有限元分析3种单侧颞颌关节强直治疗手术模型双侧髁突表面应力分布的特点  

Distribution features of surface stress on the bilateral condyles of the unilateral mandible model for 3 kinds of surgeries of temporomandibular joint ankylosis

作　　者：游弋[1] 吴汉江[1] 

机构地区：[1]中南大学湘雅二医院口腔医疗中心,长沙410011

出　　处：《中南大学学报（医学版）》2011年第3期258-264,共7页Journal of Central South University ：Medical Science

摘　　要：目的:采用三维有限元法探讨正常咬合时正常下颌骨及3种单侧颞颌关节强直治疗手术模型双侧髁突表面应力分布的特点,为临床颞颌关节强直术式选择提供参考。方法:建立正常下颌骨三维有限元模型及3种单侧颞颌关节强直治疗手术模型,对各模型下颌角区及髁突横嵴中点进行固定约束,以各个模型下颌第一磨牙咬合面为承载面,分别向各模型双侧下颌第一磨牙施加垂直于咬合面100 N的载荷,获得髁突表面等效应力图及髁突表面各单元的等效应力,并进行统计分析。结果:裂隙关节成形术手术侧髁突等效应力传递中断;点面接触关节重建术组手术侧髁突等效应力大于正常组(P<0.05);面面接触组手术侧髁突等效应力与正常组差异无统计学意义(P>0.05)。裂隙关节成形术组非手术侧髁突等效应力大于正常组(P<0.05);而点面接触、面面接触组非手术侧髁突等效应力与正常组均差异无统计学意义(P>0.05)。结论:面面接触关节重建术不仅有利于咀嚼功能的恢复,而且不增加健侧颞颌关节负担,有利于关节的健康,是值得推荐的手术方法。Objective To determine the distribution features of surface stress on the bilateral condyles of the normal mandible and the unilateral mandible model for 3 kinds of surgeries of temporomandibular joint ankylosis under normal occlusal strength.Methods The normal mandible 3-dimensional finite element model and the 3-dimensional finite element mandible model for 3 kinds of surgeries of unilateral temporomandibular joint ankylosis were built.The jaw triangle area and the condyle transverse ridge was fixed and bound at mid-point.And 100 N of load was applied to the first molars of the bilateral mandible to obtain a von Mises stress diagram of the condylar surface and the unit von Mises stress of the condylar surface.Statistical analysis was carried out.Results The transmission of von Mises stress at the operated side of fractured articular arthroplasty of the condylar was interrupted.The von Mises stress at the operated side of the condylar in the group of point-surface contact joint reconstruction was bigger than that of the normal group（P0.05） whereas there was no significant difference between the group of surface-surface contact joint reconstruction group and the normal group（P0.05）.The von Mises stress of the condylar at the non-operated side in the group of fractured articular arthroplasty was bigger than that of the normal group（P0.05）,whereas there was no significant difference between the group of point-surface contact or surface-susface contact group and the normal group（P0.05）.Conclusion The surface-surface articular reconstruction is beneficial to the recovery of the masticatory function without increasing the burden for contralateral temporomandibular joint and is helpful to the joint.Thus this surgical method is recommended.

关 键 词：颞下颌关节 关节强直 下颌骨 有限元 

分 类 号：R782.2[医药卫生—口腔医学]