Te Whakaiti i te Waku i roto i te Maimoatanga Orthodontic e ngā Paepae Here-A-Whaiaro

Kupu Whakataki

Ko te nekehanga o ngā niho orthodontic e whakawhirinaki ana ki te ngāwari o te neke o te waea āwhata i roto i ia whāriki, ā, koinei te wāhi e whakarerekē ai ngā pūnaha here-whaiaro i ngā tikanga. Engari ko te whakamahi i ngā here rapa, i ngā here whakarewa rānei, ka whakamahia e ēnei whāriki he topenga, he tatau rānei kua hangaia hei whakaiti i te kaha here i waenga i te waea me te mokowā. Ko te mutunga mai he iti ake te waku, he māmā ake te tuku kaha, ā, he maeneene ake pea te tūnga i ngā wāhanga maimoatanga matua. E whakamārama ana tēnei tuhinga i te mahi a taua hoahoa i roto i te koiora, he aha te hiranga o te waku iti mō te whai huatanga me te urupare kiko, me te wāhi e taea ai e ngā whāriki here-whaiaro te tuku painga mahi i runga i te here tikanga i te haere tonu o te maimoatanga.

He aha te hiranga o ngā whāriki here-whaiaro i roto i ngā mahi whakatikatika niho o ēnei rā

Ko te whakawhiti mai i te herenga elastomeric tikanga ki ngā pūnaha here-whaiaro he nekehanga nui o te koiora-mekanika i roto ingā mahi tiaki niho o nāianeiMā te whakakapi i ngā here o waho ki ngā topenga, ki ngā tatau rānei kua whakauruhia, ka tino whakarerekētia e ēnei pūnaha te taunekeneke i waenga i te waea āwhata me te mokowā o te whāriki. Ko te painga ā-pūkaha matua o tēnei hoahoa ko te whakaiti nui i te ātete waku i te wā e neke ana, he wāhanga nui tēnei i roto i te maimoatanga orthodontic whānui.

He mea nui te mārama ki ngā tikanga o tēnei whakaiti i te waku mō ngā tākuta niho e whai ana ki te arotau i ngā tikanga maimoatanga. Mā te whakaiti i te waku ka taea te whakamahi i ngā kaha māmā ake, tonu ake, e hangai tata ana ki ngā paepae ā-tinana pai mō te nekehanga o ngā niho. Mā tēnei huarahi ka whakaitihia te mōrearea o te aukati i ngā oko toto i roto i te hononga periodontal, ā, ka ārai i te hyalinization me te whakatairanga i te hanga hou o te wheua.

Pānga ki te whai huatanga o te maimoatanga

Ko te whai huatanga o te maimoatanga orthodontic e whakawhirinaki nui ana ki te kaha o ngā niho ki te neke haere i te waea āwhata me te iti o te ātete. I roto i ngā pūnaha tikanga, ka pēhia e ngā here elastomeric, maitai rānei te waea āwhata ki roto i te turanga o te mokowā o te bracket, ka puta he waku pumau me te waku nekeneke nui. Ka whakaitihia e ngā bracket here-whaiaro tēnei kaha noa. E whakaatu tonu ana ngā rangahau in vitro ka taea e ngā pūnaha here-whaiaro te whakaiti i te ātete waku mā te 40% ki te 50% ki te whakaritea ki ō rātou hoa here-tika, inā koa i ngā wā tuatahi o te whakataurite me te whakahāngai.

Ko te whakaiti i te waku ka whai hua tika ki te hauora. Ki te kore ngā kaha here o ngā here elastomeric, ka taea te whakatutuki i te whakataurite me te whakarārangi mā te whakamahi i ngā waea āwhata māmā ake, me te pupuri tonu i te kaha tonu. Hei tāpiri, ko te korenga o te pirau elastomeric—nā te mea ka ngaro te ngāwari o ēnei here ki te 50% i roto i ngā wiki tuatahi e whā i roto i te taiao ā-waha—ka whakarite kia rite tonu te tuku kaha i waenga i ngā wā roa.

