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CN112043426A - Periodontal ligament stretching osteogenesis mesial moving molar device and correction method - Google Patents

Periodontal ligament stretching osteogenesis mesial moving molar device and correction method Download PDF

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Publication number
CN112043426A
CN112043426A CN202010998745.7A CN202010998745A CN112043426A CN 112043426 A CN112043426 A CN 112043426A CN 202010998745 A CN202010998745 A CN 202010998745A CN 112043426 A CN112043426 A CN 112043426A
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mesial
slider
band
buccal
molar
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CN112043426B (en
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龙虎
周静
刘璐
邝芊允
张晓奇
鄢鑫语
单越
单迪
王艳
简繁
李晓龙
赖文莉
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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
    • A61C8/00Means to be fixed to the jaw-bone for consolidating natural teeth or for fixing dental prostheses thereon; Dental implants; Implanting tools
    • A61C8/0093Features of implants not otherwise provided for
    • A61C8/0096Implants for use in orthodontic treatment
    • 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
    • A61C7/10Devices having means to apply outwardly directed force, e.g. expanders

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  • Health & Medical Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Epidemiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

The invention discloses a device for stretching a bone-forming mesial moving molar by a periodontal ligament, which comprises a first band ring arranged on a molar or a premolar in the mesial of an edentulous area and a second band ring arranged on a molar needing mesial moving, wherein the first band ring and the second band ring are connected through a spiral stretching device, the spiral stretching device is arranged on the buccal side of the tooth, and the spiral stretching device comprises a first buccal slide block, a spiral rod, a nut, a second buccal slide block and a buccal slide rod; the first tongue side sliding block and the second tongue side sliding block are arranged on the tooth tongue side; the first tongue side sliding block and the second tongue side sliding block are connected through a tongue side sliding rod and an elastic device. The invention solves the problems of the prior art that the molar deflects and inclines when the molar moves near and in a long distance.

Description

一种牙周膜牵张成骨近中移动磨牙的装置及矫治方法A device and orthodontic method for moving molars by distraction osteogenesis of periodontal ligament

技术领域technical field

本发明涉及口腔医疗技术领域,具体为一种牙周膜牵张成骨近中移动磨牙的装置及矫治方法。The invention relates to the technical field of oral medical treatment, in particular to a device and a rectification method for moving molars in the middle of periodontal ligament distraction osteogenesis.

背景技术Background technique

临床常见因龋坏、外伤而缺失下颌第一或二磨牙的患者,如图1所示为缺失下颌第一或第二磨牙的示意图,目前主要的解决方案有种植修复、冠桥修复,若患者第三磨牙尚存,也可通过正畸近中移动磨牙,以第三磨牙替代第二磨牙,第二磨牙替代第一磨牙。种植治疗费用较高,患者承受不必要的种植手术风险;冠桥修复需要磨除健康的牙体组织,咀嚼功能不如正常的牙齿。而大多数患者第三磨牙尚存,可以代替缺失牙发挥正常的咀嚼功能,也更美观。Clinically, patients with missing mandibular first or second molars due to caries and trauma are common. Figure 1 shows a schematic diagram of missing mandibular first or second molars. At present, the main solutions include implant restoration and crown bridge restoration. The third molars still exist, and the molars can also be moved mesially through orthodontics to replace the second molars with the third molars and the first molars with the second molars. The cost of implant treatment is high, and the patient bears unnecessary risks of implant surgery; crown and bridge restoration requires grinding of healthy tooth tissue, and the chewing function is not as good as normal teeth. In most patients, the third molars still exist, which can replace the missing teeth to play a normal chewing function and are more aesthetically pleasing.

目前移动磨牙的方式主要有四种:There are four main ways to move teeth:

1)弓丝+橡皮链:如图2、3所示,通过颊舌侧橡皮链的拉力,使磨牙沿着弓丝近中移动。这种方法适用于磨牙小距离的移动,且容易出现磨牙近中倾斜,对前磨牙也有副作用。1) Arch wire + rubber chain: As shown in Figures 2 and 3, the molars are moved along the middle of the arch wire by the pulling force of the buccal and lingual rubber chain. This method is suitable for small distance movement of molars, and is prone to mesial inclination of molars, which also has side effects on premolars.

2)橡皮链+微种植钉:如图4、5所示,橡皮链一端挂于微种植钉,另一端加在需近中移动的磨牙上,通过橡皮链对磨牙施力拉力。这种方法可避免前磨牙不必要的移动,但是矫治时间较长,近中移动的磨牙可能出现牙根吸收。2) Rubber chain + micro-implant nails: As shown in Figures 4 and 5, one end of the rubber chain is hung on the micro-implant nails, and the other end is attached to the molars that need to be moved proximally, and the molars are exerted and pulled through the rubber chain. This method avoids unnecessary movement of the premolars, but the treatment time is longer and the mesially moved molars may experience root resorption.

3)橡皮链+连续结扎:如图6所示,通过颊舌侧的橡皮链对磨牙施加拉力,一旦磨牙发生近中倾斜,结扎丝替换橡皮链,将磨牙竖直后继续使用橡皮链近中移动磨牙。连续结扎将其他牙连成整体提供较强的支抗。该方法矫治时间过长,容易发生牙根吸收。磨牙在近中移动的过程中容易倾斜,对其他支抗牙也有副作用。3) Rubber chain + continuous ligation: As shown in Figure 6, the molar is pulled by the rubber chain on the buccal and lingual side. Once the molar is tilted mesally, the ligation wire is replaced with the rubber chain, and the molar is kept upright and the rubber chain is used to move the molar mesially. molar. Continuous ligation connects other teeth as a whole to provide strong anchorage. This method takes too long for orthodontic treatment and is prone to root resorption. The molars tend to tilt during the mesial movement, which also has side effects on other anchoring teeth.

