咬合接触对颞下颌关节应力分布影响的三维有限元分析  

A three-dimensional finite element study on the temporomandibular joint based on individual occlusal contact

作　　者：周子凌 张渊[2] 石利强[3] 杨磊[1] 刘海波[1] 丁寅[1] 

机构地区：[1]第四军医大学口腔医学院正畸科军事口腔医学国家重点实验室,西安710032 [2]第四军医大学口腔医学院颞下颌关节病科,西安710032 [3]第四军医大学口腔医学院影像诊断科,西安710032

出　　处：《中华口腔医学杂志》2015年第5期302-306,共5页Chinese Journal of Stomatology

摘　　要：目的 建立反映个性化咬合接触的颞下颌关节三维有限元模型,分析咬合接触对颞下颌关节应力分布的影响.方法 选1名个别正常（牙合）志愿者,整合CT、锥形束CT、MRI和石膏模型表面扫描三维数据,建立可反映牙齿（牙合）面形态的颞下颌关节三维有限元模型.检测牙尖交错位最大紧咬时的咬合接触区域,将相应区域上表面固定约束,以模拟咬合接触状况;并构建正常（牙合）与单侧后牙反（牙合）两种咬合关系,对颞下颌关节内部应力进行对比分析.结果 正常（牙合）双侧颞下颌关节应力分布基本对称.单侧后牙反（牙合）与正常（牙合）颞下颌关节应力分布规律基本一致,但患侧应力明显增大;患侧髁突、关节盘、关节窝von Mises应力最大值分别为10.35、3.82、3.59 MPa;而正常（牙合）相应区域yon Mises应力最大值分别为7.32、3.18、2.84 MPa.结论 反映个性化咬合接触的颞下颌关节三维有限元模型的颞下颌关节应力分布对咬合接触改变高度敏感,单侧后牙反（牙合）造成的异常咬合接触可导致患侧明显的应力集中.Objective To develope a three-dimensional finite element model based on the individual occlusal contact data to analyze the influence of occlusal contact on the stress distribution in the temporomandibular joint（TMJ）.Methods CT,cone-beam CT（CBCT）,MRI and 3D scanner were used to create a three-dimensional finite element model of the stomatognathic system,which reflected the accurate morphological characteristics of the occlusal surface.The contact area was marked on the occlusal surface of the teeth based on the individual occlusal contact data obtained during the maximal volunteer clenching （MVC）.Two occlusal contact conditions including normal occlusion and unilateral posterior crossbite（UPC） were constructed.The models were fixed on the contact areas to simulate the MVC condition in order to analyze the stress distribution in the TMJ.Results The stress distribution of the TMJ was approximately symmetrical in normal occlusion,but the stress values were somewhat different.No significant difference was found in stress distribution between UPC and normal occlusion,but the values were significantly higher on the crossbite side.The maximum values of von Mises stress were 10.35,3.82,3.59 MPa,on condylar process,articular disk,articular fossa of the crossbite side,respectively while on the corresponding side of the normal occlusion maximum values were 7.32,3.18,2.84 MPa,respectively.Conclusions The stress distribution of the TMJ in three-dimensional finite element model which indicated the personal occlusal contact was highly sensitive to the change of the occlusal contact.The abnormal occlusal contact caused by the UPC could lead to the stress concentration of the TMJ on the crossbite side.

关 键 词：颞下颌关节 有限元分析 牙(牙合) 

分 类 号：R783.5[医药卫生—口腔医学]