Te uara haumanu me te uara arumoni o te waku iti

Haunga te whai huatanga o te koiora-ā-tinana, he pai ngā painga haumanu me ngā painga arumoni mā te whakaiti i te waku. I roto i te rongoā, ko te iti o te waku me iti ake ngā kaha hei tīmata i te nekehanga o ngā niho. He maha ngā wā ka taea te pupuri i ngā taumata kaha ki raro iho i te 50 henetiNewtons (cN), he mea tino pai mō te whakamarie o te tūroro, ā, ka whakaitihia te mōrearea o te mimiti o te pakiaka. Mā te kaha māmā ake ka āwhina hoki i te whānui whakawhiti me te whanaketanga o te āwhata me te iti ake o te piko.

I te taha arumoni, ko te whakaurunga oNgā pūmau here-whaiaroki roto i tētahi mahi ka taea te whakapai ake i te wā tūru. Te whakatuwhera me te kati i tehe tere ake ngā topenga whakauru i te 20% ki te 30% te tere akei te whakatakotoranga me te tango i ngā here elastomeric takitahi. I roto i te roanga o tētahi keehi whānui 24-marama, ka taea e tēnei te penapena tae atu ki te 45 meneti o te wā tūru hohe mō ia tūroro, ka taea ai e ngā mahi nui te whakanui ake i te nui o te mahi a te tūroro i ia rā, me te kore e whakawhānui ake i ā rātou kaimahi haumanu.

Te whakaiti i te waku e ngā whāriki here-whaiaro

Ehara te waku i te mahi whakatikatika niho i te kaha kotahi, engari he huinga o te waku tawhito, te here, me te whakakoi. Ka puta te waku tawhito ina pa te waea ki te mokowā o te whāriki, ko te here me te whakakoi ia ka puta ina piko, ina hurihuri rānei te niho, ka uru te waea ki ngā taha o te whāriki. He mea hanga motuhake ngā whāriki here-whaiaro hei whakaiti i te waku tawhito mā te whakakore i te kaha nohoanga hohe o ngā here tuku iho.

Ko te nui o te whakaiti i te waku e whakawhirinaki ana ki ngā āheinga hangarau motuhake o te whāriki me ngā āhuatanga rauemi o te waea āwhata. Mā te hanga i tētahi rūma pakari, kua kati, ka taea e ngā pūnaha here-whaiaro te nekeneke noa i roto i te mokowā kia tae rā anō ki te koki whakapā matua mō te here.

Ngā āhuatanga hoahoa e pā ana ki te taunekeneke o te taura-waea

Ko te taunekeneke i waenga i te whāriki me te waea ka whakahaerea e ngā rahi o te mokowā, ngā ātete hanga, me te mutunga o te mata. Ko te nuinga o ngā pūnaha here-whaiaro e whakamahi ana i ngā rahi mokowā paerewa 0.018-inihi, 0.022-inihi rānei, engari ko te hohonu o te mokowā me te hoahoa o te topenga he mea nui ki te whakahaere i te waku. Mā te mokowā hohonu ake ka nui ake te lumen, kia kore ai ngā waea porowhita tuatahi e pa ki te topenga, kia mau tonu ai te taiao waku tata-kore.

Ko te taratara o te mata tētahi atu tawhā nui. Ka hangaia ngā whāriki here-ake kounga teitei mā te whakamahi i te whakarewa werohanga whakarewa (MIM) me te mira tika rānei hei whakatutuki i ngā uara taratara o te mata (Ra) i waenga i te 0.1 me te 0.3 µm. Ka whakaitihia te tauwehenga o te waku e ngā papa mokowā maeneene me ngā taha mokowā porowhita ina pa te waea āwhata ki ngā pakitara o te whāriki i te wā e neke ana.

Ngā whāriki here-whaiaro kore mahi, ngā whāriki here-whaiaro kaha rānei

Ko te kaha o ngā whāriki here-whaiaro ki te whakaiti i te waku e whakawhirinaki ana ki te pūnaha ngoikore, ki te pūnaha kaha rānei. Kei roto i ngā whāriki ngoikore he tatau pakari e hanga ana i tētahi ngongo tonu, e āhei ai te waea āwhata ki te paheke noa me te kore he pēhanga kaha mai i te topenga. Ko ngā whāriki kaha, he topenga puna pakari e uru ana ki roto i te mokowā hei pēhi i ngā waea tapawhā nui ake, e whakarato ana i te nohoanga kaha mō te whakaaturanga taipana.

