Udukingirizo two kwibohora: Ibyiza n'imbogamizi byo kwa muganga

Intangiriro

Ubuvuzi bw'amenyo bwarushijeho kwerekeza ku buryo bwo gufata amagufwa akingira insinga z'umugongo nta migozi ya elastomeric cyangwa ibyuma, buhindura imikorere ndetse n'imikorere ya buri munsi. Amagufwa yigenga akunze guterwa inkunga kugira ngo habeho kugabanuka kw'imitsi, guhindura insinga vuba, no kunoza ihumure, ariko agaciro kayo nyakuri mu buvuzi gaterwa n'uko ibyo bivugwa bihagaze mu bikorwa. Iyi nkuru isobanura uburyo aya magufwa akora, aho ashobora kunoza imikorere cyangwa kugenda kw'amenyo, ndetse n'imbogamizi zikomeje kuba ingenzi mu gutegura uburyo bwo kuvura, ikiguzi, isuku, n'umusaruro w'igihe kirekire. Ikiganiro gishyiraho igereranya rifatika n'amagufwa asanzwe kugira ngo inyungu n'inyungu bishobore gupimwa mu rwego rw'ubuvuzi.

Impamvu udupfunyika twishyiramo ingenzi mu buvuzi bw'amenyo bugezweho

Iterambere rya tekiniki y’imitsi ryatumye habaho impinduka ihoraho kuva ku buryo busanzwe bwo gufunga imitsi n’ibyuma (ligatures) bijya mu buryo bwubatswemo imashini.Udukingirizo twigenga (SLBs)bigaragaza impinduka ikomeye mu bijyanye n'ibinyabuzima mu buryoinsinga z'amashanyarazi zirakoramu mwanya w'agati, bigahindura uburyo amenyo agenda. Mu gushyiramo urukuta rwa kane rugenda—ubusanzwe urugi rugenda cyangwa agakoresho ko gupfunyika—izi sisitemu zikuraho gukenera ibikoresho byo gupfunyika inyuma, bigira ingaruka ku buryo butaziguye ku mikorere myiza y'amenyo ndetse no ku mikorere y'umubiri y'amenyo.

Ku muganga w’amenyo, gukoresha sisitemu zo kwihuza si ibintu gusa, ahubwo ni impinduka ikomeye mu mikorere y’ubuvuzi. Guhuza SLB bigira ingaruka ku ikoreshwa ry’amenyo, gahunda yo kubonana n’abaganga, ndetse no kumenya neza uburyo amenyo azagenda mu gihe cya mbere, bigasaba gusobanukirwa neza imikorere yayo n’aho isoko riherereye.

Ingaruka ku gihe cy'intebe n'imikorere yayo

Inyungu yihuse yo gukora ku buryo bwihuse yo gushyiramo uduce tw’insinga ni ukugabanya igihe cy’intebe yo kwa muganga. Ubushakashatsi bugaragaza buri gihe ko gukuraho insinga no kuzishyira muri sisitemu za SLB bizigama iminota 1.5 kugeza kuri 3 kuri buri mwamba ugereranije no kuzigama imashini isanzwe ya elastomeric, kandi cyane cyane iyo ugereranije no kuzigama imashini y’icyuma. Mu gihe cy’amezi 24 cyo kuvurwa gisaba guhindura insinga inshuro 12 kugeza kuri 15, ibi bivuze ko bigabanya cyane uburyo intebe zikora.

Byongeye kandi, imikorere yoroshywa no kugabanya inshuro zo gukorana n'umuganga zisabwa kugira ngo habeho gusimbuza ligature. Kubera ko elastomeric connections ihura n'ingaruka zo kubora kw'imbaraga—itakaza kugeza kuri 50% by'imbaraga zayo za mbere mu masaha 24 ya mbere kandi ikarushaho kwangirika mu kanwa—uburyo busanzwe bukunze gusaba gukorana n'umuganga buri byumweru 4 kugeza kuri 6. Uburyo bwa SLB, cyane cyane ubwoko butariho buvanze n'insinga za copper-nickel-titanium (CuNiTi), butuma habaho igihe kirekire cy'ibyumweru 8 kugeza kuri 12 mu gihe cyo gukorana n'umuganga, bigatuma gahunda ya buri munsi y'umuganga irushaho kuba nziza kandi ikongera ubushobozi bwo gukora.

