CN110141381B - Correction method and correction device for pushing molar teeth far away for invisible correction - Google Patents

Abstract

The embodiment of the application provides a method and a device for pushing molars to move far away for invisible correction, and relates to the technical field of orthodontics. The method for correcting the molar tooth far comprises the steps of determining impedance centers of teeth to be molar on two sides of an upper jaw; and applying far-moving correction force to the molar at the level of the impedance center, wherein the correction force at the two sides pushes the molar at the two sides to move towards the direction parallel to the dental arch. The correcting method and the correcting device provided by the application can apply correcting force moving towards the far direction to the molars on the two sides of the upper jaw together, and can ensure the parallel far movement of the molars. The device can cooperate with the traditional fixed appliance to remotely move the molar, can also cooperate with the invisible appliance to remotely move the molar, and prevents the anterior teeth bone windowing bone cracking caused by the inclination of the anterior teeth lips when the invisible appliance is remotely moved.

Description

Orthodontic method and orthodontic device for pushing molars distally that can be used for invisible orthodontic treatment

technical field

The present application relates to the technical field of orthodontics, and in particular, to an orthodontic method and orthodontic device for pushing molars distally that can be used for invisible orthodontic treatment.

Background technique

Orthodontics is a branch of oral medicine. Malocclusion is a deformity caused by congenital genetic factors and acquired environmental factors during the growth and development of children, such as dental, jaw, and craniofacial deformities caused by diseases, bad oral habits, and abnormal replacement teeth, such as tooth arrangement. Unevenness, abnormal relationship between upper and lower dental workers, abnormal size, shape and position of jawbone, etc. Misalignment can affect the normal development of the maxillofacial region, form a "small jaw" or "envelope," which in turn affects oral health, increases the prevalence of dental caries, periodontal inflammation, affects pronunciation, chewing and swallowing abnormalities, and Affect the appearance and beauty, and even lead to psychological disorders. It can be seen that the correction of malocclusion, especially for adolescent patients, is of great significance.

Mesial movement of molars is a common type of malocclusion in orthodontic clinics, which usually causes crowding and protrusion of the teeth. The treatment method for mesial movement of molars is to use orthodontic appliances to push the molars to move distally to restore the correctness of the molars. position while providing space for crowded teeth in the front. Among them, the distal movement of maxillary push molars to obtain interdental space is the current research hotspot, which is highly accepted by patients and has broad clinical application prospects.

There are many methods to move the molars far, such as the technique of moving the molars with the external arch of the head cap, the technique of pushing the molars distally with the external arch with the lip-bumper, and the combination of the external arch and the sliding rod (slide_-jig). Distal mobile molar technology, spiral push spring combined with head cap J hook to push molar to distal technology, pendulum correction technology (pendulum), dual-track device distal mobile molar technology, movable appliance combined with external arch distal mobile molar technology, molar push ( Jones Jig) distal mobile molar technology, movable appliance distal mobile molar technology, Keles appliance, Fangsifang "M" curve distal mobile molar technology, micro-implant anchored distal mobile molar technology and dozens of other technologies.

However, the above methods have obvious shortcomings. If the distal thrust generated by extraoral traction, movable appliance and intermaxillary traction is used, the cooperation of the patient must be required, and the anchorage of the anterior teeth will also be lost - the mesial movement of the anchorage teeth and the lip tilt of the maxillary incisors, the maxillary molars Distant tilt. For the fixed appliance that pushes the maxillary molars distally, the patient's cooperation is good, but there are still corresponding technical shortcomings, that is, the gap between the appliance pushing the molars to the distal part is caused by the distal movement of the molars, and the other part is due to the anchorage of the anterior teeth. Distal molar tilting can also occur if the molar shift is lost, and the tilted molar shift makes it more likely to recur after treatment.

SUMMARY OF THE INVENTION

In view of this, the purpose of the embodiments of the present application is to provide a orthodontic method and orthodontic device for pushing molars distally, so as to solve the problem that most of the current orthodontic appliances are prone to the distal tilt of the molars and the recurrence of the molars after the distal movement of the molars in place. question.