I ngā wāhanga tuatahi o te maimoatanga me ngā waea porowhita māmā (hei tauira, te NiTi 0.014-inihi), he iti noa te waku e whakaatuhia ana e ngā pūnaha kore mahi me ngā pūnaha hohe. Heoi, i te whanaketanga o te maimoatanga ki ngā waea tapawhā nui ake (hei tauira, te 0.019 x 0.025-inihi), ka whakauru anō ngā whāriki hohe i te waku kia tino uru te waea ki te turanga mokowā, engari ka pupuri tonu ngā whāriki kore mahi i te waku iti iho i te utu mō te iti o te takaro taipana.

Ētahi atu taurangi e pā ana ki te waku

Ahakoa te mea nui o te hoahoa o te whāriki, he maha atu anō ngā taurangi e whakatau ana i te waku tūturu e pā ana ki roto i te tinana. He hinu whakahinuhinu koiora te mahi a te huware, ahakoa he rerekē tōna pānga i runga i te matotoru me te nui o te mucin. E whakaatu ana ngā rangahau in vitro e whakatauira ana i te taiao ā-waha ka taea e te huware horihori te whakaiti i te waku hihiri mā te 15% ki te 20% ki te whakataurite ki ngā āhuatanga whakamātautau maroke.

Ka whakarerekē nui hoki te koranu o te waea āwhata i te tauwehenga waku. He nui ake te kaha o te mata me te tauhohenga matū o ngā waea Beta-titanium (TMA) ki te whakaritea ki te maitai kore waikura, ki te nickel-titanium rānei (NiTi), ka piki ake te waku ahakoa i roto i ngā pūnaha here-whaiaro. Hei tāpiri, ko te koki here nui—te koki e pa ai te waea ki ngā taha mesial me te taha tawhiti o te mokowā whāiti—ka noho tonu hei āhuatanga whakawhāiti. Kia hipa ake i tēnei koki (i waenga i te 3 ki te 5 nekehanga), ka hipa ake te waku here i te waku tawhito, ka whakaiti i ngā painga reti o te topenga here-whaiaro.

Me pēhea te aromatawai i ngā whāriki here-whaiaro

Ko te aromatawai i ngā pūnaha here-whaiaro me whai huarahi pūnaha e titiro ana ki tua atu i ngā kereme hokohoko, ā, e arotahi ana ki ngā raraunga haumanu me ngā raraunga miihini ka taea te ine. Me aromatawai ngā mahi whakatikatika niho i ēnei whāriki i runga i te pono o te hanganga, te āhua waku, me te pānga whānui ki te wā maimoatanga.

Ngā inenga mahi matua

I te wā e whiriwhiri anaNgā pūmau here-whaiaro, me whakarite e ngā tākuta he maha ngā inenga mahi matua. Ko te tuatahi ko te reiti rahunga ā-mīhini o te topenga, o te tikanga tatau rānei. Ko ngā pūnaha taumata teitei e whakaatu ana i te reiti rahunga topenga, i te reiti aukati rānei he iti iho i te 1.5% i roto i te huringa maimoatanga paerewa 24-marama. Ko ngā tikanga e ngāwari ana ki te hanga angaanga, ki te whakarerekē rānei i te āhua, ka taea te whakakore i ngā hua pai o te pūnaha.

Ko tētahi atu inenga nui ko te ātete waku motuhake i inehia i roto i ngā henetiNewton (cN) puta noa i ngā rahi waea rerekē. Me whakaatu e te whāriki here-whaiaro pono he iti iho i te 20 cN o te ātete ina honoa ki te waea NiTi 0.014-inihi i te koki kore-tohu. Hei tāpiri, me aromatawai te rahinga ota iti rawa (MOQ) me te pono o te mekameka tuku kia rite ai te whakahaere taonga.

Te whakataurite ki ngā whāriki tuku iho

Mā te whakataurite i ngā whāriki here-whaiaro ki ngā whāriki māhanga tuku iho ka kitea ngā rerekētanga mahi motuhake. Ko te rerekētanga tino tere ko te whakakorenga o ngā mowhiti elastomeric, e mōhiotia ana mō te pupuri i te paraka me te mimiti i ngā wai o te waha.

Ahakoa he iti ake te utu hoko tuatahi mō ngā whāriki tikanga, ko ngā utu huna o te roa o te wā tūru me te auau o ngā wā whakawhiti waea he maha ngā wā e whakaiti ana i ngā penapena. Ko te kaha o te pūnaha here-ake ki te pupuri i te āhua akuaku ka whai wāhi atu ki ngā putanga periodontal pai ake i roto i ngā maimoatanga roa.