4)滑杆+拉簧+微种植钉:如图7所示,颊侧拉簧一端与种植钉固定,另一端加在需近中移动的磨牙上,提供持续的拉力,舌侧的滑杆使磨牙沿着舌杆滑动。这种方法提供了强支抗,但在磨牙近中移动的过程中,磨牙会发生近中倾斜和近中旋转,舌侧滑杆容易卡住,阻碍磨牙的近中移动。而且,该方案的矫治时间较长,容易发生牙根吸收。4) Slide bar + tension spring + micro-implant nail: As shown in Figure 7, one end of the buccal tension spring is fixed with the implant nail, and the other end is added to the molar that needs to be moved mesally to provide continuous tension. The molars slide along the tongue bar. This method provides strong anchorage, but during the mesial movement of the molars, mesial tilt and mesial rotation of the molars will occur, and the lingual sliding rod is easily stuck, hindering the mesial movement of the molars. Moreover, the treatment time of this scheme is long, and root resorption is prone to occur.

综上所述,目前的矫治器和矫治方法具有以下的主要缺陷有:To sum up, the current appliances and orthodontic methods have the following main drawbacks:

1、矫治时间过长,容易出现牙根吸收;1. If the treatment time is too long, it is easy to cause root absorption;

2、近中移动磨牙多为倾斜移动,易发生牙冠近中倾斜,近中旋转,不利于力沿牙体长轴传导,不利于牙周健康;2. The mesial moving molars are mostly inclined movements, which are prone to mesial inclination of the crown and mesial rotation, which is not conducive to the transmission of force along the long axis of the tooth and is not conducive to periodontal health;

3、难以长距离移动磨牙;3. Difficulty moving molars for long distances;

4、部分方法利用其他支抗牙做支抗,会发生不必要的牙移动和倾斜;4. Some methods use other anchorage teeth as anchorage, which will cause unnecessary tooth movement and inclination;

5、近中移动的磨牙牙槽骨高度不足,不利于牙周健康。5. The height of the alveolar bone of the mesially moving molars is insufficient, which is not conducive to periodontal health.

发明内容SUMMARY OF THE INVENTION

本发明的目的在于提供一种牙周膜牵张成骨近中移动磨牙的装置及其矫治方法,旨在解决现有技术中,长距离近中移动磨牙时导致磨牙偏转和倾斜的问题。The purpose of the present invention is to provide a device for mesial moving molars by periodontal ligament distraction osteogenesis and its orthodontic method, aiming to solve the problem of deflection and inclination of molars caused by long-distance mesial moving molars in the prior art.

本发明所采用的技术方案是:一种牙周膜牵张成骨近中移动磨牙的装置,包括第一带环和第二带环,所述第一带环用于套设在缺牙区近中侧的磨牙或前磨牙上,所述第二带环用于套设在需要近中移动的磨牙上,所述第一带环和第二带环通过螺旋牵张器连接,所述螺旋牵张器固定设置在所述第一带环和第二带环的颊面侧,所述螺旋牵张器包括第一颊侧滑块和第二颊侧滑块,所述第一颊侧滑块和第二颊侧滑块之间通过螺旋杆以及颊侧滑杆连接,所述螺旋杆上设置有螺母;还包括设置在牙的舌面侧的第一舌侧滑块和第二舌侧滑块;所述第一舌侧滑块和第二舌侧滑块之间通过舌侧滑杆以及弹性装置连接。The technical scheme adopted in the present invention is: a device for moving molars in the middle of periodontal ligament distraction and osteogenesis, comprising a first belt ring and a second belt ring, the first belt ring is used to be sleeved near the tooth-missing area On the molars or premolars on the middle side, the second belt ring is used to be sleeved on the molars that need to move mesially, the first belt ring and the second belt ring are connected by a helical stretcher, and the helical stretcher The helical retractor is fixedly arranged on the buccal side of the first and second belt loops, the helical retractor includes a first buccal slider and a second buccal slider, the first buccal slider and The second buccal sliders are connected by a screw rod and a buccal slider, the screw rod is provided with a nut; it also includes a first lingual slider and a second lingual slider arranged on the lingual side of the teeth ; The first lingual sliding block and the second lingual sliding block are connected by a lingual sliding rod and an elastic device.

进一步地,所述第一颊侧滑块和第一舌侧滑块固定连接在所述第一带环的两侧,所述第二颊侧滑块和第二舌侧滑块固定连接在所述第二带环的两侧。Further, the first buccal slider and the first lingual slider are fixedly connected to both sides of the first belt ring, and the second buccal slider and the second lingual slider are fixedly connected to the same. on both sides of the second belt loop.

进一步地,第一舌侧滑块上设置有拉钩一,所述第二舌侧滑块上设置有拉钩二,弹性装置的两端挂在拉钩一和拉钩二上。Further, the first lingual slider is provided with a first pull hook, the second lingual slider is provided with a second pull hook, and both ends of the elastic device are hung on the first pull hook and the second pull hook.

进一步地,所述弹性装置为拉簧、链状橡皮圈。Further, the elastic device is a tension spring and a chain rubber ring.

进一步地,所述螺母上设置有用于调整螺母的螺旋孔,所述螺母的两侧分别设置有旋向相反的螺旋杆。Further, the nut is provided with a screw hole for adjusting the nut, and two sides of the nut are respectively provided with screw rods with opposite directions of rotation.

进一步地,仅所述颊侧滑杆的一端与第一颊侧滑块或第二颊侧滑块固定连接,仅所述舌侧滑杆的一端与第二舌侧滑块或第一舌侧滑块固定连接。Further, only one end of the buccal slider is fixedly connected with the first buccal slider or the second buccal slider, and only one end of the lingual slider is connected with the second lingual slider or the first lingual slider. Slider fixed connection.

进一步地,在需要近中移动的磨牙的近中,前磨牙之间还设置有第一支抗装置,用于为螺旋牵张器提供支抗力,所述第一颊侧滑块通过牵引件与所述第一支抗装置刚性连接。Further, in the mesial area of the molars that need to move mesally, a first anchoring device is also provided between the premolars to provide anchoring force for the helical distractor, and the first buccal slider is connected to all the molars through the traction member. The first anchorage device is rigidly connected.

进一步地,所述牵引件为不锈钢丝或结扎丝。Further, the traction member is a stainless steel wire or a ligation wire.

