri vs. Ukadaulo wa MIM mu Mabaketi a Orthodontic

Mabulaketi ambiri amalonda odzipangira okha amapangidwa ndi chitsulo chosapanga dzimbiri chopangidwa ndi cast stainless steel kapena metal injection molding (MIM). Kumvetsetsa njira izi kumathandiza kugula zisankho za ma laboratories a mano ndi ma orthodontics.

17-4 chitsulo chosapanga dzimbiriNdi aloyi yolimba yomwe ili ndi chromium (16–18%), nickel (3–5%), mkuwa (3–5%), ndi niobium. Mphamvu yake yotulutsa ya pafupifupi 1,000–1,200 MPa imapangitsa kuti ikhale yolimba kwambiri polimbana ndi kusintha kwa kutentha kwa magetsi. Zinthuzi ndizothandiza kwambiri makamaka kwa mabulaketi omwe ali ndi mphamvu zambiri panthawi yogwiritsa ntchito mphamvu.

Kupangira Injection ya Chitsulo (MIM)ndi njira yopangira mawonekedwe ofanana ndi ukonde yomwe imaphatikiza chitsulo chophwanyidwa ndi makina omangirira. Chosakanizacho chimalowetsedwa mu zinyalala zolondola, kenako chimatuluka ndikusinjidwa. Zigawo za MIM zimasonyeza kukhazikika kwabwino kwambiri (+/- 0.02mm kulolerana), komwe ndikofunikira kwambiri pa kulondola kwa miyeso ya slot mu mabulaketi odzigwirizanitsa okha. Malinga ndi kafukufuku wofalitsidwa muJournal of Zipangizo Zamakono ndi Magwiridwe Antchito, Chitsulo chosapanga dzimbiri cha 17-4 chokonzedwa ndi MIM chimakhala ndi mphamvu zofanana ndi za zinthu zomangidwa pambuyo pozitsuka bwino.

Opanga omwe amagwiritsa ntchito ukadaulo wa MIM amanena kuti amatha kupanga zinthu zoposa 10,000 pa mzere uliwonse wa kupanga, zomwe zimathandiza kuti pakhale kuwongolera kwabwino komanso mitengo yopikisana pogula zinthu zambiri.

Kuyerekeza Machitidwe Odzipangira Okha: Mitundu ya Mankhwala a Roth vs. MBT

Mankhwala awiri odziwika bwino a orthodontic amalamulira msika wa bracket yodziyimira payokha: Roth specification ndi MBT (McLaughlin, Bennett, Trevisi). Onsewa amafotokoza za torque, tip, ndi angulation values ​​zomwe zimamangidwa mu bracket slot iliyonse.

Mankhwala a Roth adapangidwa ndi Dr. Ronald Roth m'zaka za m'ma 1970 ndipo akugogomezera kukonza mopitirira muyeso kuti afotokozere zomwe zimayambitsa kubwereranso m'mbuyo. Mankhwala a MBT adachokera pakukonzanso bwino kwadongosolo ndipo amapereka mphamvu yayikulu yogwirira ntchito m'mbali mwa khungu. Ma bracket ambiri amakono omwe amalumikizana okha amapereka mankhwala onsewa m'mitundu yawo yonse.

Kukonda kwachipatala nthawi zambiri kumadalira nzeru za chithandizo cha munthu payekha, ndipo MBT ikuchulukirachulukira m'machitidwe amakono chifukwa cha kugwira ntchito kwake kolembedwa m'mitundu yosiyanasiyana ya malocclusion.

Momwe Mungaphatikizire Mabracket Odzipangira Payekha mu Kayendedwe Kanu ka Ntchito

Kusintha kukhala makina odzipangira okha zinthu kumafuna kuganizira njira zochiritsira, maphunziro a ogwira ntchito, ndi kasamalidwe ka zinthu.

Gawo 1: Unikani Njira Zosankhira Nkhani.Mabulaketi odziyimitsa okha amagwira ntchito bwino kwambiri pakakhala kuti pakufunika makina otsetsereka bwino: kutseka malo, kulumikizana kwa waya wa archwire, komanso kukhazikika pang'ono. Kufunika kwa torque yovuta kapena kuzungulira kwakukulu kungapindulebe ndi zida zochiritsira wamba.

Gawo 2: Phunzitsani Ogwira Ntchito Zachipatala pa Kugwira Ntchito kwa Makina.Mosiyana ndi mabulaketi achikhalidwe omwe amafuna kuyika mabulaketi, mabulaketi odziyikira okha amafunika njira zinazake zotsegulira ndi kutseka. Kuphunzitsidwa bwino ndi zida zowonetsera zomwe zimapangidwa ndi wopanga kumachepetsa zolakwika pambali pa mpando panthawi yoyamba kugwiritsa ntchito.

Gawo 3: Sinthani Nthawi Yokonzekera Nthawi Yokumana.Machitidwe nthawi zambiri amawonjezera nthawi yokumbukira mpaka milungu 6-8 pogwiritsa ntchito njira zodzigwirira zokha, chifukwa mphamvu imawola pang'onopang'ono ndipo kuyenda kwa mano kumachitika nthawi zonse popanda kusokonezeka chifukwa cha kukangana.

