Evaluation of Canine Retraction Strategies

犬类回缩策略的评估

• 批准号: 7799134
• 负责人: JIE CHEN
• 金额: $ 29.24万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-05 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7799134
• 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; Gingiva; Goals; Image; Individual; Inflammation; Inflammatory Response; Knowledge; Liquid substance; 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 Resorption; 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

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）：这个跨学科（数值工程建模、台式和临床实验）项目的长期目标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、所需的纠正、就诊和治疗时间——所有这些都有利于临床医生和患者。拟议的研究重点关注两种最常用的犬牙回缩治疗策略（平移与牙根矫正倾斜），这是一种常见的临床手术。三维（3D）临床正畸负载系统将受到控制；将根据牙齿移动理论预测临床结果；治疗时间、牙齿移动和牙根吸收等实际临床结果将使用新开发的技术进行量化。将监测局部炎症和骨质量所反映的生物反应。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伴随的副作用，定量评估两种常用但在原理上不同、控制良好的正畸加载方式，以及（2）确定生物因素对临床结果的作用。假设是： (H-1) 直接翻译路径（策略 1）比间接模式（策略 2）需要更少的处理时间； (H-2)策略1产生较低的应力集中； (H-3)较低应力集中的策略将减少与应力相关的副作用，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，因此与两种治疗机制的差异相比，其作用不显着。具体目标 (SA) 是： SA-1 使用我们之前开发的正畸力测试仪 (OFT) 表征和量化治疗策略的机制。 SA-2 根据临床印模模型和 Conebeam CT (CBCT) 图像评估的 3D 牙齿位移来量化临床结果。 SA-3 将治疗策略机制与临床结果直接关联。 SA-4 开发一种使用 CBCT 数据量化正畸相关牙根吸收和牙齿形态的方法。 SA-5 计算骨骼、PDL 和牙根中的机械环境，并确定牙齿阻力中心的位置。 SA-6 使用校准的正畸负载系统治疗患者并量化由此产生的牙齿移位和生物反应。这项研究的结果将为哪种策略更优越提供明确的证据。他们还将深入了解减少医源性副作用的方法以及优化治疗所需的基于证据的权衡。凭借所获得的知识，未来的正畸矫治器将被设计为减少副作用和缩短治疗时间。此外，这些结果将为优化其他正畸治疗的创新机制奠定基础。 公共卫生相关性：该项目将对同一患者的两种常用治疗策略进行临床评估。治疗时间和副作用（包括牙根吸收）都将被量化。该项目的相关性在于它将在临床上确定优越的策略和改进的方向。