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研究生：	陳穎慧 Chen, Ying-Hui
論文名稱：	評估矯正牽引的埋伏齒-追蹤與模擬 Evaluation of Orthodontic Traction on Impacted Tooth - Tracking and Simulation
指導教授：	劉佳觀 Liu, Jia-Kuang 張志涵 Chang, Chih-Han
學位類別：	碩士 Master
系所名稱：	醫學院 - 口腔醫學研究所 Institute of Oral Medicine
論文出版年：	2013
畢業學年度：	101
語文別：	英文
論文頁數：	96
中文關鍵詞：	有限元素分析、立體影像、埋伏齒
外文關鍵詞：	finite element, stereovision, impaction
相關次數：	點閱：90 下載：1
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雖然臨床上矯正治療有很高的成功率，但是對於矯正造成牙齒移動的機制仍然不完全清楚，牙齒的移動主要是由於矯正力傳到牙周韌帶與齒槽骨上造成齒槽骨的骨頭重塑作用，近年來文獻對傳統的壓力/張力成造骨頭重塑的理論提出質疑，而準確地觀察牙齒移動的資料對於研究矯正牙齒移動的機制是基本且重要的。因此本實驗目的是發展與驗證一個觀測矯正牙齒移動的系統，並且整合有限元素分析模擬矯正病人的施力初期牙齒移動以確認在模擬時重要的力學因子。本實驗架設兩台相機組成立體影像系統，在校正與驗證準確度之後，先用來測量一位病人口內矯正器的移動以進行系統操作評估；之後，再用來測量矯正埋伏齒的移動作為模擬時比對基礎。另外臨床上同時紀錄矯正埋伏齒施力方向與大小，進而比對利用有限元素方法模擬牙齒矯正時牙齒的移動。實驗結果顯示立體影像系統的準確度最大誤差小於2%。測量矯正牙齒的試驗研究中，測量矯正器之間距離呈現合理的變化；側門牙施力後18天移動大約0.5 mm，其中大約一半的移動出現在第一天，而矯正力移除後96小時，側門牙與正中門牙之間距離減少0.15 mm。臨床上共追蹤五位有埋伏齒的病人；在臨床觀測上，埋伏齒一個月移動距離為0.2 mm到3.96 mm之間，而有限元素方法能有效地模擬出各個病人施力初期矯正牙齒的移動。然而，矯正初期因為牙周膜韌帶變形造成牙齒移動，與長期的移動不完全一致。

With the high success rate in orthodontic treatments, the mechanism of tooth movement induced by orthodontic force is still unclear. It is generally agreed that this tooth movement is due from the alveolar bone remodeling, which is triggered by the orthodontic forces working on the periodontal ligaments. Recent studies question the simple principle of compression-tension remodeling concept. Accurately quantitative tracking information about the tooth movement during treatment is essential for this mechanism investigation. The aims of this study were to develop and validate a tracking system to monitor the tooth movement and integrated with a finite element simulation to simulate the initial orthodontic tooth movement for specific patients to identify important mechanical factors during simulation. A stereovision system, two cameras with their relative position calibrated, was developed and validated for the measurement of the brackets’ position within mouth. This system was then applied to track the tooth movement of patients with impacted tooth as a foundation to compare with the results of simulation. The direction and magnitude of the orthodontic force during treatments for each patient were also recorded. These mechanical as well as the tooth movement data would be employed on finite element model of individual patient to simulate orthodontic tooth movement. The accuracy validation result revealed that the stereovision measurement system presents a maximum error less than 2%. For the pilot study on patient tracking, the distance changes between each pair of bracket presented a reasonable monotone increasing or decreasing trends during treatment follow up. The lateral incisor moved about 0.5 mm during the 18 days’ tracking while approximately half of the movement occurred during the first day. At 96 hours after the elastic removed, the distance between central incisor and lateral incisor decreased by 0.15 mm consisted with the relapse phenomenon. Five patients with impacted tooth ware followed for their treatment outcomes. The impacted teeth moved ranged from 0.2 to 3.96 mm. Finite element results of the initial orthodontic tooth movement can be simulated, semi-quantitatively, on individual patient condition. However, initial orthodontic tooth movement, due to PDL deformation, did not fully consistent to long-term tooth movement.

中文摘要	1
Abstract	2
誌謝	4
List of Tables	8
List of Figures	9
Chapter 1 Introduction	13
1-1Background	13
1-2 Literature review	15
1-3 Motivation	18
1-4 Objective	…18
Chapter 2 Clinical Pilot study	20
2-1 Objective	20
2-2 Material and methods	20
2-2-1 Flow chart	20
2-2-2 Patient selection	21
2-2-3 Measurements	21
2-3 Results	25
2-3-1 Patients included in these study	25
2-3-2 Factors of impacted incisors	25
2-4 Discussion and Conclusion	29
Chapter 3 Material and methods	30
3-1 Experimental flow chart	30
3-2 Stereovision system	31
3-2-1 Setup	31
3-2-2 Camera calibration	33
3-3 Accuracy validation of the stereovision system	34
3-4 Clinical observation	35
3-4-1 Clinical observation of pilot study	35
3-4-2 Clinical observation of impacted incisors	37
3-5 Finite element analysis	38
3-5-1 Material properties	38
3-5-2 3D model construction in pilot study	39
3-5-3 3-D finite element Model	41
3-5-4 Boundary and loading conditions	43
Chapter 4 Results	45
4-1 Accuracy of stereovision system	45
4-2 Results of pilot study in single patient	46
4-3 Clinical observation of follow up	47
4-3-1 patient included in the study	47
4-3-2 Clinical tracking	48
4-3-3 Force and displacement	60
4-3-4 Actual movement of bracket	63
4-3-5 Clinical tracking before and after force application	67
4-4 Finite element analysis	68
4-4-1 Patient 2	68
4-4-2 Patient 4	69
4-4-3 Analysis model of tooth 13 with bone block	73
Chapter 5 Discussion	78
5-1 Stereovision system	78
5-1-1 Accuracy	78
5-1-2 Limitation of the stereovision system	79
5-2 Clinical observation	80
5-3 3D superimposition	81
5-4 Finite element model	83
5-4-1Single patient pilot study	83
5-4-2 Results of finite element analysis	83
5-4-3 Simplified bone block model	84
5-4-4 Material properties	85
5-5 Limitations	87
5-6 Future works	88


Chapter 6 Conclusion	89
References	90
Appendix 94
                                    

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校內：2016-08-29公開
校外：2016-08-29公開

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