牙槽突和硬腭全裂隙植骨修复对腭裂上颌骨模型的生物力学影响  

Mechanical Force Distribution on Cleft Maxillary Finite-element Models after Alveolar and Hard Palate Bone Graft

作　　者：文抑西[1] 石冰[1] 杨壮群[2] 

机构地区：[1]口腔生物医学工程教育部重点实验室,四川大学四川成都610041 [2]西安交通大学口腔医院颌面外科,陕西西安710004

出　　处：《华西口腔医学杂志》2006年第2期117-120,共4页West China Journal of Stomatology

基　　金：高等学校优秀青年教师教学和科研奖励基金资助项目(1999);陕西省科技攻关资助项目(2002K10-G8(7))

摘　　要：目的研究牙槽突及牙槽突加硬腭全裂隙植骨对腭裂上颌骨模型的生物力学影响。方法采用15岁男性患者头颅CT扫描DICOM数据建立3种单侧腭裂上颌骨三维有限元模型,通过叠加不同的植骨块形成牙槽突植骨修复及牙槽突加硬腭全裂隙植骨修复后的腭裂上颌骨模型。在上颌骨前牙区及两侧前磨牙区以正常上唇压力加载负荷,观察各种应力沿上颌骨分布的特点。结果未植骨模型,上颌骨段以变形和移位为主,各种应力集中于上颌骨前壁、牙槽突和腭板等处。植骨模型表现为应力分布均匀化。牙槽突植骨可以显著降低由于上颌骨变形而产生的剪应力和牙槽突的向内移位。牙槽突加硬腭全裂隙植骨可以使得应力分布更加均匀,但是与牙槽突植骨差异不大。结论唇裂修复手术后产生的压力是使未作植骨修复的牙槽突产生变形移位的主要原因。牙槽突植骨修复可以使腭裂上颌骨表面应力分布趋向均匀,生物力学意义重大。牙槽突加硬腭全裂隙植骨可以使得应力分布更加均匀,但与单纯牙槽突植骨效果相比,无显著性差异。Objective To investigate the biomeehanical force distribution of three different cleft maxillary finiteelement models pre- and post-bone graft with specified load to certain area of the models. Methods Developing a cleft palate bony model from a 15-year cleft palate male CT scan DICOM data and generating alveolar bone-grafted, alveolopalatal bone-grafted cleft maxillary finite-element model was set up through gluing the graft model. Also the pre-grafted model as compared, vector lip force on the anterior and anteriolateral face of the alveolar ridge was applied, and studied the press distribution properties and localized area. Results The press principal spread along the alveolar ridge and focused on anterior wall of maxillary prior to graft. But the press tended to be evenly distributed after bone grafted, whether alveolar or/and hard palate bone grafted. The grafted bone could resisted the medially deformation of alveolar crest and decreased the shear press to the nasal base bony structure. The map showed no significant differences along with alveolar or/and hard palate bone graft. Conclusion The postoperative lip pressure plays an important role for the deformation and deviation of alveolar ridge. Alveolar bone graft could even the distribution of the stresses and should be emphasized. But the grafted bony palatal appears superior to but no significant mapping and anti-deformation difference with alveolar bone graft.

关 键 词：腭裂 上颌骨有限元模型 牙槽突 硬腭 植骨 

分 类 号：R782[医药卫生—口腔医学]