Gawo 4: Yang'anirani Zinthu zomwe zili muakaunti yanu ndikusintha nthawi yogulira zinthu.Mabulaketi odziyikira okha nthawi zambiri amakhala ndi ndalama zambiri pa unit kuposa mabulaketi achizolowezi koma amachotsa kufunika kwa zinthu zosiyana zogwirira ntchito. Werengani ndalama zonse za wodwala aliyense kuphatikizapo zowonjezera zonse kuti muwone bwino ndalama zomwe zasungidwa.

Kusanthula Kugwiritsa Ntchito Mtengo Moyenera: Mabaketi Odzigwira Okha Mosiyana ndi Machitidwe Achizolowezi

Mitengo yoyambira ya ma bracket a makina odziyimitsa okha nthawi zambiri imakhala yokwera ndi 20-40% kuposa ma bracket achikhalidwe awiri. Komabe, kusanthula ndalama zonse kukuwonetsa chithunzi chosiyana kwambiri.

Kusunga ndalama mwachindunji kumaphatikizapo:kuchotsa ma elastic ligatures ($3–$8 pa wodwala aliyense paulendo uliwonse), kuchepetsa nthawi yochitira opaleshoni zomwe zimapangitsa kuti odwala azitha kugwiritsa ntchito bwino zinthu zambiri, komanso kuchepetsa zinthu zomwe zili m'zida.

Mapindu osalunjika ndi awa:kusintha kwa chithandizo cha odwala (palibe kusintha kwa ululu m'mitsempha), kuchepetsa maulendo obwera mwadzidzidzi chifukwa cha kusweka kapena kutayika kwa mitsempha, komanso kuchuluka kwa njira zoyezera momwe ntchito ikuyendera.

Kusanthula mtengo kwa 2020 komwe kwafalitsidwa muMagazini ya Clinical Orthodonticsadawerengera kuti machitidwe osinthira ku machitidwe odzigwirira okha adachepetsa ndalama zonse za wodwala aliyense ndi pafupifupi 8–12% poganizira za kuchotsa ma ligature ndi kusunga nthawi mu njira yochizira ya miyezi 18.

Mafunso Ofunsidwa Kawirikawiri

Kodi kusiyana kwakukulu pakati pa mabulaketi odzigwira okha ndi osagwira ntchito ndi kotani?

Mabraketi odzigwira okha amagwiritsa ntchito chogwirira chodzaza ndi kasupe chomwe chimayika mphamvu yopepuka pa waya wa arch, zomwe zimapangitsa kuti zikhale zothandiza pa magawo oyambirira a kulinganiza. Mabraketi odzigwira okha okha ali ndi kapangidwe ka chipata chosasuntha chomwe sichigwiritsa ntchito mphamvu yogwira ntchito pa waya, zomwe zimachepetsa kukangana panthawi yoyenda. Kusankha kumadalira gawo la chithandizo ndi zolinga za biomechanical.

Kodi ma bracket odzigwirizanitsa okha amapanga kukangana kotani poyerekeza ndi ma bracket achizolowezi?

Mabraketi odzigwira okha amachepetsa kukangana ndi pafupifupi 60–80% poyerekeza ndi mabraketi awiri achizolowezi okhala ndi ma ligature otanuka, malinga ndi kafukufuku wa labotale. Kuchepetsa kumeneku kumathandiza kuti mphamvu zopepuka zopitilira zitheke kuyendetsa bwino mano.

Ndi zipangizo ziti zomwe zimagwiritsidwa ntchito popanga mabulaketi odzipangira okha?

Mabraketi ambiri odzipangira okha amapangidwa ndi chitsulo chosapanga dzimbiri cha 17-4 precipitation-hardening pogwiritsa ntchito precision casting kapena metal injection molding (MIM). Ukadaulo wa MIM umapereka kulondola kwapamwamba kwambiri komanso mawonekedwe okhazikika a slot, zomwe ndizofunikira kwambiri pakuwonetsa mphamvu yeniyeni.

Kodi mabulaketi odziyimitsa okha amafupikitsa nthawi yonse yochizira mano?

Kafukufuku wambiri wa zachipatala wanena kuti nthawi ya chithandizo yafupika ndi miyezi 4-6 kwa odwala onse omwe amagwiritsa ntchito njira zodzipangira okha. Nthawi yokumana ndi dokotala nthawi zambiri imatha kukulitsidwa kuyambira milungu 4 mpaka milungu 6-8, kuchepetsa kuchuluka kwa maulendo onse pamene chithandizocho chikupitilira kugwira ntchito bwino.

Kodi mabulaketi odzipangira okha ndi oyenera mitundu yonse ya malocclusion?

Mabulaketi odziyimitsa okha ndi othandiza pa mitundu yambiri ya malocclusion kuphatikizapo kudzazana, mtunda, ndi kukonza kwa Gulu Lachiwiri. Komabe, milandu yomwe imafuna mphamvu yowonjezereka kapena makina ovuta ingapindulebe ndi zida zowonjezera. Kusankha chikwama kuyenera kutengera zofunikira za biomechanical payekha.