6种咬合负载情况下下颌体骨折坚强内固定的三维有限元分析  

Three-dimensional finite element analysis of rigid internal fixation of mandibular body fracture under six kinds of different occlusal conditions

作　　者：孙庚林[1] 周健[1] 李滨飞[1] 郑孝慈[2] 吴炜[1] 

机构地区：[1]天津医科大学总医院口腔科,天津300052 [2]天津理工学院CAE中心,天津300000

出　　处：《中国口腔颌面外科杂志》2004年第4期282-285,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:运用三维有限元法分析下颌骨体部骨折坚强内固定在6种咬合负载情况下的应力分布和骨折段位移,为下颌骨骨折的坚强内固定治疗提供参考。方法:利用ANSYS软件建立下颌骨体部骨折及坚强内固定的三维有限元模型,在模型上对下颌骨体部骨折在6种咬合负载情况下对上、下缘单板及双板固定3种方法的工况进行有限元分析,并以无板固定为对照,比较各种工况下骨折断层的应力、骨折段位移,评价不同内固定方法固定的效果。结果:前牙咬合、正中咬合、患侧及健侧磨牙咬合、患侧及健侧前磨牙咬合负载下,上缘单板固定时骨折段位移分别为0.03887mm、0.04195mm、0.11043mm、0.006955mm、0.175625mm和0.00696mm;下缘单板固定时骨折段位移分别为0.046215mm、0.1962278mm、0.09593mm、0.009414mm、0.158956mm和0.010594mm;双板固定时骨折段位移分别为:0.006245mm、0.020233mm、0.022952mm、0.003876mm、0.021451mm和0.005344mm;患侧磨牙、前磨牙咬合骨断层应力分布下部为张力带、上部为压力带。结论:体部骨折用单板固定存在着隐患,对下颌体部骨折应尽量采用双板或下缘单板结合单颌固定,以增加骨断端的稳定性。PURPOSE: Finite element method was used to analyze the stress distribution and the mobility of fracture segment under six kinds of different occlusal conditions and different fixation methods, so as to provide reference optimizing rigid internal fixation design. METHODS: Through the models of mandibular body fracture and the fracture with rigid internal fixation (RIF), the regularity of stress distribution of mandibular body fracture and the mobility of fracture segment under different conditions(six kinds of occlusal conditions and single upper plate,single lower plate and double plates fixation methods) were analyzed by ANSYS software, with investigation of the effect of the different fixation methods. RESULTS: Under the six kinds of occlusal conditions (the incisor occlusion,the central occlusion, molar occlusion in the fractured and healthy side?premolar occlusion in the fractured and healthy side),when fixed with single upper plate, the mobility of fracture segment accordingly was 0.03887mm, 0.04195mm, 0.11043mm, 0.006955mm, 0.175625mm and 0.00696mm;When fixed with single lower plate, the mobility of fracture segment accordingly was 0.046215mm, 0.1962278mm, 0.09593mm, 0.009414mm, 0.158956mm and 0.010594mm;When fixed with double plates, the mobility of fracture segment accordingly was 0.006245mm, 0.020233mm, 0.022952mm, 0.003876mm, 0.021451mm and 0.005344mm;When occlusion by molar and premolar of fracture part, the stress of upper fracture part was bending force and the lower was compressing force. CONCLUSION: There is shortcoming in the method of using single plate to fix the mandibular body fracture. Two plates should be used in order to provide more stability for the facture segment.

关 键 词：下颌骨骨折 坚强内固定 有限元 

分 类 号：R782.4[医药卫生—口腔医学]