进一步地,还具有第二支抗装置,所述第二支抗装置的一端与所述第一带环固定连接,与第一支抗转台管制共同作用进一步限制了磨牙在移动中不会倾斜和偏转。Further, there is also a second anchorage device, one end of the second anchorage device is fixedly connected with the first belt ring, and the joint action of the first anchorage turntable control further restricts the molars from inclining and moving during movement. deflection.

进一步地,所述第二支抗装置包括第三带环、舌弓和第四带环,所述第三带环套设在牵张侧前磨牙上,所述第四带环套设在对侧的前磨牙上,所述第三带环与所述第四带环通过所述舌弓相连,所述舌弓位于下前牙舌隆突之上。Further, the second anchorage device includes a third band loop, a lingual arch and a fourth band loop, the third band loop is sleeved on the distraction side premolar, and the fourth band ring is sleeved on the opposite side. On the lateral premolars, the third belt loop and the fourth belt loop are connected through the lingual arch, and the lingual arch is located on the lingual eminence of the lower anterior teeth.

进一步地,所述第三带环包绕在牵张侧至少一颗前磨牙上,所述第四带环包绕在对侧至少一颗前磨牙上,所述第三带环与第一带环固定连接。Further, the third band loop is wrapped around at least one premolar on the distraction side, the fourth band loop is wrapped around at least one premolar on the opposite side, and the third band loop is connected to the first band. Ring fixed connection.

还提供了一种磨牙近中移动的矫治方法,其步骤如下:Also provided is a method for correcting the mesial movement of molars, the steps of which are as follows:

a.获取口腔牙列模型的三维数据;a. Obtain the three-dimensional data of the oral dentition model;

b.制作前述的磨牙近中移动的装置;b. Making the aforementioned device for mesial movement of molars;

c.在磨牙的近中牙槽骨做牙槽骨骨松质切除术;c. Do alveolar bone cancellectomy in the mesial alveolar bone of the molar;

d.佩戴并固定磨牙近中移动的装置;d. Wear and fix the device for the mesial movement of molars;

e.调整牙周膜牵张成骨的速率,进行牙周膜牵张成骨,近中移动磨牙。e. Adjust the rate of periodontal ligament distraction osteogenesis, perform periodontal ligament distraction osteogenesis, and move molars mesially.

进一步地,所述步骤b中,根据获取的牙槽骨和牙根数据以及口内扫描或藻酸盐取模获得的模型制作磨牙近中移动的装置;Further, in the step b, according to the acquired alveolar bone and root data and the model obtained by intraoral scanning or alginate casting, a device for molar mesial movement is fabricated;

在所述步骤c中,根据需要种植第一支抗装置和/或第二支抗装置;In the step c, plant the first anchorage device and/or the second anchorage device as needed;

以及在所述步骤e中根据需要近中移动的磨牙牙根数量来决定牵张成骨的速率。And in the step e, the rate of distraction osteogenesis is determined according to the number of molar roots that need to move mesially.

本发明相对于现有技术,至少具有以下技术效果:Compared with the prior art, the present invention has at least the following technical effects:

(1)相比于种植修复和冠桥修复,该方法用患者自体天然牙代替第二磨牙,最大程度利用天然牙恢复缺失牙的功能,且避免了种植手术治疗风险/健康牙体组织磨除;(1) Compared with implant restoration and crown bridge restoration, this method replaces the second molar with the patient's natural teeth, maximizes the use of natural teeth to restore the function of the missing teeth, and avoids the risk of implant surgery / grinding of healthy tooth tissue ;

(2)该方法通过微种植钉提供强支抗,通过第三带环、第四带环和舌弓提供加强支抗,对邻牙无副作用;(2) The method provides strong anchorage through micro-implantation nails, and provides reinforced anchorage through the third belt ring, the fourth belt ring and the lingual arch, and has no side effects on the adjacent teeth;

(3)配合骨松质切除术,减少骨阻力,大大减少矫治时间,不易出现牙根吸收,且不损伤牙髓;(3) Cooperate with cancellectomy to reduce bone resistance, greatly reduce the treatment time, less prone to root resorption, and no damage to the pulp;

(4)利用牙周膜牵张成骨原理,长距离整体移动磨牙,大大降低了磨牙近移的难度;(4) Using the principle of periodontal ligament distraction osteogenesis, the molars can be moved as a whole over a long distance, which greatly reduces the difficulty of proximal molar movement;

(5)牵张成骨过程中不断有骨形成,牙槽骨恢复良好,有利于牙周健康;(5) There is continuous bone formation in the process of distraction osteogenesis, and the alveolar bone recovers well, which is beneficial to periodontal health;

(6)可局部矫治,仅涉及缺牙侧磨牙或第二前磨牙,不需全口弓丝,可缩短治疗时间,节约治疗成本;(6) Local orthodontic treatment is possible, involving only missing lateral molars or second premolars, without full-mouth arch wires, which can shorten the treatment time and save the treatment cost;

(7)装置加工铸造而成,复诊操作少,时间短,舒适度高;(7) The device is machined and cast, with few follow-up operations, short time and high comfort;

(8)该装置由患者自主加力,患者参与度高,依从性好;(8) The device is independently augmented by the patient, with high patient participation and good compliance;

附图说明Description of drawings

为了更清楚地说明本发明实施例的技术方案,下面将对本发明实施例或现有技术描述中所需要使用的附图作简单地介绍,显而易见地,下面所描述的附图仅仅是本发明的一些实施例,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获得其他的附图。In order to illustrate the technical solutions of the embodiments of the present invention more clearly, the following briefly introduces the accompanying drawings that are used in the description of the embodiments of the present invention or the prior art. Obviously, the drawings described below are only for the present invention. In some embodiments, for those of ordinary skill in the art, other drawings can also be obtained according to these drawings without any creative effort.

