横腭杆在正畸临床中的应用及其力学机制的研究进展

Research progress on the application of the transpalatal arch in orthodontic clinics and its mechanical mecha⁃nism

横腭杆是一种在正畸临床中应用广泛的固定矫治器的辅助装置。本文就横腭杆在正畸临床中的应用及其力学机制进行综述,为临床医师提供参考。与传统观念不同,单独使用横腭杆并不能有效加强支抗,将其与其他传统支抗加强装置联合使用可以在某些情况下提供充足的支抗。同时,横腭杆可以辅助唇侧固定矫治维持牙弓宽度,辅助排齐牙列,纠正不良习惯,使矫治效率得以提高,副作用减少。用作主动矫治装置时,横腭杆可以使单侧或双侧磨牙在三维方向进行移动,尤其适用于改正磨牙旋转和宽度不调。应用力学原理对横腭杆与双侧磨牙连接构成的双力偶系统进行分析,可以增进对于矫治机制的理解,提高矫治结果的确定性。近年来,横腭杆常常与种植体支抗联合使用以压低磨牙或整体近移或远移上牙列。未来研究者可探讨更多横腭杆与种植体支抗、上颌骨性扩弓装置等结合方案以进行正畸治疗。

The transpalatal arch(TPA)is widely used in clinical orthodontics for various purposes.This article reviews the versatile clinical uses and mechanics of TPAs for clinical reference.Traditionally,TPA is conceived as an anchorage reinforcement device.However,the literature does not support the sole use of TPA for anchorage control.TPA,combined with other conventional anchorage means,can only provide sufficient anchorage in certain cases.As an adjunct to fixed appliance treatment,TPA can be applied for arch width maintenance,tooth alignment and habit braking to improve treatment efficiency and reduce side effects.Meanwhile,TPA can be used to provide active orthodontic forces for maxillary molars to move or rotate bilaterally and unilaterally in all three planes of space,especially on occasions where molar rotation and transverse discrepancy exist.A twocouple system is formed with a TPA connecting bilateral maxillary first molars,the mechanical analysis of which can improve the understanding of treatment mechanics and make tooth movement more predictable.In recent years,TPA has also been used in combination with temporary anchorage devices for maxillary molar intrusion and full arch mesialization or distalization.The combined use of TPA with TADs and maxillary skeletal expanders could be further investigated in the future.