臺灣博碩士論文加值系統

下顎阻生第二大臼齒多是利用迷你植體搭配牙齒矯正裝置進行治療，但目前並沒有確切數據能說明植體失效的原因，為提高治療成功率本次實驗取得下顎骨CT掃描檔案建構實體、牙齒透過逆向工程進行掃描疊圖、牙周韌帶模型依照齒根曲線製作等厚外型，再使用3D繪圖軟體建立組合模型，最後依微血管血壓與人體收縮壓判別不同的Omega半徑、材質、斷面造型和Open loop角度之彈線對矯正的影響。分析結果顯示牙周韌帶受任一組彈線的矯正力作用，皆會先在牙根尖端產生侵入的矯正效果，矯正力增加骨重塑區會依序從牙周韌帶遠心側牙根、牙頸，再到近心側牙根與牙頸產生，另外在相同條件下，橢圓形斷面較其它兩種斷面可提升約18%的矯正力；彈線在相同材質和斷面的條件下，改變Omega 半徑與Open loop角度進行實驗並透過雙因子變異數分析實驗結果，經整理得知Open loop角度對牙周韌帶應力影響較顯著，如需快速提升矯正矯正力，建議改變Open loop角度，若是矯正力微調，建議改變Omega半徑，同時Open loop角度不得低於1°；彈線在相異材質其餘條件皆相同的實驗中，將彈線材質從Ti-6Al-4V替換成AISI 316L可提升82%矯正力，另外使用斷面造型與材料進行雙因子ANOVA變異數分析與重複試驗，由結果得知材料對牙周韌帶應力影響較彈線的造型變異顯著，且各因子交互作用不顯著。綜觀上述結果可以得知彈線使用Omega半徑0.6mm、材料316L、橢圓形斷面在Open loop 2.5°時可以產生最佳矯正力，且牙齒位移方式不受材質影響，最後可搭配應力影響區與牙齒向量位移圖預估牙齒矯正治療效果。

The treatment of mandibular impacted second molars commonly involves the use of mini-implants in combination with orthodontic devices. However, there is currently no definitive data explaining the causes of implant failure. To improve treatment success rates, this experiment obtained CT scan files of the mandible to construct physical models, scanned and superimposed the teeth using reverse engineering, and created a periodontal ligament model based on the root curve. A combination model was then established using 3D drawing software. Finally, the effects of different Omega radii, materials, cross-sectional shapes, and Open loop angles of elastic wires on orthodontic forces were determined based on capillary blood pressure and human systolic pressure. The analysis results showed that under the corrective force of any elastic wire, the periodontal ligament initially produced an intrusive corrective effect at the root apex. As the corrective force increased, bone remodeling zones sequentially emerged from the distal root of the periodontal ligament, to the cervical area, and then to the mesial root and cervical area. Additionally, under the same conditions, elliptical cross-sections enhanced the corrective force by approximately 18% compared to the other two cross-sections. Experiments altering the Omega radius and Open loop angle of elastic wires under the same material and cross-section conditions, followed by two-way ANOVA, indicated that the Open loop angle had a more significant impact on periodontal ligament stress. For a rapid increase in corrective force, adjusting the Open loop angle is recommended, while for minor adjustments in corrective force, changing the Omega radius is advisable, with the Open loop angle not falling below 1°. In experiments with different materials but the same other conditions, replacing Ti-6Al-4V elastic wires with AISI 316L increased the corrective force by 82%. Further two-way ANOVA and repeated tests using cross-sectional shapes and materials revealed that material had a more significant impact on periodontal ligament stress than wire shape variation, with no significant interaction between factors. Overall, the optimal corrective force was achieved with elastic wires using an Omega radius of 0.6mm, material 316L, elliptical cross-section, and an Open loop angle of 2.5°, and the tooth displacement pattern was not affected by the material. Finally, the effects of stress and tooth displacement vectors can be used to predict orthodontic treatment outcomes.

摘要 i
ABSTRACT iii
誌謝 v
目錄 vi
表目錄 ix
圖目錄 xi
第一章 緒論 1
1.1 前言 1
1.2 齒列矯正介紹 2
1.2.1 牙齒結構與牙周組織 2
1.2.2 齒列矯正 3
1.2.3 齒列矯正裝置 3
1.3 文獻回顧 7
1.4 研究目的與動機 10
第二章 理論介紹 11
2.1 牙齒概述 11
2.1.1 口腔環境座標 11
2.1.2 牙齒排列 12
2.2 牙齒矯正 14
2.2.1 咬合不正症狀 14
2.2.2 齒顎矯正原理 17
2.2.3 骨重塑 18
2.3 有限元素分析簡介 20
2.4 逆向工程 21
2.5 等效應力 21
2.6 牙周韌帶受力分析 22
2.7 牙齒運動分析 23
2.8 變異數分析 24
第三章 研究方法與實驗流程 27
3.1 模型建立 27
3.1.1 牙齒模型 27
3.1.2 牙周韌帶模型 31
3.1.3 下顎齒槽骨模型 32
3.1.4 矯正托架與彈線 34
3.1.5 組合模型 37
3.2 模型之材料設定 39
3.3 邊界條件設定 40
3.4 網格元素建立 47
3.4.1 有限元素分析模型簡化 49
3.4.2 有限元素模型收斂性分析 52
3.5 研究因子設計 55
第四章 模擬分析結果與討論 57
4.1 3^3矩陣因子 彈線矯正力分析 57
4.2 3^3矩陣因子 下顎阻生第二大臼齒矯正分析 59
4.3 彈線斷面造型對矯正之影響 63
4.4 Omega 半徑對矯正之影響 75
4.5 彈線材料對矯正之影響 86
第五章 結論與未來展望 94
5.1 結論 94
5.2 未來展望 95
參考文獻 96

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