图1是缺失下颌第二磨牙的示意图;Figure 1 is a schematic view of the missing mandibular second molar;

图2是现有技术中弓丝牵引方式方式的示意图;Fig. 2 is the schematic diagram of the archwire pulling mode in the prior art;

图3是现有技术中弓丝牵引方式方式的示意图;Fig. 3 is the schematic diagram of the archwire pulling mode in the prior art;

图4是现有技术中橡皮链+微种植钉方式的示意图;Fig. 4 is the schematic diagram of rubber chain+micro-planting nail mode in the prior art;

图5是现有技术中前磨牙区种植钉+推簧方式的示意图;Fig. 5 is the schematic diagram of the premolar region implant nail+push spring mode in the prior art;

图6是现有技术中橡皮链+连续结扎方式的示意图;Fig. 6 is the schematic diagram of rubber chain+continuous ligation mode in the prior art;

图7是现有技术中滑杆+拉簧+微种植钉方式的示意图;Fig. 7 is the schematic diagram of slide bar+tension spring+micro-planting nail mode in the prior art;

图8是本发明的移动磨牙的装置颊侧安装示意图;8 is a schematic view of the buccal installation of the device for moving molars of the present invention;

图9是本发明的移动磨牙的装置舌侧结构示意图;9 is a schematic view of the lingual structure of the device for moving molars of the present invention;

图10是本发明的移动磨牙的装置沿螺杆轴向示意图;10 is a schematic diagram of the device for moving molars of the present invention along the axial direction of the screw;

图11是本发明的移动磨牙的装置第二支抗装置的颊侧示意图;11 is a buccal schematic view of the second anchorage device of the device for moving molars of the present invention;

图12是本发明的移动磨牙的装置的第二支抗装置的舌侧示意图;12 is a lingual schematic view of the second anchorage device of the device for moving molars of the present invention;

图13是本发明的移动磨牙的装置的第二支抗装置的合面侧示意图;13 is a schematic view of the occlusal side of the second anchorage device of the device for moving molars of the present invention;

图14是本发明的移动磨牙方法的流程图。Figure 14 is a flow chart of the method of moving teeth of the present invention.

附图标记说明:Description of reference numbers:

11 固定件Fastener 22 第一颊侧滑块first buccal slider 33 螺旋杆screw rod 44 螺母nut 55 第二颊侧滑块second buccal slider 66 第一带环first belt loop 77 颊侧滑杆Buccal Slider 88 第二带环second belt loop 99 拉钩二Retractor two 1010 弹性装置elastic device 1111 拉钩一hook one 1212 第二舌侧滑块second lingual slider 1313 第一舌侧滑块first lingual slider 1414 舌侧滑杆lingual slider 1515 螺旋孔Spiral hole 1616 第一支抗装置first support device 1717 第二支抗装置second anchorage device 1818 第三带环third belt loop 1919 舌弓tongue arch 2020 第四带环Fourth belt loop

具体实施方式Detailed ways

下面详细描述本发明的实施例,所述实施例的示例在附图中示出,其中自始至终相同或类似的标号表示相同或类似的元件或具有相同或类似功能的元件。下面通过参考附图描述的实施例是示例性的,旨在用于解释本发明,而不能理解为对本发明的限制。对于本领域的普通技术人员而言,可以根据具体情况理解上述术语在本发明中的具体含义。The following describes in detail the embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein the same or similar reference numerals refer to the same or similar elements or elements having the same or similar functions throughout. The embodiments described below with reference to the accompanying drawings are exemplary, and are intended to explain the present invention and should not be construed as limiting the present invention. For those of ordinary skill in the art, the specific meanings of the above terms in the present invention can be understood according to specific situations.

为了使本发明的目的、技术方案及优点更加清楚明白,以下结合附图及实施例,对本发明进行进一步详细说明。In order to make the objectives, technical solutions and advantages of the present invention clearer, the present invention will be further described in detail below with reference to the accompanying drawings and embodiments.

本发明采用的牙周膜牵张成骨移动近中磨牙装置是一种利用牙周膜牵张成骨原理,配合骨松质切除术,借助前磨牙牙根间微种植钉和对侧牙支抗,长距离整体近中移动磨牙以替代缺失磨牙的装置。The periodontal ligament distraction osteogenesis mobile mesial molar device adopted in the present invention is a device that utilizes the periodontal ligament distraction osteogenesis principle, cooperates with cancellectomy, and uses the inter-root micro-implantation nails of the premolars and the contralateral tooth anchorage. , a device for long-distance integral mesial movement of molars to replace missing molars.