The embodiment of the present application provides an orthodontic method for pushing molars distally that can be used for invisible orthodontic treatment, including:

Determine the impedance center of the molars to be pushed on both sides of the maxilla;

The orthodontic force is applied to the molars to be pushed at the impedance center, and the orthodontic forces on both sides push the molars on both sides to move in a direction parallel to the dental arch.

In the above-mentioned realization process of applying an orthodontic force to the molar to be pushed at the impedance center, and the orthodontic force on both sides pushes the molars on both sides to move in a direction parallel to the dental arch, one of the preferred embodiments includes:

An arc-shaped palatal arch main body is connected between the impedance centers of the molars to be pushed on both sides, and the palatal arch main body is parallel to the distal end of the dental arch;

A force applying element is connected to the main body of the palatal arch, and the force applying element transmits the correction force through the two ends of the main body of the palatal arch.

In the above implementation process, a force applying element is connected to the main body of the palatal arch, and the force applying element transmits the orthodontic force through the two ends of the main body of the palatal arch including:

An anchorage was implanted in the maxillary palatal suture;

A distal support arm is installed on the anchor, the distal support arm includes two support arms extending in the distal direction, the ends of the support arms extend to the second molar, and the installation centers of the two support arms ends The height is the same as the impedance center height of the molar to be pushed;

Traction hooks are respectively provided on both sides of the middle position of the main body of the palatal arch;

An elastic piece is used to connect the traction hook and the end of the support arm on the same side, and the elastic piece is in a stretched state.

In the above implementation process, the height of the end of the support arm is located 1-2 mm below the bifurcation of the root.

In the above implementation process, the determining the impedance centers of the molars to be pushed on both sides of the maxilla includes:

The position of the impedance center of the molar to be pushed was photographed and confirmed by a cone beam projection computerized reconstruction tomography device. The working principle of the cone beam projection computer reconstruction tomography equipment is that the X-ray generator performs a circular digital projection around the projection body with a low radiation dose, and then "intersection" after multiple digital projections around the projection body The data obtained in the computer are reconstructed in the computer to obtain a three-dimensional image. Using cone beam projection computer reconstruction tomography equipment and three-dimensional finite element analysis can accurately obtain the impedance center position of molars.

According to another aspect of the present invention, there is also provided an orthodontic device for pushing molars distally that can be used for invisible orthodontic treatment, comprising:

an arc-shaped palatal arch main body, comprising two ends respectively for connecting with the impedance centers of the molars to be pushed on both sides of the maxilla; a traction hook is respectively provided on both sides of the middle part of the palatal arch main body;

Implant anchorage for placement in the maxillary palatine suture;

a distal support arm, comprising two support arms for extending to the second molar in the distal direction, and the installation center height of the ends of the two support arms is the same as the impedance center height of the molar to be pushed;

Two force-applying elements are respectively connected to the towing hook and the end of the support arm on the same side.

In the above implementation process, the main body of the palatal arch is parallel to the distal part of the dental arch. The main body of the palatal arch is parallel to the distal end of the dental arch. When the main body of the palatal arch pushes the molars on both sides to move distally, the dental arch will also be pushed in parallel by the main body of the palatal arch, and then move to the distal direction, so as to realize the dental arch and the molars. The overall far-distance movement.

In the above implementation process, the distal support arms are connected by a palatal support for fixing in the maxillary palatal suture region. The palatal tray is fixed to the maxillary palatal suture region by the anchorage. By fixing the two support arms on the palatal support, the palatal support can increase the contact area with the palatal suture, which is beneficial to anchorage fixation, and can also make the fixation of the support arms more firm and stable.

In the above implementation process, the anchorage is a micro-implant nail. Micro-implant anchorage, the anchorage unit does not have the participation of the teeth, the force of pushing the molars far away is all released to the implant, no anchorage loss occurs, and the anterior teeth will not have corresponding labial tilt, and it can be more efficient than traditional anchorages. Move your molars. Due to the small size of the implant nail, the implantation position is flexible. In the embodiment of the present application, the implantation nail can be implanted on both sides of the midpalatal suture in addition to the midpalatal suture, and the implantation position can be adjusted as required.

