- 學位論文
超音波輔助齒顎矯正器拆除工具之開發
Developing of an Ultrasonic Vibration Assisted Orthodontic Brackets Debonding Tool
摘要
目前牙科臨床上多使用鉗子來拆除齒顎矯正器，但其力量過大會使病患在過程中感覺到疼痛或者不適，若是移除陶瓷矯正器則更多了容易碎裂的問題，此會導致病患或醫生受傷等危害。有牙醫師使用瑞士EMS公司( Electro Medical Systems, Switzerland )型號為SL4的超音波刮骨器，其原先用途是拿來刮骨粉的，在測試中發現SL4刮骨器於拆除牙套上具可行性，但是順手度較差。因此本研究即想要開發一款刀具，專門做為齒顎矯正器拆除的用途，目標希望降低拆除力量以提升患者舒適感，以及改善陶瓷矯正器脆性易破碎的問題。 本研究以SL4超音波刮骨器作為基礎設計模型，在經過實際觀察操作後，並實地走訪牙醫部門詢問使用者的意見及探討設計上的參數及限制條件。使用Solidworks設計研究來最佳化模型結構，配合Solidworks Simulation和Ansys有限元素來模擬分析頻率、振幅還有應力等參數，最後設計出兩款齒顎矯正器拆除器(Optimal Bracket Debonder, OBD)分別為無鋸齒款及鋸齒款，並個別命名為OBD-1及OBD2。最後實驗比較兩者與SL4刮骨器的拆除時間、力量、ARI、矯正器及牙齒狀況和溫度變化。 由於矯正器黏著時所使用的光固化樹脂為脆性材料，在破斷前幾乎沒什麼塑性變形，裂縫會以非常快的速度擴展。若是以有限元素分析來看其振動模態，刀具前端是水平的劈入樹脂，伴隨著往上拉開的力，如同破壞力學中張裂型破壞模式。實驗結果顯示，OBD拆除器能夠順利移除矯正器，且每顆矯正器的移除時間皆不超過1秒。拆除力量相較於其他移除器械或者SL4刮骨器都更小，可望改善病患在拆除過程中的不適感。使用OBD拆除後更可以保持陶瓷矯正器的完整，也不會對牙釉質造成傷害。而超音波振動所造成的刀具溫升並不容易帶到牙釉質上，所以不須擔心溫度對牙齒有不良影響。 OBD-2平均切削力量為2.11 N，比OBD-1的5.29 N降低了約60%的力，原因應該為鋸齒形刃端與樹脂黏著層的接觸面積較小，應力較大所以可更容易地移除齒顎矯正器。
並列摘要
Nowadays, the dentists often use pliers to remove the orthodontic brackets, however the patients would feel uncomfortable due to the fierce force. It would lead to another problem which the ceramic brackets may be broken into pieces and cause harm to patients and doctors if you use pliers as the debonding tool. Someone uses ultrasonic bone scraper (SL4 instrument, Electro Medical Systems, Switzerland), which is used for winning autologous bone material during surgery, to debond brackets. The purpose of this research is to develope a new tool especially for debonding orthodontic brackets and aims to reduce the debonding force and not to damage the ceramic brackets. SL4 ultrasonic bone scraper was the basic design model because of its feasibility to debond brackets though it was not made for orthordotics originally. Solidworks Design Studies, Solidwork Simulation and Ansys FEM were used to find out the optimal design model and analyze the natural frequency, amplitude, stress of the structure. It was with the aid of many professors and dental clinics to develop these two new OBD (Optimal Bracket Debonder), OBD-1(toothless) and OBD-2(tooth).The debonding force, time requring, ARI, brackets and enamel conditions and temperatures variations will be discussed in the article. The light activated resins would show brittle characteristic after hardening by curing light. There is little or no gross plastic deformation before it fractures. The mode shape of OBD correspond to the opening mode in failure mechanics. The experimental results showed that OBD can remove brackets easily without damaging the ceramic brackets and enamels. It takes less than 1 second to debond each bracket with lower force. And the thermal energies are hard to transmit upon the surface of teeth so it won’t do harm to teeth. Compare to OBD-1, the OBD-2 can debond brackets with a lower force. The reason may be the saw tooth can increase the stress because of the smaller contact area. This would make it debond the orthodontic brackets more easily.
參考文獻
延伸閱讀
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