Uburyo bwo guhitamo udukingirizo twihariye two kuvurwa no kuvura amagufwa

Udukingirizo twigenga twahinduye uburyo bwo kuvura indwara y'amenyo mu myaka makumyabiri ishize. Bitandukanye n'udukingirizo dusanzwe dukenera udukingirizo tworoshye cyangwa tw'insinga kugira ngo dufashe insinga, udukingirizo twigenga dukoresha icyuma cyubatswemo cyangwa uburyo bwo kuzunguruka. Iyi miterere igabanya gukururana, igagabanya igihe cyo kubonana n'abaganga, kandi ikanoza ihumure ry'umurwayi. Nk'uko bivugwa n'Ishyirahamwe ry'Abanyamerika ry'Abaganga b'Amagufwa (AAO), abarwayi bagera kuri miliyoni 4 muri Leta Zunze Ubumwe za Amerika bavurwa indwara y'amenyo buri mwaka, aho uburyo bwo kuvura indwara ari bwo butuma umubare w'abarwayi wiyongera. Imyitozo yo gukoresha udukingirizo twigenga ivuga ko bigabanya igihe mpuzandengo cyo ku ntebe ku murwayi ho iminota 15-20 kuri buri murwayi.

Iyi mfashanyigisho isuzuma ibintu by'ingenzi abaganga b'amenyo n'abaganga b'amenyo bagomba gusuzuma mu gihe bahitamo udukingirizo two kwibohora, ikaba ikubiyemo itandukaniro mu miterere y'imashini, amakuru y'imikorere y'ubuvuzi, imiterere y'ibikoresho, n'ibipimo by'ikiguzi.

Udukingirizo two kwibohora ni iki kandi dukora gute?

Udukingirizo twigenga ni ibikoresho byo mu mutwe bifite uburyo bwo gufunga buhuza insinga z’umugongo n’umugozi w’umugongo bitabaye ngombwa ko dukingirwa inyuma. Igice cy’agakingirizo kiba gifite agakingirizo, irembo, cyangwa isoko ishobora gufungurwa kugira ngo insinga zishyirwemo hanyuma igafungwa kugira ngo ihambirwe mu mwobo.

Hari ubwoko bubiri bw'ibanze bwa mekanike:

Udukingirizo twigenga tudakoraIfite ifunga rikomeye kandi rihoraho ridakoresha imbaraga zikora ku nsinga. Uburyo bwo kunyerera butuma insinga ifatana neza n'insinga, ibyo bigatuma igabanya imbaraga zo gushwanyagurika mu gihe cyo kunyerera amenyo. Iyi miterere ikwiriye cyane cyane mu bihe byo gukurura no mu masanduku akeneye uburyo bwo kunyerera neza.

Udukingirizo twikora twigengaShyiramo agakoresho cyangwa urugi rufite impeta rushyiramo umuvuduko woroheje ku nsinga. Iyo insinga ari nto ugereranyije n'ingano y'aho iherereye, impeta ifata insinga cyane, igatanga imbaraga zo kuyihuza neza mu ntangiriro z'ubuvuzi.

Isuzuma ryakozwe mu 2019 ryasohotse mu kinyamakuruIterambere mu buvuzi bw'amenyoIkinyamakuru cyasanze sisitemu zitagira imbaraga zituma habaho imbaraga nke zo gukururana (ubusanzwe zigera kuri garama 50–200 ku gice cyageragejwe cy’insinga/imirongo) mu gihe sisitemu zikora zagaragaje uburyo bwo guhuza bwa mbere bwihuse mu bihe byo gucucikana byoroheje kugeza ku rugero rwo hagati.

Impamvu udukingirizo two kwibohora tugabanya igihe cyo kuvurwa no gusura intebe

Imwe mu nyungu zavuzwe cyane zo kwishyira mu mashanyarazi ni ukugabanya igihe cyo kuvurwa muri rusange n'umubare w'ibizamini bisabwa. Ubushakashatsi bwa muganga butanga amakuru afatika:

• Igerageza ryakozwe ku buryo bw’umwihariko ryagaragaje ko igihe cyo kuvurwa cyagabanutseho hafi amezi atandatu ku barwaye indwara zisanzwe hakoreshejwe uburyo bwo kwibohora butagira aho buhuriye n’imitsi ugereranije n’uburyo busanzwe bwo kuvura indwara ebyiri.
• Akenshi igihe cyo kubonana gishobora kongerwa kuva ku byumweru 4 kugeza ku byumweru 6-8 bitewe n’imbaraga zihoraho no kugabanuka kw’imibanire.
• Gukuraho gushyiramo no gukuraho imitsi bigabanya iminota 5-8 kuri buri mugongo kuri gahunda, nk'uko ubushakashatsi bugaragaza igihe cyakoreshejwe mu mashuri makuru y'amenyo.

Uburyo bwo kunoza ubu buryo bushingiye ku kugabanya uburyaryate. Muri sisitemu zisanzwe, imigozi ikora neza ituma amenyo ahuzwa neza n'insinga, cyane cyane mu gihe cyo kugenda. Sisitemu zikora zigabanya ubwitonzi kugeza kuri 60-80%, bigatuma imbaraga zoroheje zikomeza kugenda neza mu menyo binyuze mu igufwa rya alveolar.

