Biomechanik: Was hat sich geändert?

Zusammenfassung

Um die Effektivität kieferorthopädischer Behandlungen in Hinblick auf die Behandlungsdauer und die Ästhetik der verwendeten Apparaturen zu verbessern, sind unterschiedliche Geräte und Verfahren entwickelt worden.

Durch die Einführung der skelettalen Verankerung hat sich die biomechanische Effektivität deutlich verbessert. Bei Verfahren, welche die biologische Antwort des Patienten beeinflussen, scheint die Kortikotomie mit oder ohne Knochenaufbau und Weichgewebetransplantation eher in Bezug auf die Qualität, als auf die Geschwindigkeit von Zahnbewegungen am vielversprechendsten zu sein. Eine Finite Elemente-Studie konnte zeigen, dass sich eine Translationsbewegung nach der Veränderung der Knochendichte schneller und länger durchführen lässt. Im Zusammenhang mit unsichtbaren bzw. weniger sichtbaren Apparaturen ist die Biomechanik im Rahmen der Lingualtherapie bei der Kontrolle der Inklination der unteren Schneidezähne sowohl bei Jump Bite-Geräten und bei der Retraktion überlegen. Der Enthusiasmus, mit dem die Aligner-Therapie eingeführt worden ist, hat inzwischen nachgelassen. Es ist klar geworden, dass diese Art der Behandlung bei einigen Zahnbewegungen nicht die biomechanischen Vorteile bieten kann, die festsitzende Geräte auszeichnen. Für einfachere Zahnbewegungen sind sie jedoch geeignet und hier besonders bei der hybriden Behandlung, bei der die biomechanischen Vorteile festsitzender Geräte mit den ästhetischen Vorteilen der Aligner kombiniert werden.

Abstract

With the need to improve the efficiency of orthodontic treatment in terms of treatment speed and appliance aesthetics, various appliances and approaches are introduced into the orthodontic landscape.

Biomechanical efficiency was improved through the introduction of skeletal anchorage. Among the techniques that tend to modify the patient's biological response, corticotomy, combined or not with bone and or soft tissue grafting, seems to be the most promising in term of quality rather than for speed of movement. A finite element study showed that by modifying bone density the translation movement tends to be expressed sooner and longer. Regarding the invisible or less visible techniques, the biomechanics of the lingual technique is advantageous for controlling the inclination of the lower incisors, both in the use of bite jumper appliances and during retraction. The enthusiasm with which aligner therapy has invaded the orthodontic scene is at the moment downplayed, as it is evident that for some movements this type of therapy does not offer the biomechanical advantages of fixed therapy, whereas it is indicated for simpler movements, but especially in hybrid therapy, which combines the biomechanical advantages of fixed therapy with the aesthetic advantages of aligner therapy.

Schlüsselwörter

Biomechanik - Kieferorthopädie - Regionally Accelerated Phenomenon (RAP) - Zahnbewegung

Key words

biomechanics - orthodontics - Regionally Accelerated Phenomenon (RAP) - tooth movement

Publikationsverlauf

Artikel online veröffentlicht:
23. September 2022

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