具体的,如图8-10所示,一种磨牙近中移动的装置,包括第一带环6及第二带环8,所述第一带环6用于套设在缺牙区近中侧的磨牙或前磨牙上,所述第二带环8用于套设在需要近中移动的磨牙上,并通过粘接剂辅助固定,优选地,第一带环6设置在缺牙侧近中的磨牙或前磨牙上,第二带环8设置在磨牙上;所述螺旋牵张器固定设置在所述第一带环6和第二带环8的颊面侧,为了方便调节螺旋牵张器以及使螺旋牵张器具有更大的调节范围,所以螺旋牵张器优先设置在牙的颊面侧,所述螺旋牵张器用于提供牵张成骨的牵引力;所述螺旋牵张器包括第一颊侧滑块2和第二颊侧滑块5,第一颊侧滑块2与第一带环6固定连接,第二颊侧滑块5与第二带环8固定连接,所述第一颊侧滑块2和第二颊侧滑块5之间通过螺旋杆3以及颊侧滑杆7连接,所述螺旋杆3上设置有用于调节螺旋杆3的螺母4;在第一颊侧滑块2和第二颊侧滑块5上分别设置有螺纹孔和光孔,螺纹孔用于连接螺旋杆3,光孔用于连接颊侧滑杆7;还包括设置在牙的舌面侧的第二舌侧滑块12和第一舌侧滑块13;所述第二舌侧滑块12和第一舌侧滑块13之间通过舌侧滑杆14连接,第二舌侧滑块12和第一舌侧滑块13上设置有连接舌侧滑杆14的光孔,在第二舌侧滑块12和第一舌侧滑块1之间还连接有弹性装置10,在第二舌侧滑块12和第一舌侧滑块1的下部还设置有用于连接弹性装置10的挂钩。Specifically, as shown in FIGS. 8-10 , a device for moving molars in the middle includes a first belt ring 6 and a second belt ring 8 , and the first belt ring 6 is used to be sleeved on the mesial side of the edentulous area. On the molars or premolars, the second band ring 8 is used to be sleeved on the molars that need mesial movement, and is assisted by adhesive to fix, preferably, the first band ring 6 is arranged on the mesial side of the missing tooth. On the molars or premolars, the second belt ring 8 is arranged on the molars; the helical stretcher is fixedly arranged on the buccal side of the first belt ring 6 and the second belt ring 8, in order to facilitate the adjustment of the helical stretcher And make the helical distractor have a larger adjustment range, so the helical distractor is preferentially arranged on the buccal side of the tooth, and the helical distractor is used to provide traction for distraction osteogenesis; the helical distractor includes the first A buccal slider 2 and a second buccal slider 5, the first buccal slider 2 is fixedly connected with the first belt ring 6, the second buccal slider 5 is fixedly connected with the second belt ring 8, the A buccal slider 2 and a second buccal slider 5 are connected by a screw rod 3 and a buccal slider 7, and the screw rod 3 is provided with a nut 4 for adjusting the screw rod 3; on the first buccal side The slider 2 and the second buccal slider 5 are respectively provided with a threaded hole and a smooth hole, the threaded hole is used to connect the screw rod 3, and the smooth hole is used to connect the buccal sliding rod 7; it also includes a threaded hole arranged on the lingual side of the tooth. The second lingual slider 12 and the first lingual slider 13; the second lingual slider 12 and the first lingual slider 13 are connected by a lingual slider 14, and the second lingual slider 12 and the first lingual slider 13 is provided with a light hole for connecting the lingual slider 14, an elastic device 10 is also connected between the second lingual slider 12 and the first lingual slider 1, and the second lingual slider 12 is connected to the first lingual slider 1. The lower parts of the side slider 12 and the first lingual slider 1 are also provided with hooks for connecting the elastic device 10 .

所述第一颊侧滑块2和第一舌侧滑块13固定连接在所述第一带环6的两侧,所述第二颊侧滑块5和第二舌侧滑块12固定连接在所述第二带环8的两侧。第一颊侧滑块2、第一舌侧滑块13、第二颊侧滑块5、第二舌侧滑块12、第一带环6、第二带环8、螺旋杆3、螺母4为不锈钢材质、钴铬合金或是镍钛合金中的一种或多种制成。The first buccal slider 2 and the first lingual slider 13 are fixedly connected on both sides of the first belt ring 6 , and the second buccal slider 5 and the second lingual slider 12 are fixedly connected on both sides of the second belt loop 8 . First buccal slider 2, first lingual slider 13, second buccal slider 5, second lingual slider 12, first belt ring 6, second belt ring 8, screw rod 3, nut 4 Made of one or more of stainless steel, cobalt-chromium alloy or nickel-titanium alloy.

所述第二舌侧滑块12上设置有拉钩二9,第一舌侧滑块13上设置有拉钩一11,弹性装置10的两端挂在拉钩二9和拉钩一11上,所述磨牙拉钩为直角拉钩或弧形拉钩。所述弹性装置10优选为拉簧,可辅助施加拉力,使颊侧和舌侧的拉力基本均等,避免磨牙在近移的过程中发生近中旋转,被舌侧滑杆卡住。The second lingual slider 12 is provided with the second hook 9, the first lingual slider 13 is provided with the first hook 11, the two ends of the elastic device 10 are hung on the second hook 9 and the first hook 11, the molars are The hook is a right-angle hook or an arc hook. The elastic device 10 is preferably a tension spring, which can assist in applying tension, so that the tension on the buccal and lingual sides is basically equal, so as to prevent the molars from mesial rotation during proximal movement and being caught by the lingual sliding rod.

如图8所示,所述螺母4上设置有螺旋孔15,所述螺母4的两侧分别设置有旋向相反的螺旋杆3,螺旋杆3的螺纹为细牙自锁螺纹,防止螺旋杆3或螺母4的非调节移动,将调节杆插入螺旋孔15内,按一定速率旋转螺母4进而实现螺旋杆3带动第一颊侧滑块2和第二颊侧滑块5移动,从而实现螺旋牵张器的牵引力的精准调节。当第一颊侧滑块2与种植钉刚性连接时,只有第二颊侧滑块5向缺牙侧移动。As shown in FIG. 8 , the nut 4 is provided with a screw hole 15, and two sides of the nut 4 are respectively provided with screw rods 3 with opposite directions of rotation. 3 or the non-adjustable movement of the nut 4, insert the adjusting rod into the screw hole 15, rotate the nut 4 at a certain rate, and then realize the screw rod 3 to drive the first buccal slider 2 and the second buccal slider 5 to move, so as to realize the screw Precise adjustment of the traction force of the stretcher. When the first buccal slider 2 is rigidly connected with the implant nail, only the second buccal slider 5 moves to the missing tooth side.

如图10所示,仅所述颊侧滑杆7的一端与第一颊侧滑块2或第二颊侧滑块5固定连接,仅所述舌侧滑杆14的一端与第二舌侧滑块12或第一舌侧滑块13固定连接,具体可采用过盈连接方式。在螺旋牵张器施力拉力的过程中,舌侧滑杆14使磨牙沿着设定的方向前移,可避免磨牙的倾倾和近中旋转。As shown in FIG. 10 , only one end of the buccal slider 7 is fixedly connected to the first buccal slider 2 or the second buccal slider 5 , and only one end of the lingual slider 14 is connected to the second lingual slider. The sliding block 12 or the first lingual side sliding block 13 is fixedly connected, and specifically, an interference connection can be adopted. During the pulling force of the screw distractor, the lingual sliding rod 14 makes the molar move forward along the set direction, which can avoid the inclination and mesial rotation of the molar.