As a preferred embodiment, the force applying element is any one of a tension spring, an elastic rubber ring and a chain rubber ring.

It can be seen from the above technical solutions that the orthodontic method and the orthodontic device described in this application can apply a orthodontic force that moves to the distal direction to the molars on both sides of the maxilla, and at the same time, the orthodontic force can also drive the entire dental arch to move to the distal direction. This avoids the recurrence of malocclusion after corrective treatment.

Description of drawings

In order to explain the technical solutions of the embodiments of the present application more clearly, the following briefly introduces the accompanying drawings that need to be used in the embodiments of the present application. It should be understood that the following drawings only show some embodiments of the present application, therefore It should not be regarded as a limitation of the scope. For those of ordinary skill in the art, other related drawings can also be obtained from these drawings without any creative effort.

1 is a schematic flowchart of a method for treating a molar distally that can be used for invisible orthodontic treatment provided by an embodiment of the present application;

FIG. 2 is a schematic structural diagram of an orthodontic device for pushing molars distally that can be used for invisible orthodontic treatment provided by an embodiment of the present application;

FIG. 3 is a force applying diagram of the force applying element acting on the main body of the palatal arch in the orthodontic device shown in FIG. 2 .

Icons: 1- Palatal arch body; 2- Implant anchorage; 3- Distal arm; 4- Force element; 10- Palatal arch body end; 11- Traction hook;

Detailed ways

The technical solutions in the embodiments of the present application will be described below with reference to the accompanying drawings in the embodiments of the present application.

It should be noted that like numerals and letters refer to like items in the following figures, so once an item is defined in one figure, it does not require further definition and explanation in subsequent figures. Meanwhile, in the description of the present application, the terms "first", "second", etc. are only used to distinguish the description, and cannot be understood as indicating or implying relative importance.

Among the dozens of existing methods for distally moving molars, some of them use extraoral traction, movable appliances and intermaxillary traction to generate distal thrust. Such correction methods can cause loss of anchorage of anterior teeth - mesial movement of anchorage teeth and maxillary traction. Labial inclination of the incisors, distal inclination of the maxillary molars. The other part is the use of fixed appliances to push the maxillary molars to move distally. This kind of orthodontic method has a good degree of patient cooperation, but because the appliance pushes the molars to the distal gap, part of the distance is caused by the distal movement of the molars, and the other part is due to the anchorage. Loss of tooth advancement and gain, distal tilting of maxillary molars also occurs. The oblique movement of the maxillary molars is the reason for the recurrence of malocclusion after the molar push-to-distal orthodontic treatment.

In order to prevent the maxillary molars from moving obliquely, the inventor of the present application adopts the neutral force applied by the molars and applies the orthodontic force to move the maxillary molars in the distal direction together, and the orthodontic force can also drive the entire dental arch to the distal direction. movement, thereby avoiding the recurrence of malocclusion that was treated with corrective treatment.

The orthodontic method for pushing molars to the distal in the present application will be described in detail below. FIG. 1 shows a schematic flowchart of a method for orthodontic pushing a molar distally provided by an embodiment of the present application. As shown in Figure 1, it includes:

S101: Determine the impedance center of the molars to be pushed on both sides of the maxilla.

In this step, the impedance center of each molar to be pushed is confirmed by CBCT (Cone beam Computed Tomography) and three-dimensional finite element analysis.

The working principle of the cone beam projection computer reconstruction tomography equipment is that the X-ray generator does a circular DR (digital projection) around the projection body with a lower radiation dose. The data obtained in the "intersection" of multiple digital projections around the projection body are then recombined in the computer to obtain a three-dimensional image. Using cone beam projection computer reconstruction tomography equipment can accurately obtain the impedance center position of molars.

It should be noted that, in this embodiment, the use of cone beam projection computer reconstruction tomography equipment to obtain the impedance center position of the molar is only one of the preferred implementations, and this application does not specifically limit the acquisition method of the impedance center position.

S102: Apply an orthodontic force to the molar to be pushed at the impedance center, and the orthodontic force on both sides pushes the molars on both sides to move in a direction parallel to the dental arch.

