5种不同张口位时下颌骨颏部受力瞬间对TMJ关节盘及髁突软骨影响的有限元分析  

Three-dimensional Finite Element Analysis of Articular Disk and Articular Cartilage of TMJ with Forces at Chin in 5 Different Mouth Openings.

作　　者：韶波[1] 胡开进[1] 孔亮[1] 宋俐[2] 杨水成[2] 魏锋涛[2] 杨劲[3] 

机构地区：[1]第四军医大学口腔医学院颌面外科,陕西西安710032 [2]西安理工大学机械与精密仪器工程学院 [3]西北工业大学力学与土木建筑学院

出　　处：《口腔医学研究》2006年第4期380-383,共4页Journal of Oral Science Research

基　　金：陕西省自然科学基金资助(编号:2004C2-65)

摘　　要：目的:利用三维有限元分析法,从生物力学角度探讨颏部受力瞬间关节盘及髁突软骨的应力变化。方法:建立5个不同张口度(闭口位、1 cm、2 cm、3 cm、4 cm张口位)包含下颌骨的颞下颌关节(TM J)三维有限元数字模型;于颏部正中矢状面内分别施以与眶耳平面(参考平面)垂直、呈60°夹角、平行3个不同方向的1 000 N压力。获取受力后TM J(左侧)的关节盘和髁突软骨产生的平均主应力的分布情况及其峰值大小。结果:1)在不同施力方向、不同张口位时,关节盘EQV应力峰值多位于后带,髁突软骨则多位于前斜面;2)不同施力方向对比,平行施力时关节盘和髁突软骨平均主应力峰值明显较大;3)闭口位时,3个方向的力在TM J上产生的平均主应力峰值都明显较小。结论:1)本组模型较精确的反映了实物,并且实验结果与临床实际相接近,成功地解决了以往实验中遇到的一些问题,为TM J的生物力学研究提供了新的途径。2)关节盘后带病变及髁突器质性病变可能由下颌骨创伤后造成的TM J间接性损伤引起;颏部受到平行于正中矢状面的外力时,由前方打击颏部较下方打击引起的TM J间接性损伤更严重。3)稳定的咬合关系可以明显减小TM J的间接性损伤。Objective： To study the stress variation in articular disk and articular cartilage of temporomandibular joint （TMJ） while forces were applied in chin by 3D finite element analysis. Methods： Reconstruct mandible and TMJ 3D finite element models for 5 mouth opening positions （closed, 1cm, 2cm, 3cm ,and 4cm mouth opening） ; 1000N forces with directions, which were 90°, 60°, and 0° angle to the frankfort plane, were applied in chin in the middle saggital plane. The Von Mises stress （equivalent stress, abbreviated EQV stress） distribution and maximum EQV stress were used to display the stress in articular disk and articular cartilage. Results： 1 ） Among all groups, most of the max EQV stresses in articular disk existed at the posterior band, and in the articular cartilage at the anterior oblique surface; 2） After comparing 3 directions, 0° led to the highest stress in articular disk and articular cartilage; 3 ） In closed mouth opening position, the max EQV stresses in articular disk and articular cartilage were obversely lower than in other mouth opening positions. Conclusion： 1 ） Our models precisely correspond with real TMJ and mandible, and the results of this study correspond with the clinical cases. Some problems in past experiments were solved with these models. This is a new method to study TMJ biomechanics. 2 ） Mandible trauma may be the reason that most articular disc diseases occured at the posterior band and most condylar process diseases occured at anterior oblique surface. The force from the front of chin hurted the TMJ most severely; 3） TMJ could be protected by stable occlusion position.

关 键 词：颞下颌关节 关节盘 髁突软骨 三维有限元分析 EQV应力 

分 类 号：R782.6[医药卫生—口腔医学]