为了减轻装置的重量,所述颊侧滑杆7和所述舌侧滑杆14可以为非金属材质,能起到导向的作用即可。为了进一步保证装置移动的方向不产生倾斜或偏转,所述颊侧滑杆7和所述舌侧滑杆14的截面形状为圆形。In order to reduce the weight of the device, the buccal sliding rod 7 and the lingual sliding rod 14 can be made of non-metallic materials, which can play a guiding role. In order to further ensure that the moving direction of the device is not inclined or deflected, the cross-sectional shapes of the buccal sliding rod 7 and the lingual sliding rod 14 are circular.

如图8所示,在远离磨牙和前磨牙一侧的牙根区还设置有第一支抗装置16,用于为螺旋牵张器提供支抗力,第一支抗装置16的设置保证磨牙朝向第一支抗装置16的方向移动,所述第一颊侧滑块2通过固定件1与所述第一支抗装置16刚性连接,所述第一颊侧滑块2上设置有供固定件1连接的牵引钩,所述第一支抗装置16可以为微种植钉,钛钉,钛板等正畸第一支抗装置。As shown in FIG. 8 , a first anchorage device 16 is also provided in the root area on the side away from the molars and premolars, which is used to provide anchorage force for the helical distractor. The setting of the first anchorage device 16 ensures that the molars are facing Moving in the direction of an anchorage device 16, the first buccal slider 2 is rigidly connected to the first anchorage device 16 through a fixing member 1, and the first buccal slider 2 is provided with a fixing member 1 For the connected traction hook, the first anchorage device 16 may be an orthodontic first anchorage device such as a micro-implant nail, a titanium nail, a titanium plate, or the like.

所述固定件1为固定不锈钢丝或固定结扎丝,固定件1套接或钩接在第一支抗装置16上,可提供强支抗,避免支抗牙向缺牙侧移动。The fixing member 1 is a fixed stainless steel wire or a fixed ligation wire. The fixing member 1 is sleeved or hooked on the first anchorage device 16 to provide strong anchorage and prevent anchorage teeth from moving to the missing tooth side.

如图11-13所示,还具有第二支抗装置17,所述第二支抗装置17的一端与所述第一带环6固定连接。第二支抗装置17是一种加强支抗装置,与第一支抗装置16共同作用进一步限制了支抗牙向缺牙区移动。As shown in FIGS. 11-13 , there is also a second anchorage device 17 , and one end of the second anchorage device 17 is fixedly connected to the first belt ring 6 . The second anchorage device 17 is a reinforcing anchorage device, which cooperates with the first anchorage device 16 to further limit the movement of the anchoring teeth to the edentulous area.

进一步地,所述第二支抗装置17包括第三带环18、舌弓19和第四带环20,所述第三带环18套设在牵张侧前磨牙上,所述第四带环20套设在对侧的前磨牙上,所述第三带环18与所述第四带环20通过所述舌弓19相连,所述舌弓19位于下前牙舌隆突之上。第三带环18、舌弓19和第四带环20为不锈钢材质、钴铬合金或是镍钛合金中的一种或多种制成。Further, the second anchorage device 17 includes a third belt loop 18, a lingual arch 19 and a fourth belt loop 20, the third belt loop 18 is sleeved on the premolar on the distraction side, and the fourth belt The ring 20 is sleeved on the opposite side premolar, and the third belt ring 18 and the fourth belt ring 20 are connected through the lingual arch 19, and the lingual arch 19 is located on the lingual eminence of the lower anterior teeth. The third belt loop 18, the lingual arch 19 and the fourth belt loop 20 are made of one or more of stainless steel, cobalt-chromium alloy or nickel-titanium alloy.

进一步地,所述第三带环18包绕在牵张侧至少一颗前磨牙上,所述第四带环20包绕在对侧至少一颗前磨牙上,所述第三带环18与第一带环6固定连接。Further, the third band loop 18 wraps around at least one premolar on the distraction side, the fourth band loop 20 wraps around at least one premolar on the opposite side, and the third band loop 18 and The first belt loop 6 is fixedly connected.

使用时,将第一带环6、第二带环8、第三带环18和第四带环20戴入相应牙位,并用粘接剂粘固。前磨牙第一颊侧滑块2通过不锈钢丝或结扎丝与第一支抗装置16固定连接,通过第三带环18和第二支抗装置17固定连接,调节钥匙插入颊侧螺旋牵张器的螺旋孔15内,按一定的速率拧动,螺旋杆3的长度变短,可对相应磨牙施加拉力,沿着颊舌侧的所述颊侧滑杆7和所述舌侧滑杆14滑动,舌侧的拉簧可辅助加力。When in use, the first belt loop 6 , the second belt loop 8 , the third belt loop 18 and the fourth belt loop 20 are inserted into the corresponding tooth positions and fixed with adhesive. The first buccal slider 2 of the premolar is fixedly connected with the first anchorage device 16 through stainless steel wire or ligation wire, and is fixedly connected through the third band ring 18 and the second anchorage device 17, and the adjustment key is inserted into the buccal helical distractor In the screw hole 15, screw at a certain rate, the length of the screw rod 3 is shortened, and the corresponding molars can be pulled to slide along the buccal sliding rod 7 and the lingual sliding rod 14 on the buccal and lingual side. , the tension spring on the tongue side can assist the force.

如图14还提供一种利用上述的磨牙近中移动的装置移动磨牙的矫治方法,其步骤如下:Figure 14 also provides a method for orthodontic treatment using the above-mentioned molar mesial moving device to move molars, the steps of which are as follows:

a.获取口腔牙列模型的三维数据;a. Obtain the three-dimensional data of the oral dentition model;

b.制作前述的磨牙近中移动的装置,具体地根据获取的牙槽骨和牙根数据以及口内扫描或藻酸盐取模获得的模型制作磨牙近中移动的装置;b. Making the aforementioned device for mesial movement of molars, specifically making a device for mesial movement of molars according to the acquired alveolar bone and root data and the model obtained by intraoral scanning or alginate casting;

c.在磨牙的近中牙槽骨做牙槽骨骨松质切除术,同时根据需要种植第一支抗装置和/或第二支抗装置;c. Perform alveolar bone cancellectomy on the mesial alveolar bone of the molar, and implant the first anchorage device and/or the second anchorage device as needed;

d.佩戴并固定磨牙近中移动的装置;d. Wear and fix the device for the mesial movement of molars;

e.调整牙周膜牵张成骨的速率,,进行牙周膜牵张成骨,近中移动磨牙。e. Adjust the rate of periodontal ligament distraction osteogenesis, perform periodontal ligament distraction osteogenesis, and move molars mesially.