Ngā taunakitanga kua whakaputaina e whakaatu ana

E whakaatu ana ngā tuhinga pūtaiao i tētahi tirohanga matatini mō ngā whāriki here-ā-unoa. He nui ngā taunakitanga e whakaatuhia ana e ngā rangahau in vitro e whakaiti ana ngā pūnaha here-ā-unoa i te waku pūmau me te waku nekeneke i whakaritea ki ngā whāriki here-ā-unoa. E whakaatu tonu ana ngā tauira taiwhanga i te whakahekenga kaha tae atu ki te 50% i te wā e whakatauirahia ana te mahi reti.

Heoi, e whakaatu ana ngā whakamātautau haumanu matapōkere (RCT) kāore i te tino whakaitihia te roa o te maimoatanga whānui. Ahakoa he maha ngā wā ka tere ake te wāhanga whakatikatika mā te 10 ki te 15 wiki, ko te wāhanga whakaoti—e whakawhirinaki nui ana ki te here me te whakaaturanga taipana kaua ki te reti—he rite tonu te roa ahakoa te momo tauera. Ko te kitenga haumanu tino ōrite puta noa i ngā arotake pūnaha ko te whakaiti i te wā tūru mō ia haerenga me te whakahaere i ngā wā roa ake i waenga i ngā whakaritenga.

Me pēhea te whakatinana i ngā whāriki here-whaiaro i roto i te mahi

Ko te whakauru i te hangarau here-whaiaro ki roto i te mahi whakatikatika niho me whai huringa rautaki i roto i ngā kawa haumanu. Nā te mea he rerekē te koiora-mīhini i ngā pūnaha tuku iho, me whakarerekē e ngā tākuta whakatikatika niho ā rātou huarahi ki te whakahaere take, inā koa mō te haere whakamua o ngā taura whatu me te whakarite wā whakarite.

Te whiriwhiri i te keehi me te raupapatanga waea āwhata

Ko te whakanui ake i ngā painga iti-waku o ngā whāriki here-whaiaro e whakawhirinaki ana ki te raupapatanga tika o ngā waea āwhata. Ko te tikanga ka tīmata te maimoatanga me ngā waea tino pakari, he iti te diameter, pērā i te CuNiTi 0.013-inihi, 0.014-inihi rānei. Nā te mea kāore he kaha here o ngā whāriki, ka taea e ēnei waea māmā te paheke noa, ka whakatau i te pupuhi nui me te tīmata i te whānui o te āwhata me te iti o te mamae o te tūroro.

Ka taea e ngā tākuta niho whakaroa i te wā i waenga i ngā whakaritenga whakatikatika wawe ki te 8, ki te 10 wiki rānei, kia taea ai e ngā kaha māmā, tonu o ngā waea NiTi te whakaatu katoa i a rātou anō. Me whakaroa te neke ki ngā waea tapawhā rite (hei tauira, 0.016 x 0.022-inihi) kia tata rite rawa ngā mokowā, nā te mea ka puta he waku here i te whakaurunga wawe o ngā waea taumaha, ā, ka mutu te nekehanga o ngā niho, ka kore ai e whai hua te pūnaha waku iti.

Te whakahaere i ngā mōrearea mahi

Ahakoa ō rātou painga, he maha ngā tūponotanga mahi a ngā pūnaha here-whaiaro me whakahaere. Ko te raruraru tino kitea ko te kohikohinga o te anga niho, te paraka rānei i roto i te pūnaha reti, ka taea ai te aukati i ngā tatau. Me whakaako e ngā tākuta ngā tūroro ki te akuaku waha, ā, me whakamahi pea i tētahi ine ultrasonic hei whakakore i ngā paru i mua i te ngana ki te whakatuwhera i tētahi topenga piri.

Ko te hototahi o ngā taputapu tētahi atu āhuatanga nui. Mā te ngana ki te whakatuwhera i ngā topenga o te pūmau motuhake me ngā taputapu tirotiro niho paerewa ka taea te whakapiko i te konganuku, ka ngaro te pupuri o te topenga, ka pakaru rānei te miihini. Me whakarite e ngā kaimahi he nui ngā taputapu whakatuwhera me te kati motuhake a te kaihanga i roto i ia mahi hei ārai i te kino iatrogenic ki ngā taputapu o te pūmau.