Ibikoresho: Ikoranabuhanga rya 17-4 Stainless Steel vs. MIM muri Orthodontic Brackets

Udupfunyika twinshi tw’ubucuruzi twihuza ibyuma bikozwe mu cyuma gikozwe mu cyuma kitagira umugese cyangwa mu cyuma gikozwe mu ijosi (MIM). Gusobanukirwa izi nzira bifasha kugura ibyemezo byo mu mavuriro y’amenyo no mu mavuriro y’amenyo.

Ibyuma 17-4 bita icyuma gifunganyeni aloyi ikora nk'iy'imvura irimo chromium (16-18%), nikeli (3-5%), umuringa (3-5%), na niobium. Ingufu zayo zingana na MPa 1.000–1.200 zituma idahinduka cyane mu gihe cy'imitsi. Iki gikoresho ni cyiza cyane ku mabaraza akoreshwa ku gipimo cyo hejuru cy'imbaraga mu gihe cyo kugaragaza imbaraga.

Gutera Inshinge mu Byuma (MIM)ni uburyo bwo gukora ibyuma bisa n'umuyoboro uhuza icyuma gifu n'uburyo bwo gufunga. Iki gikoresho gishyirwa mu byuma bikozwe neza, hanyuma kigakurwamo hanyuma kigasibwa. Ibice bya MIM bigaragaza imiterere myiza cyane (+/- 0.02mm yo kwihanganira), ibi bikaba ari ingenzi cyane kugira ngo imiterere y'ibice ikoreshwe neza mu dukingirizo twigenga. Dukurikije ubushakashatsi bwasohotse muIkinyamakuru cy'Ubwubatsi bw'Ibikoresho n'Imikorere, Ibyuma bita 17-4 byatunganyijwe na MIM bigira imiterere ingana n'iy'ibikoresho byakozwe nyuma yo gucukurwa neza.

Abakora bakoresha ikoranabuhanga rya MIM batangaza ubushobozi bwo gukora buri cyumweru bw’ibikoresho birenga 10.000 ku murongo umwe w’ibikorwa, bigatuma habaho igenzura ry’ubuziranenge rihoraho n’ibiciro bihangana mu kugura ibicuruzwa byinshi.

Kugereranya sisitemu zo kwibohora: Uburyo bwo gutanga imiti ya Roth vs. MBT

Uburyo bubiri bwo kuvura indwara zo mu mutwe bukoreshwa cyane ni bwo bwiganje ku isoko ry’imitsi yo mu mutwe: uburyo bwo kuvura indwara zo mu mutwe bwa Roth na MBT (McLaughlin, Bennett, Trevisi). Byombi bigena agaciro k’umuvuduko w’amaraso, impera, n’ingufu z’amaraso byubatswe muri buri mwanya w’imitsi yo mu mutwe.

Uburyo bwo kuvura bwa Roth bwakozwe na Dr. Ronald Roth mu myaka ya 1970, kandi bushimangira ko umuntu agomba gukosora cyane kugira ngo arebe ko ashobora gusubira inyuma. Uburyo bwo kuvura bwa MBT bwaturutse ku buryo bunoze kandi butanga uburyo bwo kuvura imbere. Imirongo myinshi igezweho itanga uburyo bwo kuvura bwombi mu bwoko butandukanye bw'ibicuruzwa byayo.

Gukunda kwa muganga akenshi biterwa n'amahame y'ubuvuzi bw'umuntu ku giti cye, aho MBT igenda yiyongera mu bikorwa bya none bitewe n'ubushobozi bwayo bwanditse mu bwoko butandukanye bwa malocclusion.

Uburyo bwo gushyiramo uduce twigenga mu myitozo yawe

Guhindura uburyo bwo gushyira ibintu mu masanduku bwite bisaba gusuzuma amabwiriza y’ubuvuzi, amahugurwa y’abakozi, n’imicungire y’ibikoresho.

Intambwe ya 1: Suzuma Ibipimo ngenderwaho byo Guhitamo Urubanza.Udukingirizo twigenga dukora neza mu gihe gisaba uburyo bwiza bwo kugenda: gufunga umwanya, guhuza insinga z'umurambararo, no kumenya neza ko umuvuduko uhagaze neza. Gusaba imbaraga zidasanzwe cyangwa kuzunguruka cyane bishobora kugirira akamaro ibikoresho bisanzwe by'inyongera.

Intambwe ya 2: Guhugura abakozi b'ubuvuzi ku mikorere y'uburyo.Bitandukanye n'udukingirizo dusanzwe dusaba gushyirwaho udukingirizo, udukingirizo twishyiramo udukingirizo dukenera uburyo bwihariye bwo gufungura no gufunga. Kwitoza gukoresha ibikoresho by'icyitegererezo byatanzwe n'uruganda bigabanya amakosa yo ku ntebe mu gihe cyo kuyikoresha bwa mbere.