其中,为了确定患者是否适用本发明的磨牙移动方法,需在治疗前获取患者的磨牙缺失状态,并判断患者是否满足该治疗的适应症,如第一磨牙或第二磨牙缺失,且第三磨牙牙根长度正常,根分叉较小,则可采用本发明进行矫治;Among them, in order to determine whether the patient is suitable for the molar moving method of the present invention, it is necessary to obtain the patient's missing molar state before treatment, and determine whether the patient meets the indications for the treatment, such as the first molar or the second molar is missing, and the third molar is missing, and the third molar is missing. If the root length is normal and the root bifurcation is small, the present invention can be used for orthodontic treatment;

具体地:specifically:

在步骤a中,主要通过对患者口内进行扫描获取模型以及拍摄全景片和口腔CBCT;In step a, the model is mainly obtained by scanning the patient's mouth, and the panoramic film and oral CBCT are taken;

在步骤b中,还需将制作好的移动磨牙的装置在患者口内试戴,确保就位良好,加力顺利,如存在尺寸不匹配,调节不顺利等情况则需重新制作;In step b, it is also necessary to try on the prepared mobile molar device in the patient's mouth to ensure that it is in good position and the force is applied smoothly.

在步骤c中,根据CBCT的检查结果设计牙槽骨松质骨切除术的颊舌侧范围和深度,在需要近中移动的磨牙的近中牙槽骨做牙槽骨骨松质切除术,保留颊侧和舌腭侧骨板,缝合,并根据需要在相应部位植入种植钉。如经过判断不需要植入第一支抗装置16,则可省略该步骤;配合骨松质切除术,可减少骨阻力,可实现长距离整体近中移动磨牙,可加快牙齿移动速率,大大减少矫治时间,且不易出现牙根吸收。In step c, the buccal and lingual extent and depth of alveolar cancellous bone resection are designed according to the examination results of CBCT, and cancellous alveolar bone resection is performed on the mesial alveolar bone of the molar that needs mesial movement, and the retention Buccal and lingual and palatal bone plates were sutured, and implants were placed in the corresponding locations as needed. If it is judged that the first anchorage device 16 does not need to be implanted, this step can be omitted; with cancellectomy, the bone resistance can be reduced, the overall mesial movement of the molars can be realized over a long distance, the tooth movement rate can be accelerated, and the orthodontic treatment can be greatly reduced. time, and root resorption is not easy to occur.

同时,根据需要选择第一支抗装置16和第二支抗装置17以及植入部位,具体可同时采用第一支抗装置16和第二支抗装置17,或仅采用其中的一种支抗方式,第一支抗装置16提供强支抗,第二支抗装置17则作为进一步的加强支抗,对邻牙均无副作用。如经过判断不需要植入支抗装置,则可省略该步骤。At the same time, the first anchorage device 16 and the second anchorage device 17 and the implantation site are selected according to the needs. Specifically, the first anchorage device 16 and the second anchorage device 17 can be used at the same time, or only one anchorage among them can be used. In this way, the first anchorage device 16 provides a strong anchorage, and the second anchorage device 17 serves as a further strengthening anchorage, which has no adverse effect on the adjacent teeth. If it is judged that the anchorage device is not required to be implanted, this step can be omitted.

在步骤d中,一周后待患者手术创口愈合后,将牙周膜牵张成骨装置戴入患者口内,并用正畸粘接剂粘接,根据需要在舌侧加上拉簧;使用的正畸粘接剂为玻璃离子粘接剂或蓝胶粘接剂;In step d, after the patient's surgical wound is healed a week later, the periodontal ligament distraction osteogenesis device is inserted into the patient's mouth, bonded with orthodontic adhesive, and a tension spring is added on the lingual side as needed; The deformed adhesive is glass ionomer adhesive or blue glue adhesive;

在步骤e中,根据患者需要近中移动的磨牙牙根数量确定牙周膜牵张速率,根据所述牵张速率调整移动磨牙的装置。该装置可由患者自主加力调节,患者参与度高,依从性好。牵张成骨过程中不断有骨形成,牙槽骨恢复良好,有利于牙周健康。In step e, the periodontal ligament stretch rate is determined according to the number of molar roots that the patient needs to move mesally, and the device for moving the molars is adjusted according to the stretch rate. The device can be adjusted by the patient's voluntary force, with high patient participation and good compliance. During the process of distraction osteogenesis, there is continuous bone formation, and the alveolar bone recovers well, which is beneficial to periodontal health.

通过使用本发明的牙齿移动方法相比于种植修复和冠桥修复,该方法用患者自体天然牙代替缺失磨牙,最大程度恢复了缺失牙的功能,且避免了种植手术治疗风险/健康牙体组织磨除;该方法通过微种植钉提供强支抗,通过第三带环、第四带环和舌弓提供加强支抗,对邻牙无副作用;配合骨松质切除术,减少骨阻力,大大减少矫治时间,不易出现牙根吸收,且不损伤牙髓;利用牙周膜牵张成骨原理,长距离整体移动磨牙,大大降低了磨牙近移的难度;牵张成骨过程中不断有骨形成,牙槽骨恢复良好,有利于牙周健康;可局部矫治,仅涉及缺牙区两侧的牙位,不需全口弓丝,可缩短治疗时间,节约治疗成本。装置加工铸造而成,复诊操作少,时间短,舒适度高;该装置由患者自主加力,患者参与度高,依从性好。By using the tooth moving method of the present invention, compared with implant restoration and crown bridge restoration, the method replaces the missing molars with the patient's natural teeth, restores the function of the missing teeth to the greatest extent, and avoids the risk of implant surgery/healthy dental tissue Grinding; this method provides strong anchorage through micro-implantation nails, and provides enhanced anchorage through the third belt ring, fourth belt ring and hyoid arch, and has no side effects on adjacent teeth; in conjunction with cancellectomy, it reduces bone resistance and greatly reduces bone resistance. Reduces the treatment time, is less prone to root resorption, and does not damage the pulp; uses the principle of periodontal ligament distraction osteogenesis to move the molars as a whole over a long distance, greatly reducing the difficulty of proximal molar movement; Bone formation continues during the process of distraction osteogenesis , the alveolar bone recovers well, which is beneficial to the periodontal health; it can be partially corrected, only involving the teeth on both sides of the edentulous area, without the need for full-mouth arch wires, which can shorten the treatment time and save the treatment cost. The device is machined and cast, with few follow-up operations, short time and high comfort; the device is empowered by the patient independently, with high patient participation and good compliance.