Me pēhea te whakatau mēnā he tika ngā whāriki here-whaiaro

He tātaitanga uaua te whakatau ki te neke ki ngā pūnaha here-whaiaro e uru ana ki te paunatia o ngā painga haumanu ki ngā āhuatanga pūtea me ngā āhuatanga whakahaere. Me whakahaere e ngā kaipupuri mahi he tātaritanga utu-painga hōhonu hei whakatau mēnā e hangai ana te hangarau ki te taupori me te tauira pakihi o ā rātou tūroro.

Ngā āhuatanga haumanu, whakahaere, me te utu

Ko te arai matua ki te whakamahi i ngā whāriki here-ā-unoa ko te utu rauemi i te tīmatanga. Ko te utu mō te huinga katoa o ngā whāriki here-ā-unoa i waenga i te $30 me te $60, he pikinga 200% ki te 300% i ngā whāriki takirua paerewa. Hei whakamārama i tēnei whakapaunga, me whakamahi ngā mahi i ngā whai huatanga whakahaere e whakaratohia ana e te pūnaha. Mō ngā pātai e pā ana kite hoko nui me ngā whakaritenga pūnaha, ka taea e ngā mahi te kōreroNgā pūmau here-whaiarongā tohunga ki te aromatawai i ngā mekameka tuku taonga utu-whai hua.

Ka tutuki te ROI whakahaere mā te whakanui ake i te kaha. Mā te whakaiti i ngā wā whakarite whakawhiti waea mā te 5 ki te 10 meneti me te whakakore i te 2 ki te 4 haerenga i roto i te roanga o te maimoatanga, ka taea e te tākuta te whakanui ake i te kawenga tūroro hohe mā te 15% ki te 20% me te kore e whakaroa i ngā hāora o te whare. Hei tāpiri, ko te whakaiti i ngā haerenga ohorere mō ngā here elastomeric whati, ngā here wero rānei ka whakapai ake i te hua o te whare hauora.

Āhea te wā e tika ai ngā whāriki here-whaiaro

Ko ngā whāriki here-ā-unoa te nuinga

He pānui anō:

• Ngā pūmau here-whaiaro
• Ngā pūmau here-whaiaro
• Ngā pūmau here-whaiaro

Ngā Whakaaro Matua

• Ngā whakatau me ngā take matua mō ngā whāriki here-ā-unoa
• Ngā whakaritenga, ngā whakaritenga, me ngā arowhai mōrearea e tika ana kia whakamanahia i mua i tō whakaae
• Ngā mahi whai muri me ngā whakatūpato ka taea e ngā kaipānui te tono tonu

Ngā Pātai Auau

Me pēhea e whakaiti ai ngā whāriki here-ā-unoa i te waku?

He topenga, he tatau rānei kei roto, kaua e whakamahia he here rapa, kia kore ai e piri te waea āwhata ki roto i te mokowā. Ka whakaitihia te ātete i te wā e neke ana.

He pai ake ngā whāriki here-ā-unoa mō te maimoatanga waku-iti?

Ae, he maha ngā wā i te tīmatanga o te whakaōrite. Mā ngā hoahoa kore mahi ka nui ake te wāhi huri noa i ngā waea porowhita, ka āwhina i te whakaiti i te pa atu, ā, ka noho maeneene tonu te reti.

Ka taea e ngā whāriki here-ake te whakapoto i te wā tūru?

Āe. He tere ake te whakatuwhera me te kati i ngā topenga whakauru i te whakarerekē i ngā here elastomeric, ka taea ai te penapena i te wā puta noa i ngā haerenga whakatikatika noa.

Ka pai ake te maimoatanga nā ngā whāriki here-ā-unoa?

Ka taea e rātou. Mā te iti o te waku ka māmā ake, ka mau tonu ngā kaha, ka whakaiti i te pēhanga ki runga i ngā niho, ka pai ake hoki te whakamarie i te wā e whakatikatika ana.

He aha ngā mea me tirotiro e ngā whare hauora ina hoko ana i ngā whāriki here-whaiaro mai i DenRotary?

Tirohia te tika o te mokowā, te pono o te topenga, te maeneene o te mata, me ngā kōwhiringa 0.018-inihi, 0.022-inihi rānei e wātea ana. Ka pā tika ēnei āhuatanga ki te whakahaere waku me te whai huatanga haumanu.