Imiterere y'ubuvuzi n'isoko bituma habaho ikoreshwa ry'ibicuruzwa

Isoko ry’imitsi ku isi ryabonye impinduka zihuse mu kwishyira hamwe kw’imitsi, aho igice cya SLB cyaguka ku gipimo cy’iterambere ry’umwaka (CAGR) kingana na 7.5%, biteganijwe ko kizarenga miliyari 1.2 z’amadolari ku isi mu mpera z’iki mwaka. Iri zamuka riterwa n’ibikenewe bibiri: abaganga bashaka imikorere myiza n’abarwayi basaba kunoza ubwiza n’isuku.

Byongeye kandi, guhuza uburyo bwo gutunganya ibyuma mu buryo bwa digitale na sisitemu zo gushyira ibyuma mu buryo bwa bracket byihutishije ikoreshwa rya SLB. Uburyo bwinshi bugezweho bwo gupima ibyuma mu kanwa no guhuza ibyuma mu buryo butaziguye bunoze kugira ngo bukoreshwe mu buryo bwikora, kuko kutagira amababa ya elastomeric bituma habaho imiterere mito y’ibyuma no gukora ibishushanyo mbonera by’ikoranabuhanga neza. Abakora ibikoresho barimo bashora imari mu bushakashatsi no guteza imbere SLB z’ubuziranenge, bashyira isoko kure y’udukingirizo tusanzwe.

Udukingirizo twigenga ni iki n'uko dukora

Gusobanukirwa imikorere y'udukingirizo twigenga bisaba gusesengura imikoranire iri hagati y'agace k'udukingirizo, uburyo bwo kudukingirizo, n'insinga. Bitandukanye n'udukingirizo tubiri dusanzwe twishingikiriza ku guhindagurika kw'umugozi wa polyurethane kugira ngo dushyireho insinga, SLB zikoresha icyuma gikonje cyangwa gikonje. Iri tandukaniro ry'ibanze mu miterere rigena uburyo bwo kudacika intege (friction) n'urwego rw'ubugenzuzi umuganga agira ku muvuzi mu byiciro bitandukanye byo kuvura.

Sisitemu za "Passive" vs "active bracket"

Sisitemu zo kwihuza zishyirwa mu byiciro bibiri bitandukanye bya biomechanical: passive na active. SLBs zidakora zifite urugi rudahindagurika cyangwa clip ihindura bracket mo tube yoroshye. Iyo ifunze, clip ntabwo ishyira imbaraga ku archwire, ndetse n'iyo insinga nini (urugero: 0.019 × 0.025-inch mu 0.022-inch) zifatanye. Iyi miterere igabanya friction ya kera, akenshi igumana resistance iri munsi ya garama 50 mu gihe cyo kugorora no guhuza, bigatuma archwire inyerera neza kandi ikagaragaza imiterere yayo ya superelastic.

Ibinyuranye n'ibyo, SLB zikora zikoresha agace k'ubushyuhe gashobora koroha (ubusanzwe gakozwe muri nickel-titanium cyangwa cobalt-chromium) gafata umwanya w'aho kajya. Mu gihe gakoresha insinga nto zizengurutse, agace gakoresha cyane insinga nini z'urukiramende (urugero, zirenze santimetero 0.016 × 0.022). Iyi mbaraga yo kwicara ihoraho yongera imbaraga zo gukururana—akenshi zirenga garama 150 z'ubudahangarwa—ariko gatanga uburyo bwo kugenzura neza imiterere itatu, cyane cyane mu kugaragaza imbaraga no kurangiza gukosora mu gihe cyo kurangiza ubuvuzi.

Ibiranga igishushanyo, imiterere y'imikino, n'ibikoresho

Gukora neza agace k'icyuma gifunga icyuma n'uburambe bwa clip ni ingenzi cyane ku mikorere ya SLB. Sisitemu nyinshi ziboneka mu bipimo bya cm 0.018 cyangwa cm 0.022, nubwo agace ka cm 0.022 gakundwa cyane muri sisitemu zitagira ingufu kugira ngo insinga nto zigenda zihindagurika. Uduce ubwatwo tugomba kwihanganira umunaniro ukabije; uduce twa cobalt-chromium tw’ubuziranenge twakozwe kugira ngo turwanye impinduka zidashira nubwo twahura n’imbaraga zo gufungura no gufunga kugeza kuri kilogarama 1.5 mu gihe cy’amezi 24.