以上所述仅为本发明的较佳实施例而已,并不用以限制本发明,凡在本发明的精神和原则之内所作的任何修改、等同替换和改进等,均应包含在本发明的保护范围之内。The above descriptions are only preferred embodiments of the present invention and are not intended to limit the present invention. Any modifications, equivalent replacements and improvements made within the spirit and principles of the present invention shall be included in the protection of the present invention. within the range.

Claims (13)

1. A device for periodontal ligament distraction osteogenesis mesial moving molar, comprising a first band (6) and a second band (8), wherein the first band (6) is used for sleeving on a molar or an premolar on the mesial side of an edentulous area, the second band (8) is used for sleeving on a molar needing mesial moving, the first band (6) and the second band (8) are connected through a spiral distractor, characterized in that the spiral distractor is fixedly arranged on the buccal side of the first band (6) and the second band (8), the spiral distractor comprises a first buccal slider (2) and a second buccal slider (5), the first buccal slider (2) and the second buccal slider (5) are connected through a spiral rod (3) and a buccal slider (7), and a nut (4) is arranged on the spiral rod (3); the tongue-shaped belt is characterized by further comprising a first tongue-shaped side sliding block (13) arranged on the tongue surface side of the first belt ring (6), and a second tongue-shaped side sliding block (12) arranged on the tongue surface side of the second belt ring (8); the second tongue-side sliding block (12) is connected with the first tongue-side sliding block (13) through a tongue-side sliding rod (14) and an elastic device (10).
2. The device for periodontal ligament distraction osteogenesis mesial mobile molar according to claim 1, wherein the first buccal slider (2) and the first lingual slider (13) are fixedly attached to both sides of the first band (6), and the second buccal slider (5) and the second lingual slider (12) are fixedly attached to both sides of the second band (8).
3. The device for periodontal ligament distraction osteogenesis mesial mobile molar according to claim 2, wherein the first lingual slider (13) is provided with a first draw hook (11), the second lingual slider (12) is provided with a second draw hook (9), and two ends of the elastic device (10) are hung on the first draw hook (11) and the second draw hook (9).
4. A device for periodontal ligament distraction osteogenesis mesial mobile molar according to claim 3, wherein said elastic means (10) is a tension spring or a chain rubber band.
5. Device for periodontal ligament distraction osteogenesis mesial mobile molars according to any of claims 1 to 4, wherein said nut (4) is provided with a screw hole (15) for adjusting the nut, and said nut (4) is provided with screw rods (3) with opposite directions of rotation on both sides.
6. The device for periodontal ligament distraction osteogenesis mesial mobile molar according to claim 3, wherein only one end of the buccal slide bar (7) is fixedly connected to the first buccal slider (2) or the second buccal slider (5), and only one end of the lingual slide bar (14) is fixedly connected to the second lingual slider (12) or the first lingual slider (13).
7. Device for periodontal ligament distraction osteogenesis mesial mobile molar according to claim 2, characterized in that it is further provided with a first anchorage means (16) providing an anchorage force to the helical distractor, said first buccal slider (2) being rigidly connected to said first anchorage means (16) by means of a fixture (1).
8. The device for periodontal ligament distraction osteogenesis mesial mobile molars according to claim 7, wherein said fixture (1) is a stainless steel wire or a ligature wire.
9. The device for periodontal ligament distraction osteogenesis mesial mobile molars according to claim 7, further comprising a second anchorage device (17), wherein one end of said second anchorage device (17) is fixedly connected to said first band (6).
10. The device for periodontal ligament distraction osteogenesis mesial mobile molars according to claim 9, wherein said second anchorage device (17) comprises a third band (18) fitted over the distraction side premolars, a lingual arch (19) and a fourth band (20), said fourth band (20) fitted over the contralateral premolars, said third band (18) and said fourth band (20) being connected by said lingual arch (19), said lingual arch (19) being located above the lower anterior lingual bulge.
11. The device for periodontal ligament distraction osteogenesis mesial mobile molars according to claim 10, wherein said third band (18) is wrapped around at least one premolar on the distraction side, said fourth band (20) is wrapped around at least one opposite premolar, said third band (18) being fixedly connected to the first band (6).
12. A correction method for mesial movement of molar teeth comprises the following steps:
a. acquiring three-dimensional data of an oral dentition model;
b. means for making a periodontal ligament distraction osteogenesis mesial mobile molar according to any of claims 1 to 11;
c. performing alveolar cancellous bone resection on the middle proximal alveolar bone of the molar;
d. a device for wearing and fixing the mesial mobile molar;
e. and adjusting the rate of periodontal ligament stretching and osteogenesis, and performing mesial moving molar of periodontal ligament stretching and osteogenesis.
13. The method of correcting mesial molar movement of claim 12,
in the step b, a device for grinding the teeth to move in the mesial direction is manufactured according to the obtained alveolar bone and tooth root data and a model obtained by intraoral scanning or alginate mold extraction; in the step c, planting a first anchorage device and/or a second anchorage device according to needs; and determining the bone distraction rate according to the number of molar roots required to move medially in the step e.
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