Evaluation of Canine Retraction Strategies

犬类回缩策略的评估

基本信息

批准号：
8220980
负责人：
JIE CHEN
金额：
$ 28.86万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-04-05 至 2014-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8220980
关键词：
Adverse effects Affect Alleles Bilateral Biological Biological Factors Bone Density Canis familiaris Clinical Cuspid Data Disadvantaged Edentulous Mouth Engineering Ensure Environment Evaluation Evidence based treatment Foundations Future Genetic Genotype Gingival Crevicular Fluid Goals Image Individual Inflammation Inflammatory Response Interleukin-12 Knowledge Location Measures Mechanics Methods Modality Modeling Monitor Morphology Office Visits One-Step dentin bonding system Orthodontic Orthodontic Appliances Orthodontic Space Closure Orthodontics Outcome Outcome Study Patients Pattern Plant Roots Play Procedures Process Resistance Role Root Resorption Safety Simulate Stress System Technology Testing Time Tooth Movement Tooth structure Translating Translational Research Translations Treatment outcome base bone bone quality design evidence base impression improved inflammatory marker innovation insight interest public health relevance research study response theories treatment strategy

项目摘要

DESCRIPTION (provided by applicant): The long-term goal of this interdisciplinary (numerical engineering modeling, bench-top and clinical experiments) project is to improve the predictability of orthodontic treatment. Predictability will produce reductions in iatrogenic side effects, needed corrections, office visits, and treatment time - all to benefit clinician and patient. The proposed study focuses on the two most used treatment strategies (translation vs. tipping with root correction) for canine retraction, a frequent clinical procedure. The three dimensional (3D) clinical orthodontic load systems will be controlled; the clinical outcomes based on tooth movement theory will be predicted; and the actual clinical outcomes in terms of treatment time, tooth movement, and root resorption will be quantified using newly developed technologies. Biological responses as reflected by local inflammation and bone quality will be monitored. Furthermore, the effect of genotype on clinical outcomes will also be evaluated. The main objectives are to (1) quantitatively evaluate two commonly used, but philosophically divergent, well-controlled orthodontic loading modalities by comparing treatment times and their attendant side effects, and (2) identify the roles of biological factors on the clinical outcomes. The hypotheses are: (H-1) the direct translation path (Strategy 1) needs less treatment time than the indirect pattern (Strategy 2); (H-2) Strategy 1 produces lower stress concentrations; (H-3) the strategy with the lower stress concentration will produce reduced stress-related side effects such as root resorption and inflammatory responses; and (H-4) IL- 12 Allele affects the treatment time of both strategies in a similar way, thus playing an insignificant role in comparison to the differences in the two treatment mechanics. The specific aims (SA) are: SA-1 Characterize and quantify the mechanics of the treatment strategies using our previously developed orthodontic force tester (OFT). SA-2 Quantify the clinical outcomes in terms of 3D tooth displacements assessed from casts of clinical impressions and Conebeam CT (CBCT) images. SA-3 Directly associate treatment strategy mechanics with the clinical outcome. SA-4 Develop a method to quantify orthodontics-associated root resorption and tooth morphology using CBCT data. SA-5 Calculate the mechanical environment in bone, PDL, and root and determine the location of the tooth's center of resistance. SA-6 Treat patients with calibrated orthodontic load systems and quantify the resulting tooth displacements and biological responses. The outcomes of this study will provide clear evidence as to which strategy is superior. They will also provide insight into ways of reducing iatrogenic side effects and into the necessary evidence-based trade-offs for optimized treatment. With the knowledge gained, future orthodontic appliances will be designed to reduce side effects and treatment time. Furthermore, these results will provide a foundation for innovative mechanics that optimize other orthodontic treatments. PUBLIC HEALTH RELEVANCE: The project will clinically evaluate two commonly used treatment strategies on the same patient. Both treatment time and side effects including root resorption will be quantified. The relevance of this project is that it will clinically identify the superior strategy and the directions for improvement.

描述（由申请人提供）：该跨学科的长期目标（数值工程建模，台面和临床实验）项目是提高正畸治疗的可预测性。可预测性将减少医源性副作用，所需的校正，办公室就诊和治疗时间 - 都使临床医生和患者受益。拟议的研究着重于犬缩回的两种最常用的治疗策略（翻译与倾斜的倾倒），这是一种频繁的临床程序。将控制三维（3D）临床正畸负载系统；将预测基于牙齿运动理论的临床结果；在治疗时间，牙齿运动和根部吸收方面，实际的临床结果将使用新开发的技术进行量化。将监测由局部炎症和骨骼质量反映的生物反应。此外，还将评估基因型对临床结果的影响。主要目标是（1）通过比较治疗时间及其随之而来的副作用来定量评估两种常用但哲学上不同，控制良好的正畸负载方式，以及（2）确定生物学因素在临床结果中的作用。假设是：（H-1）直接翻译路径（策略1）所需的治疗时间少于间接模式（策略2）；（H-2）策略1产生较低的应力浓度；（H-3）应力浓度较低的策略将产生与压力相关的副作用降低，例如根吸收和炎症反应；（H-4）IL-12等位基因以类似的方式影响两种策略的治疗时间，因此与两种治疗力学的差异相比，起着微不足道的作用。具体目的（SA）是：SA-1使用我们先前开发的正畸力测试仪（OFT）来表征和量化治疗策略的机制。 SA-2根据临床印象和锥形CT（CBCT）图像评估的3D牙齿位移来量化临床结果。 SA-3将治疗策略力学与临床结果联系起来。 SA-4开发了使用CBCT数据量化与正畸相关的根部吸收和牙齿形态的方法。 SA-5计算骨骼，PDL和根中的机械环境，并确定牙齿阻力中心的位置。 SA-6治疗校准正畸负载系统的患者，并量化所得的牙齿位移和生物反应。这项研究的结果将提供明确的证据，表明哪种策略是优越的。他们还将提供有关减少医源性副作用的方式以及以优化治疗的必要证据权衡的洞察力。随着知识的增加，未来的正畸电器将旨在减少副作用和治疗时间。此外，这些结果将为优化其他正畸治疗的创新力学提供基础。公共卫生相关性：该项目将在临床上评估同一患者的两种常用治疗策略。治疗时间和副作用都将被量化，包括根吸收。该项目的相关性是，它将在临床上确定卓越的策略和改进方向。