TTBA (Tandem Traction Bow Appliance) 장착 시 스트레인게이지를 이용한 악골의 변형률 변화
Difference of strain in craniofacial skeleton according to retraction force of TTBA (Tandem Traction Bow Appliance)
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본 연구는 Tandem Traction Bow Appliance(TTBA)가 비상악복합체, 하악골과 두개저에 교합력이 전달되는 양상에 어떠한 영향을 미치는지 알아보기 위하여 시행하였다. 성인 정상 교합자의 컴퓨터 단층촬영 데이터를 삼차원 영상으로 재건한 후 상,하악을 분리한 실험 모델을 만들었다. 여기에 인공치아를 식립한 상, 하악 치열의 인상을 채득하여 TTBA를 제작하였다. 실험 모델의 비상악복합체에 8개, 하악골에 4개, 두개저에 5개의 스트레인게이지를 각각 부착하였다. TTBA 장착 전(대조군), TTBA 장착 후 각각 300 g, 500 g의견인력을 가한 후(실험군), 100 N의 압축력을 부하하여 각각의 변형률을 측정하였다. 200 N, 300 N의 압축력 하에서도 동일하게 실험하였다. 스트레인게이지의 값을 측정 후 분석하였다. 두개저는 TTBA에 영향을받지 않았다. 치아와 가까이 위치해 있기 때문에 교합력에 의해 많은 영향을 받는 부위인 상악 제1대구치 치근단, 상악 제2대구치 치근단, 악설융기와 하악 제2대구치 치근단의 교차점은 TTBA의 견인력에 의한 하악골의 하후방 회전과 TTBA 스플린트의 교합력 재분배에 따라 수직 압력이 감소하여 변형률이 감소하였다. 그러나 하악 과두돌기 목 부분에서는 TTBA 장착 후 변형률이 증가하였으며, 이는 TTBA의 악정형 효과가크게 영향을 미쳤기 때문으로 생각된다
Abstract
The purpose of this study was to determine the effects of the Tandem Traction Bow Appliance (TTBA) on the transfer of occlusal force on the nasomaxillary complex, mandible, and cranial base. The experimental model, in which the maxilla and mandible were separate, was built on the basis of a 3-D reconstruction of a computed tomography image obtained from an adult male patient with normal occlusion. TTBA was built after implanting artificial teeth and taking an impression of the maxillary and mandibular tooth arrangement. Eight strain gauges were placed on the nasomaxillary complex; 4, on the mandible; and 5, on the cranial base. Before and after installation of TTBA with 300 g and 500 g of traction force, 100 N of compressive force was applied, and the strain values were measured. The same experiment was repeated under 200 N and 300 N of compressive force. The strain values were measured, and the data were stored and analyzed using dedicated software. TTBA was not affected to the transfer of occlusal force to the cranial base. The strain values decreased in the root apex of the maxillary first molar, root apex of the maxillary second molar, intersection of mylohoid ridge and lingual root apex of the mandibular second molar. These areas were close to the teeth that were strongly affected by the occlusal force, but because of the traction force of the TTBA that caused the mandible to rotate downward and backward and the redistribution of the occlusal force by the TTBA splint a decrease in perpendicular pressure was exhibited. The condylar neck showed an increase in strain after installation of TTBA because it was affected by the orthopedic force of the TTBA.
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