A PHOTOELASTIC STUDY ON THE INITIAL STRESS DISTRIBUTION OF THE MOLAR ANCHORING SPRING(MAS) DURING RETRACTION OF THE MAXILLARY CANINE

상악견치 후방견인시 저항원 조절을 위한 MAS(Molar Anchoring Spring)의 초기 응력분포에 관한 광탄성학적 연구

The efficiency of maxillary canine retraction by means of sliding mechanics along an 0.016 continuous labial arch and an 0.009 inch in diameter with a lumen of 0.030 inch NiTi closed coil spring was compared with that using the same NiTi closed coil spring and Molar Anchoring Spring(MAS) which was designed by author. MAS was made of .017" X .025" TMA wire and was given 60 degree tip-back bend on the wire close to the molar tube. This study was designed to investigate molar and canine root control during retraction into an extraction site with continuous arch wire system. Two techniques were tested with a continuous arch model embedded in a photoelastic resin. A photoelastic model was employed to visualize the effects of forces applied to canine and molar by two retraction mechanics. With the aid of polarized light, stresses were viewed as colored fringes. The photoelastic overview of the upper right quadrant showed that stress concentrations were observed in its photoelastic model. The obtained results were as follows. 1. Higher concentration of compression can be seen clearly at the distal curvature of the canine and mesial curvature of the molar and premolar when NiTi closed coil spring was applied only, which means severe anchorage loss of the molar and uncontrolled tipping of the canine. 2. The least level compression was presented at the mesial root area of the molar and premolar, and mesial root area of the canine when NiTi closed coil spring and MAS were used simultaneously. Especially mesial alveolar crest region of the canine was shown moderate level of compression that means MAS can be used as a appliance for anchorage control and prevention of canine extrusion and uncontrolled tipping during canine retraction.

저자는 마찰견인법으로 상악견치 후방견인시 저항원상실을 최소화하기 위해 근심 경사된 구치를 직립시키는 Molar Uprighting Spring의 작용기전을 응용하고 마찰견인법의 장점을 이용하여 임상적으로 사용이 용이하며 저항원상실이나 견치의 조절되지 못한 경사이동(uncontrolled tipping)등의 부작용을 최소화 할 수 있는 장치인 Molar Anchoring Spring(MAS)을 고안하였다. MAS를 임상에 적용한 결과 비교적 만족스러운 결과를 얻어 이에 장치를 소개하며 MAS의 저항원 조절능력과 견치의 이동양상을 평가하기 위하여 광탄성 모형을 제작한 후 주호선에 diameter 0.009" lumen size 0.030" NiTi closed coil spring만을 장착하여 250gm의 견인력이 발생하도록 한 경우와, 같은 NiTi closed coil spring으로 동일한 견인력 이 발생하도록 하고 .017" X .025" TMA wire로 $60^{\circ}$의 tip-back bend를 부여하여 수직교정력이 60-70gm이 되도록 제작한 MAS를 제1대구치 auxiliary tube에 삽입하고 견치 전방에 걸어준 경우를 비교실험 하여 견치견인시 초기응력분포를 관찰한 결과 다음과 같은 결과를 얻었다. 1. 주호선(main arch wire)에 저항원 조절을 위한 조치없이 견치에 수평견인력만을 가했을 때 구치부에 심한 저항원상실은 물론 견치의 원심이동양상도 조절되지 못한 경사이동(uncontrolled tipping)으로 나타났다. 2. 구치부의 저항원 조절을 위해 사용한 MAS는 견치의 원심이동 초기에 구치부 저항원 조절효과와 견치의 정출없는 조절된 경사이동(controlled tipping)을 유도할 수 있는 장치로 나타났다.