本論文研製牙科空間維持器的數位設計、分析與製作，由於乳牙生長期對於恆牙萌發十分關鍵，當乳牙提早脫落會造成牙齒移動與恆牙生長空間損失，在這種情況便會使用空間維持器預防牙弓長度喪失，台灣最常使用的空間維持器為舌側維持器。本研究使用牙醫提供的兒童舌側維持器與病患的牙齒石膏模進行掃描與編輯設計生成牙齒、牙周膜(PDL)及齒槽骨的3D建模，並使用3D設計軟體Blender For Dental與Meshmixer去依照病患石膏模繪製環形維持器與優化牙醫提供的舌側維持器，再將範本維持器與自行繪製之維持器使用有限元素分析軟體Ansys分析當下顎左側牙齒施加力時有或無缺牙及缺牙後配戴各樣式空間維持器等等不同狀態下的未成熟之第一恆牙的位移量。最後使用光聚合的增材製造 (AM)印製維持器模型配戴至石膏模上觀察配戴情況。藉由數位設計、分析與製作能比起牙醫提供的傳統式空間維持器更確保維持器的設計自由度、高解析度、尺寸精度、表面光潔度與正確配合以及能減少維持器製作後修改率及降低失敗率進而節省材料與時間。經由研究結果得知當配戴醫師提供之舌側維持器與缺牙且無配戴維持器之未成熟之第一恆牙的位移量相差無幾。而自行設計之維持器中環形維持器配戴效果最佳，其未成熟之第一恆牙的位移量能與無缺牙狀態位移量接近達成最理想配戴狀況。

This paper develops the digital design, analysis and production of dental space maintainers. Since the growth period of deciduous teeth is very critical for the eruption of permanent teeth, early loss of deciduous teeth will cause tooth movement and loss of space for the growth of permanent teeth. In this case, space maintenance will be used. The device prevents the loss of dental arch length. The most commonly used space maintainer in Taiwan is the lingual maintainer.This study uses the children's lingual retainer provided by the dentist and the patient's dental plaster cast to scan and edit the design to generate a 3D model of the teeth, periodontal ligament (PDL) and alveolar bone, and uses the 3D design software Blender For Dental and Meshmixer uses the patient's plaster cast to draw the ring retainer and optimize the lingual retainer provided by the dentist. Then, the template retainer and the self-drawn retainer are analyzed using the finite element analysis software Ansys to analyze whether there are any defects when the force is applied to the teeth on the left side of the mandible. The displacement and stress distribution of immature first permanent teeth in different states after wearing various types of space maintainers after missing teeth. Finally, the photopolymerized additive manufacturing (AM) printed maintainer model was used and put on the plaster mold to observe the wearing condition.Through digital design, analysis and production,it can ensure the design freedom, high resolution, dimensional accuracy, surface finish and correct fit of the maintainer compared to traditional space maintainers provided by dentists, and it can reduce the rate of post-production modifications of the maintainer which reduce the failure rate and save materials and time. According to the research results, it is known that the displacement amount of the lingual retainer provided by the doctor is almost the same as that of the immature first permanent tooth with missing teeth and no retainer. Among the self-designed retainers, the ring retainer has the best wearing effect. The amount of displacement of the immature first permanent tooth can be close to the displacement of the intact tooth, achieving the optimal wearing condition.

摘要...i
Abstract...ii
誌謝...iii
目錄...iv
表目錄...vii
圖目錄...viii
第一章 緒論...1
1.1 研究背景...1
1.2 研究目的與動機...1
1.3 文獻回顧...2
1.3.1 數位設計方法於牙科的應用...2
1.3.2 積層製造在牙科的發展...2
1.3.3 牙科空間維持器的功效...3
1.3.4 有限元素法於牙科的力學分析...4
1.4 研究方法...6
1.5 論文架構...7
第二章 基礎理論...8
2.1空間維持器的原理、特性與設計...8
2.2數位設計與積層製造...10
2.2.1 數位設計...10
2.2.2 積層製造...11
2.3 有限元素分析...14
第三章 牙齒解剖與空間維持器三維模型結構建立...16
3.1 使用設備與軟體...16
3.1.1 Medit T 710桌面掃描器...16
3.1.2 Phrozen Sonic Mighty 8K LCD光固化3D列印機...17
3.1.3 Medit Link...17
3.1.4 Meshmixer...18
3.1.5 Geomagic Studio...18
3.1.6 Blender for dental...18
3.2 牙齒、牙周膜、齒槽骨與空間維持器設計流程...19
3.3牙齒、牙周膜、齒槽骨製備...21
3.4空間維持器製備...25
3.5併入3D繪圖模型...30
第四章 空間維持器配戴於牙模之結構分析...31
4.1前言...31
4.2有限元素分析前處理...32
4.3材料性質...32
4.4網格收斂...34
4.5接觸設定...35
4.6邊界條件...37
第五章 結果與討論...38
5.1 數位設計及製造成果...38
5.2 位移量結果...41
5.3 舌側空間維持器與環形空間維持器的差異與討論...45
5.4 數位設計與傳統牙技工藝空間維持器的差異與討論...46
5.5 空間維持器的功效與臨床可用的平衡與討論...48
第六章 結論與未來展望...50
6.1 結論...50
6.2 未來展望...51
參考文獻...52
Extended Abstract...55

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