抗菌牙科矯正器於牙齒錯咬之治療影響與生物相容性研究

Biocompatibility research and anterior cross bite correction treatment effect on antibacterial dental orthodontics

林信介(Hsin-Chieh Lin)

指導教授 ： 吳慶榕

臺北醫學大學/口腔醫學院/醫療器材產業碩士專班/碩士(2013年)

https://doi.org/10.6831/TMU.2013.00136

摘要

指樣彈線矯正器是臨床上解決牙齒前牙錯咬的方法之ㄧ，但相關文獻針對該裝置力學分析及牙齒施力機轉過程並無明確詳述。因此，本研究以目前臨床慣用之不銹鋼指樣彈線矯正器進行設計並建構3D立體模型，藉DEFORM-3D有限元素分析，進行最接近實際牙齒受力後移動狀況之擬真動態分析，探討指樣彈線之材料、直徑、長度、外型設計等各式條件，對牙齒施力、牙齒受力、牙齒位移及齒槽骨應力分布之影響，以期找出指樣彈線矯正器之外型最佳化設計，達到最佳齒列矯正效果，並得到牙齒移動之牙周生物力學機制。而新型抗菌矯正器材料之開發備製，係添加不同含量之銀元素於AISI 316不銹鋼中，藉由光學顯微鏡(OM)、X光繞射儀(XRD)、掃描式電子顯微鏡(SEM)與穿透式電子顯微鏡(TEM)等儀器進行材料微結構分析；且依據日本JIS Z2801:2010規範進行抗菌測試及細菌貼附之觀察。分析結果顯示：合金添加銀元素後，於沃斯田鐵基地中會析出富銀化合物，而抗菌測試中亦發現，添加銀能有效增進材料之抗菌活性、提高抗菌率以及降低細菌貼附，當銀添加量增加至0.2 wt.%時，合金對於金黃色葡萄球菌與大腸桿菌有高達99.9%之抗菌率，故此合金可發展成一潛力之價格低廉且同時兼具抗菌特性之不銹鋼矯正器。

關鍵字

指樣彈線矯正器,DEFORM分析,抗菌不銹鋼

並列摘要

Finger spring is one of the effective methods to solve anterior cross bite in clinic. But there have not been any researches about the mechanic analysis of the finger spring and biomechanics of orthodontic tooth movements. Thus, the present study set a 3D model from a clinical generally used stainless steel finger spring and performed the mechanical analysis with DEFORM-3D. The optimize simulation will be accomplished and then the influences from materials, diameter, length and design of the finger spring upon the pressure, loading, movement of tooth and the stress of alveolar bone will be discussed. The study anticipates finding out the optimum design and effect of finger spring for orthodontics. In addition, the bacteria adhesion on the surface of the biomedical materials gives rise to infection problem which is related to human health and clinical treatment. Therefore, prevent bacterial adhesion on the biomedical materials is one of the significant objectives in the current research. In this study, different concentrations of Ag element were added to austenite stainless steel and the microstructures were analyzed by optical microscopy (OM), X-ray diffraction (XRD), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Moreover, the antibacterial tests and observation of bacterial adhesion were performed according to the JIS Z2801:2010 specification. The antibacterial tests indicated that presence of Ag-rich compounds can promote antibacterial activity, enhance antibacterial effect and reduce bacterial adhesion. When the Ag content reaches about 0.2 wt.%, the alloy exhibits an excellent antibacterial properties against Staphylococcus aureus and Escherichia coli, with an antibacterial rate of nearly 99.9%. Thus, the Ag-containing stainless steel can be developed as potential antimicrobial biomaterials for orthodontics applications.

並列關鍵字

Finger spring, DEFORM analysis, Antibacterial stainless steel

參考文獻

[3] Kaare Reitan, M.S.D.　Tissue Behavior During Orthodontic Tooth Movement.　American Journal of Orthodontics. 1960; 46: 881-900.

[10] K.L. Ou, S.Y. Chiou and M.H. Lin, J. Electrochem. Soc., 151 (2004) G766.

[22] K.A. Abou-El-Hossein and Z. Yahya, J. Mater. Process. Technol. 162–163 (2005) 596.

[24] N. Lopez, M. Cid and M. Puiggali, Corros. Sci. 41 (1999) 1615.

[25] R.A. Weinstein, Clin. Infect. Dis. 33 (2001) 1386.