After obtaining the impedance center positions of the two molars to be pushed on both sides of the maxilla, orthodontic force was applied to the two molars to be pushed. In the orthodontic method in the present application, the force application position is the impedance center of the molars on both sides, and the orthodontic force on both sides needs to be applied at the same time, and the orthodontic effect is that while pushing the molar to be pushed distally, the orthodontic force on both sides can also drive the maxilla. The dental arch moves in the distal direction to realize the overall distal movement of the dental arch and the molars, thus making it difficult for the molars to recur after the distal movement of the molars.

In order to realize the orthodontic force on both sides and push the molars on both sides to move parallel to the dental arch, as one of the preferred solutions, an arc-shaped palatal arch main body is connected between the impedance centers of the molars to be pushed on both sides. The dental arches are parallel distally. A force applying element is connected to the main body of the palatal arch, and the force applying element transmits the correction force through the two ends of the main body of the palatal arch.

As a preferred embodiment, the force-applying element transmitting the orthodontic force through the two ends of the main body of the palatal arch includes: implanting an anchorage in the midpalatal suture of the maxilla; the anchorage is preferably an implant anchorage. Implant manipulation in the palatal suture is simple and easy to implement, easy to clean and maintain, and has minimal risk of damage to adjacent teeth.

In order to facilitate the application of force near the molar to be pushed, a distal arm is installed on the anchor. The distal arm includes two left and right arms, and the ends of the two arms extend in the distal direction to the back of the molar to be pushed, that is, close to the molar to be pushed. The position of the ends on both sides of the maxillary dental arch, and the height of the installation center of the ends of the two support arms is the same as the height of the impedance center of the molar to be pushed.

As a clinically preferred solution, the ends of the two support arms are located in the distal direction and the height is 1-2 mm below the root bifurcation of the molar to be pushed. The specific position can be determined based on the patient's CBCT data.

Traction hooks are respectively provided on both sides of the middle position of the main body of the arch of the palatine. Connect the tow hook and the end of the arm on the same side with an elastic piece. The elastic pieces located at the ends of the hook and the support arm are in a stretched state, the elastic force of the elastic pieces acts on the main body of the palatal arch, and the end of the main body of the palatal arch applies orthodontic force to the molars to be pushed along the distal direction.

Corresponding to the above-mentioned orthodontic method, the embodiment of the present invention further provides an orthodontic device for pushing molars distally. Fig. 2 is a schematic structural diagram of an orthodontic device for pushing molars distally provided by an embodiment of the application. As shown in Fig. 2 , the orthodontic device for pushing molars distally includes an arc-shaped palatal arch main body 1, an anchorage 2, a distal The middle support arm 3 and the force applying element 4.

The arc-shaped palatal arch main body 1 includes two end portions 10, which are respectively located at the impedance centers M1 and M2 of the molars to be pushed on both sides of the maxilla. The impedance center of the molar to be pushed is preferably confirmed by a cone beam projection computerized reconstruction tomography device, which will not be repeated here. Preferably, the palatal arch body 1 is parallel to the distal end of the dental arch.

Anchorage 2 was implanted in the maxillary palatal suture. The anchorage 2 in this application is preferably two implants, and the implants can be micro-implant nails A, or implants with other structures can also be selected. In clinical practice, micro-implant anchorages are often implanted in patients who need to push the molars backward. The anchorage unit does not involve the teeth. All the force of pushing the molars far away is released on the implants, and there is no anchorage loss, and no corresponding anterior teeth will occur. Lip tilt and move molars more efficiently than traditional anchorages.

Preferably, the traction hooks 11 of the arc-shaped palatal arch main body 1 are hooks, which are respectively arranged on both sides of the middle part of the palatal arch main body 1 . The hook structure is easy to manufacture and easy to clean, and it is implanted in the mouth without leaving food residues, which is beneficial to oral hygiene.

The distal support arm 3 includes a palatal support 30 and two support arms 31, and the palatal support 30 is fixed in the maxillary palatal suture region by the above-mentioned two micro-implantation nails. The two support arms 31 are fixed on the palatal bracket 30 and extend in the distal direction. The end of each support arm extends after the molar to be pushed, and the installation center height of the end of the two support arms is the same as the impedance center height of the to-be-pushed molar. In this application, after the molars are to be pushed, the position is close to the ends on both sides of the maxillary dental arch. In this embodiment, the front and rear of the molars to be pushed are based on the distal direction, the side close to the maxillary incisors is the front, and the side away from the maxillary incisors is the back.