Guhitamo ibikoresho byo gushyiramo agace gashyirwa ...koreshwa mu buvuzi nabyo bigena akamaro k'ubuvuzi.Icyuma kitagira umwanda gifite 17-4 PHBikomeje kuba igipimo cya zahabu cyo kuramba no kugabanya imiyoboro, icyifuzo cy’abarwayi cyatumye habaho iterambere rya SLB za polycrystalline alumina (ceramic). Kugira ngo hirindwe kuvunika kwa ceramic mu gihe cyo gukoresha clip, SLB zigezweho zikunze kugira imiterere ivanze, zirimo icyuma gishyirwamo cyangwa icyuma cyihariye gitwikiriwe na rhodium gihuza neza n’umubiri wa ceramic mu gihe gikomeza kuba cyiza.

Kugereranya n'udukingirizo dusanzwe

Kugira ngo hagaragazwe neza itandukaniro riri hagati y’imikorere y’umubiri n’imikorere y’umubiri, imbonerahamwe ikurikira igereranya uduce dusanzwe hamwe n’uduce tudakora n’uduce twigenga mu buryo bw’imikorere y’umubiri mu buryo bw’ingenzi bw’ubuvuzi.

Iri gereranya rigaragaza ko nta sisitemu imwe iruta izindi zose; ahubwo, amahitamo ashingira ku kuba gahunda yo kuvura ishyira imbere umuvuduko wo guhuza hakiri kare (guhitamo SLB zidafite aho zihuriye) cyangwa kugenzura kurangiza mu cyiciro cya nyuma (guhitamo SLB zikora cyangwa sisitemu zisanzwe).

Ibyiza n'imbogamizi by'imikoreshereze y'amabati yo kwishyira ku giti cyawe

Impinduka igana ku kwishyira mu mwanya w’amenyo ishingiye ahanini ku bisubizo byihariye by’ubuvuzi, nyamara inyandiko n’uburambe bw’ubuvuzi bigaragaza ukuri gutandukanye. Nubwo SLB zikora neza mu nzego zimwe na zimwe z’ibinyabuzima, zigaragaza imbogamizi abaganga b’amenyo bagomba gukemura, cyane cyane ku bijyanye no gushyira amenyo neza mu byiciro bya nyuma by’ubuvuzi bw’amenyo.

Ibyiza mu gukoresha neza isuku no gutunganya ibintu neza

Inyungu nyamukuru ya SLBs mu buvuzi ishingiye ku gukora neza kw'amenyo, cyane cyane mu gihe umuntu ahuze cyane. Mu kugabanya ubushobozi bwo kwirinda kunyerera kugeza kuri 60% ugereranije n'udupfunyika duhambiriyeho elastomeric mu gihe cyumye, SLBs zidafite imbaraga zemerera imbaraga z'urumuri kandi zihoraho gukwirakwira ku menyo menshi. Ibi byoroshya kwaguka no guhuza amenyo mu buryo bunyuranyije n'amategeko, bigatuma amenyo atakaza imbaraga zo guhagarara neza. Mu buvuzi, ibi akenshi bituma amenyo ahuze vuba mu mezi 6 kugeza ku 9 ya mbere yo kuvurwa.

Isuku ni ikindi cyiza gikomeye. Imiterere ya elastomeric ishobora kwibasirwa cyane no kwikubira kwa plaque no kwiyongera kwa bagiteri. Ubushakashatsi bwa muganga bwerekana ko imiterere ya elastomeric igumana hafi 38% bya plaque biofilm kurusha ubuso bworoshye bwa SLB clips. Mu gukuraho imiterere ya polyurethane ifite imyenge, sisitemu zo kwihuza zigabanya umutwaro wa mikorobe zikikije igice cyo hasi cy’uruti, bityo bikagabanya ibyago byo kwangirika kw'amabara yera (demineralization ya enamel) no kwiyongera k'ubugimbi mu gihe cyo kuvurwa igihe kirekire.