Intambwe ya 3: Hindura ibihe byo gutegura gahunda.Ubusanzwe imyitozo yongerera igihe cyo kwibuka kugeza ku byumweru 6-8 iyo hakoreshejwe uburyo bwo kwihuza amenyo butagira aho buborera, kuko imbaraga zibora buhoro buhoro kandi amenyo agenda neza nta guhagarara bitewe no gukururana.

Intambwe ya 4: Kugenzura ububiko bw'ibikoresho no kongera gutondekanya.Udusanduku twishyiramo ubwatwo dusanzwe dutwara amafaranga menshi kuri buri gikoresho ugereranyije n’udusanduku dusanzwe, ariko ntibisaba ko habaho ibikoresho bitandukanye byo gufunga. Gerageza kubara ikiguzi cyose cya buri murwayi harimo n’ibikoresho byose kugira ngo umenye neza amafaranga uzigamye.

Isesengura ry'Ikiguzi: Udukingirizo two Kwibohora Ugereranije na Sisitemu Zisanzwe

Ikiguzi cy’ibanze cy’ibice bya sisitemu zo kwihuza ubusanzwe kiri hejuru ya 20-40% ugereranyije n’ibice bibiri bisanzwe. Ariko, isesengura ry’ibiciro rusange rigaragaza ishusho y’uburyo burambuye.

Kuzigama amafaranga mu buryo butaziguye birimo:gukuraho imigozi ikora neza (3–8$ kuri buri murwayi kuri buri musurwa), kugabanya igihe cyo kubagwa bigatuma umubare w’abarwayi urushaho kwiyongera, no kugabanya ibikoresho byo mu bubiko bw’ibikoresho.

Inyungu zitaziguye zirimo:kunoza ubunararibonye bw'abarwayi (nta mpinduka zibabaza mu mitsi), kugabanuka kw'ibizamini byihutirwa ku mitsi yangiritse cyangwa yatakaye, no kunoza ibipimo by'imikorere myiza y'imyitozo.

Isesengura ry'ibiciro ryo mu 2020 ryasohotse muIkinyamakuru cy'ubuvuzi bw'amagufwayabaze ko uburyo bwo guhindura uburyo bwo kwihuza bwagabanyije ikiguzi kuri buri murwayi kigera kuri 8–12% ubwo hashyirwaga mu bikorwa byo gukuraho inshinge no kuzigama igihe mu gihe cy’amezi 18 yo kuvurwa.

Ibibazo Bikunze Kubazwa

Ni irihe tandukaniro rikomeye riri hagati y'udukingirizo twigenga dukora n'udukingirizo tudakora?

Udukingirizo twigenga dukora (Active ligating brackets) dukoresha agakoresho gafite umuvuduko woroheje ku nsinga, bigatuma bigira akamaro mu byiciro byo guhuza mu ntangiriro. Udukingirizo twigenga tudakora dufite imiterere y'irembo ritakoresha imbaraga zikora ku nsinga, bigagabanya gukururana mu gihe cy'ubukanishi bunyerera. Amahitamo aterwa n'icyiciro cyo kuvurwa n'intego za biomechanical.

Udukingirizo twigenga dukora gute ugereranije n'udukingirizo dusanzwe?

Udukingirizo twigenga tudakora neza tugabanya kwangirika ku kigero cya 60-80% ugereranije n'udukingirizo dusanzwe dufite udukingirizo duto, nk'uko byagaragajwe n'ubushakashatsi bwa laboratwari. Uku kugabanuka gutuma imbaraga zoroshye zikomeza kugera ku kwihuta kw'amenyo neza.

Ni ibihe bikoresho bikoreshwa mu gukora udukingirizo twigenga?

Udukingirizo twinshi twigenga dukora mu byuma 17-4 bikoresha precision casting cyangwa metal injection molding (MIM). Ikoranabuhanga rya MIM ritanga ubuziranenge buhanitse kandi buhamye, ibyo bikaba ari ingenzi cyane mu kugaragaza neza torque.

Ese udupfunyika twishyiramo imigozi tugabanya igihe cyo kuvurwa n'amenyo muri rusange?

Ubushakashatsi bwinshi bw’ubuvuzi bugaragaza ko igihe cyo kuvurwa cyagabanutseho amezi 4-6 ku barwayi basanzwe hakoreshejwe uburyo bwo kwihuza butagira aho bubogamira. Igihe cyo kubonana n’umurwayi akenshi gishobora kongerwa kuva ku byumweru 4 kugeza ku byumweru 6-8, bigabanura umubare w’abajya kwa muganga mu gihe hagakomeza kubaho imikorere myiza.

Ese udukingirizo twigenga tubereye ubwoko bwose bwa malocclusion?

Udukingirizo twigenga tugira akamaro ku bwoko bwinshi bwa malocclusion harimo gucurika, intera, no gukosora icyiciro cya kabiri. Ariko, ibibazo bisaba torque ikabije cyangwa mekanike igoye bishobora kubyazwa inyungu ku bikoresho by'inyongera. Guhitamo udukingirizo bigomba gushingira ku bisabwa na biomekanike ku giti cyabyo.