It should be noted that, in addition to the palatal suture, the implant nails used in the embodiments of the present application can be implanted on both sides of the palatal suture, about between the maxilla 45, and the implantation position can be adjusted as required. The present application does not specifically limit the position of the implant nail.

As a preferred embodiment, the ends of the two support arms are located at a distance of about 1-2 mm from the bifurcation of the root of the molar to be pushed.

The force-applying element 4, preferably an elastic piece, connects the hook and the end of the support arm on the same side respectively through the elastic piece. The elastics at the ends of the hooks and arms are stretched.

FIG. 3 is a force applying diagram of the force applying element acting on the main body of the palatal arch in the orthodontic device shown in FIG. 2 . As shown in Figure 3, M1 and M2 are the impedance centers of the maxillary bilateral molars to be pushed, respectively, and the ends of the two arms of the distal arm 3 are B1 and B2, respectively. The elastic force is transmitted to the ends of the two arms to form the applied forces F1 and F2 on both sides. Since the installation center of the ends of the two arms is aligned with the resistance center of the molar to be pushed, the palate The distal end of the arch body 1 applies an orthodontic force along the distal direction to the molar to be pushed. The orthodontic force on both sides pushes the molars on both sides to move parallel to the dental arch, thereby realizing the overall parallel and distal movement of the molars.

The elastic member described in this application can be any one of a tension spring, an elastic rubber ring and a chain rubber ring.

It can be seen from the above solutions that the orthodontic method and orthodontic device described in this application can apply orthodontic force to move the molars on both sides of the maxilla in the distal direction, and the orthodontic force can also drive the entire dental arch to move in the distal direction, and then To avoid recurrence of malocclusion with corrective treatment.

The above descriptions are merely examples of the present application, and are not intended to limit the protection scope of the present application. For those skilled in the art, various modifications and changes may be made to the present application. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of this application shall be included within the protection scope of this application. It should be noted that like numerals and letters refer to like items in the following figures, so once an item is defined in one figure, it does not require further definition and explanation in subsequent figures.

It should be noted that, in this document, relational terms such as first and second are only used to distinguish one entity or operation from another entity or operation, and do not necessarily require or imply any relationship between these entities or operations. any such actual relationship or sequence exists. Moreover, the terms "comprising", "comprising" or any other variation thereof are intended to encompass a non-exclusive inclusion such that a process, method, article or device that includes a list of elements includes not only those elements, but also includes not explicitly listed or other elements inherent to such a process, method, article or apparatus. Without further limitation, an element qualified by the phrase "comprising a..." does not preclude the presence of additional identical elements in a process, method, article or apparatus that includes the element.

Claims (5)

1. An appliance for push molars distancing that can be used for invisible appliances, comprising:

the arch palatal arch body comprises two end parts which are respectively connected with teeth to be milled on two sides of an upper jaw, and the shape of each end part is a wave shape which can be fit with the teeth to be milled; two sides of the middle part of the faucial pillar body are respectively provided with a traction hook;

two anchorage members which are implanted in the maxillary palatal suture, wherein the connecting line of the centers of the two anchorage members and the symmetrical axis of the arc-shaped palatal arch body form an acute angle;

the distal support arms comprise two support arms which are used for extending to the second molar part in the distal direction, and the installation center height of the tail ends of the two support arms is the same as the impedance center height of the teeth to be ground;

two force application elements are respectively connected with the traction hook and the tail end of the support arm on the same side.

2. The appliance of claim 1, wherein the palatal arch body is parallel to the distal aspect of the arch.

3. The orthodontic device of claim 1, wherein the distal arm further comprises a palatal support for securing in the maxillary palatal midline region.

4. The orthodontic device of claim 1, wherein the anchorage is a micro-implant nail.

5. The orthosis apparatus according to any one of claims 1 to 4, wherein the force application member is any one of a tension spring, an elastic rubber band, and a chain rubber band.

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