Imipaka mu kugenzura no kurangiza ibikorwa byo kuzunguruka

Nubwo zikora neza mu kugabanya umuvuduko hakiri kare, SLB zidafite imbaraga zikunze kugorwa no kugenzura no gukoresha imbaraga mu gihe cyo kurangiza. Kubera ko urugi rukomeye rudakanda insinga y'umugozi mu gice cyo hasi cy'umugozi, hari "gukina" hagati y'insinga n'agakingirizo. Urugero, insinga y'urukiramende ya santimetero 0.019 × 0.025 mu mwanya wa santimetero 0.022 igaragaza imbaraga za dogere 10.5. Niba umuganga akeneye imbaraga nyinshi zo gukoresha imbaraga mu gukuraho insinga, iki gikorwa gisaba gukoresha amasoko y'insinga zifasha mu gukuraho insinga cyangwa gutera insinga zuzuye vuba, bishobora kugorana mu buvuzi.

SLB zikora zigabanya ubu busembwa bwa torque mu gihe cy'impeshyi, ariko zishyiramo imbogamizi zazo. Izi clip zikora zishobora kugerwaho n'umunaniro wa tekiniki; mu gihe cy'amezi 18 kugeza kuri 24 cyo kuvurwa, stress ihoraho ishobora kugabanya imbaraga zo kwicaraho ku kigero cya 15% kugeza kuri 20%, bikabangamira igenzura rya nyuma. Byongeye kandi, ubwiyongere bw'imirire cyangwa imyanda y'ibiribwa rimwe na rimwe ishobora kubangamira uburyo bugoye bwo kugenda bw'imitsi idafite imbaraga n'ikora, bigasaba ingamba zitwara igihe kinini kugira ngo zifungure clip cyangwa, mu bihe bikomeye, bigasaba gusimbuza bracket.

Uburyo bwo gusuzuma uduce twishyiramo ibintu mu guhitamo ingwate

Guhindura cyangwa guhitamo sisitemu nshya yo kwihuza bisaba isuzuma rikomeye. Ubuvuzi bw'amagufwa bugomba gusuzuma ibipimo bya biomechanical ugereranije n'ukuri kw'ibikoresho, kugira ngo ibikoresho byatoranijwe bihuze na filozofiya y'umuganga n'ibikorwa remezo by'ikigo.

Ibipimo by'ingenzi byo kugereranya sisitemu

Mu gusuzuma sisitemu za SLB, abaganga bagomba kureba kure y’ibisabwa mu kwamamaza no gusesengura ibipimo byihariye by’ubuhanga. Ubuso bw’ibanze n’uburyo bwo kubika ni ingenzi cyane; SLB yizewe igomba kugira ishingiro rya mesh ya gauge 80 cyangwa micro-retention ya laser kugira ngo imbaraga za shear bond zirenze 10 MPa, bityo bigabanye igipimo cyo gucika kw’ingufu. Ubunini bw’urukiramende (bupimwe muri milimetero kuva ku rundi ruhande rw’amenyo kugeza ku ruhande rw’inyuma rw’urukiramende) nabwo ni ingenzi cyane, kuko imiterere yo hasi (urugero, munsi ya mm 2.5) igabanya cyane ukwivanga kw’ingufu no kubabara kw’imitsi yoroshye y’umurwayi.

Uburyo bwo gufungura no gufunga ni ikintu cy'ingenzi cyane. Sisitemu zikenera ibikoresho byihariye kandi bigoye cyane zishobora kubangamira imikorere y'igikoresho iyo gishyizwe mu mwanya wacyo cyangwa gikozwe nabi. Sisitemu zemerera gufungura hakoreshejwe umuvuzi w'amenyo usanzwe cyangwa igikoresho cyoroshye cyo kuzunguruka zikunze kwinjizwa mu buryo bunoze mu mavuriro asanzwe.

Guhitamo, guhugura abakozi, no gushyira mu bikorwa

Gushyira mu bikorwa neza sisitemu ya SLB ntibigarukira ku muganga w’amenyo gusa ahubwo bijya ku baganga bose b’abaganga. Imyitozo y’abafasha b’amenyo bava ku mibanire ya elastomeric bakajya ku mibanire ya mechanical isanzwe imara amezi 1 kugeza kuri 2 mbere yuko imikorere y’ibanze igaruka. Abakozi bagomba guhugurwa ku mbaraga zihariye zisabwa kugira ngo bafungure imibanire ya amenyo badateye ikibazo cyo kuva ku ruhande cyangwa ngo umurwayi agire ububabare, ndetse n’amabwiriza yo kwemeza ko imibanire ya amenyo yicaye neza kandi ifunze mbere yuko umurwayi yirukanwa.

