颧种植体应用于双侧上颌骨缺损修复的生物力学分析  

Biomechanical evaluation of zygomatic implant in bilateral maxillary defect restoration

作　　者：吴轶群[1,2] 张志愿[3] 铁瑛[4] 张志勇[5] 王冬梅[4] 张陈平[3] 王成焘[4] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔颅颌面种植科,上海200011 [2]上海市口腔研究所 [3]上海交通大学医学院附属第九人民医院.口腔颌面外科,上海200011 [4]上海交通大学机械工程学院生命质量与机械工程研究所,上海200030 [5]上海交通大学医学院附属第九人民医院.口腔颅颌面种植科.上海市口腔研究所

出　　处：《中国口腔种植学杂志》2009年第2期125-126,共2页Chinese Journal of Oral Implantology

摘　　要：目的:评价颧种植体结合血管化腓骨修复双侧上颌骨缺损的生物力学分布情况。方法:基于CT扫描数据和图像及图形处理技术,模拟上颌骨双侧骨缺损状态,依照临床修复情况设计上颌骨双侧缺损的修复方法,利用三维有限元法评价该设计的生物力学情况。结果:颧种植体结合血管化腓骨修复双侧上颌缺损模型的应力分布中,应力最大值分别出现在颧种植体穿过腓骨和颧骨的部位。种植体结构中弯曲变化的位移不明显,并且种植体整体位移在颧骨附近逐渐减小为零。结论:实验表明合力引起的应力主要由颧骨和腓骨所承担,颧种植体结合血管化腓骨修复双侧上颌骨缺损能够合理分散并传导合力,其周围支持组织具有良好的应力分布。该方法恢复了颧突支柱的功能,是一种双侧上颌骨缺损功能性重建的有效临床方法。Purpose:The objective of this study was to analyse the stress distribution in craniofacial skeleton of bilateral maxillectomy reconstruction using the vascularized fibula graft and zygomatic implants.Methods:Based on the Digital Imaging and Communications in Medicine(DICOM)data and the image process technology,a modularized geometrical and finite element model of the human skull was built to simulate bilateral defective pattern of the maxillary.Biomechanical properties of the zygomatic implants and the connected implants were evaluated using finite element analysis(FEA)method.Results:The deformation tendency of the zygomatic implants is identical,the displacement of bending is not obviously observed.The displacement of the zygoma fixture near the zygoma is greatly decreased to zero.The highest stress peaks concentrate at the neck of the zygoma fixture on the fibula bone and on the zygoma,while the rest of the peri-implant bone appears to bear lower stress.Conclusions:Stress due to occlusal forces is mainly supported by the zygomatic bone and the fibula bone.The transmission of the occlusal force and stress distribution of the peri-implant bone of this reconstruction protocol is reliable.Reconstitutions of the buttresses system ensure a stable base for occlusion and stress,which is secure and feasible to optimal bilateral maxilla rehabilitation.

关 键 词：颧种植体 双侧上颌骨缺损 血管化腓骨 三维有限元 应力分析 

分 类 号：R782[医药卫生—口腔医学]