Gucunga ububiko bw'ibikoresho no kubiguraNanone bigira uruhare mu guhitamo. Abakora ubusanzwe bashyira mu bikorwa ibiciro biri hagati ya 10 na 20 by'ibikoresho by'abarwayi ku bicuruzwa bya mbere, hamwe n'ibiciro binini biboneka ku biciro binini. Imyitozo igomba gusuzuma uburyo uruganda rutanga ibicuruzwa rwizewe, rukareba ko uduce dusimbura, imiyoboro yihariye ya archwire ijyanye na sisitemu ya SLB, n'ibikoresho byihariye byo gufungura biboneka byoroshye nta gihe kinini cyo kubikoresha.

Uburyo bwo gufata ibyemezo byo guhitamo udukingirizo twishyira hamwe

Icyemezo cyo gushyira mu bikorwa uburyo bwo kuvura indwara mu buryo bworoshye gisaba urwego rw’ingamba ruhuza ibisubizo by’ubuvuzi, ibyo abarwayi bakeneye, n’ubushobozi bwabo mu by’imari. Nubwo ibyiza bya biomechanical mu ndwara zihariye zo kutagira ubuvuzi bw’ibanze byagaragajwe neza, ingaruka z’ubukungu ku buvuzi zigomba gupimwa neza kugira ngo hamenyekane impinduka.

Guhuza ibisubizo, ibyo umurwayi akeneye, n'ikiguzi

Ikiguzi ni cyo kibazo cyihuse cyane ku ikoreshwa rya SLB.

Ibintu by'ingenzi byakunzwe

• Imyanzuro y'ingenzi n'impamvu zo kwishyira hamwe kw'amakuru
• Ibisobanuro, kubahiriza amategeko, n'igenzura ry'ingaruka bikwiye kwemezwa mbere yo kwiyemeza
• Intambwe zikurikiraho zifatika n'ibyo abasomyi bashobora gushyira mu bikorwa ako kanya

Ibibazo Bikunze Kubazwa

Ni gute udupfunyika twishyiramo imigozi tugabanya igihe cyo kwicara?

Bakoresha agakoresho ko gupfunyika cyangwa urugi byubatswemo aho gukoresha imigozi ya elastomeric, bityo guhindura insinga bikaba byihuse. Mu by'ukuri, ibi bishobora kuzigama iminota mike kuri buri mfuruka no gushyigikira igihe kirekire hagati yo gusura aho gupfunyika hakiri kare.

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

Sisitemu zidakora zituma insinga nto zigenda buhoro buhoro, ibyo bikaba bifasha guhuza neza insinga hakiri kare. Sisitemu zikora zikoresha imbaraga nyinshi ku nsinga nini, zigatanga imbaraga nziza zo gucura no kugenzura uruziga mu gihe cyo kurangiza.

Ese udukingirizo twishyira hamwe buri gihe twihuta kurusha udukingirizo dusanzwe?

Si buri gihe. Akenshi binoza imikorere n'imikorere myiza mu gihe cy'intambwe ya mbere, ariko igihe cyose cyo kuvurwa giterwa n'uburemere bw'indwara, uburyo umurwayi akurikirana, ubufatanye n'abarwayi, ndetse n'uburyo bwo kuvura.

Ni ibihe bintu by'ingenzi mu guhitamo udukingirizo twigenga?

Shaka ingano nyayo y'aho ibintu biherereye, imikorere yizewe ya clip, imiterere idahindagurika cyane, n'ibikoresho biramba. Denrotary igaragaza ibyuma bitarangirika bya MIM 17-4 n'inganda zikora mu rwego rw'ubuvuzi hamwe n'amahame ya CE, FDA, na ISO13485.

Ese udupfunyika two kwibohora dushobora kunoza isuku ku barwayi?

Bashobora gufasha kuko nta migozi ya elastomeric ifata plaque cyangwa ibara ringana. Abarwayi baracyakeneye kozwa neza, gusukurwa hagati y'amenyo, no gusuzumwa buri gihe kugira ngo barebe isuku y'amenyo.