颌间牵引对颞下颌关节区应力分布及位移影响的有限元研究  

Finite element analysis of the effect of intermaxillary traction on stress distribution and displacement in temporomandibular joint

作　　者：付欣[1] 房玉镇 叶之慧[1] 

机构地区：[1]佳木斯大学口腔医学院,黑龙江佳木斯154000 [2]济南市第三人民医院口腔科,山东济南250132

出　　处：《中国体视学与图像分析》2017年第4期477-484,共8页Chinese Journal of Stereology and Image Analysis

基　　金：黑龙江省教育厅项目(No.2016-KYYWF-0611)

摘　　要：目的通过建立包含颞下颌关节、上下颌骨、上下牙列的三维有限元模型,模拟使用临床颌间II类、III类牵引,加载不同力值,分析各工况下颞下颌关节区的应力分布和位移变化,为临床选择合适的颌间牵引力值提供参考。方法选取临床样本一例,对其进行螺旋CT扫描,获得原始的建模数据,运用三维重建软件,建立结构完整,具有较好几何相似性的三维有限元模型,运用有限元分析软件分析当加载100 g、200 g、300 g力值时髁突各部分的受力和位移情况。结果颌间II类牵引时,髁突前面受压应力,后面受拉应力,髁突顶部的范·米塞斯(Von-Mises)应力最大,前面略高于后面,外侧面高于内侧面,随着载荷力增大,髁突周围的Von-Mises应力呈线性增大。位移方面,髁突的位移趋势为向前向下移动,随着载荷力增大,髁突的位移也逐渐增加。颌间III类牵引时,压应力集中在髁突后面;前面为拉应力。髁突顶部的Von-Mises应力最大,其次为前面和后面,外侧面高于内侧面。随着载荷力增大,髁突周围的Von-Mises应力呈线性增大。髁突呈现向后向上的位移,随着载荷力增加,位移逐渐增大。结论随着载荷的增大,髁突的应力和位移都会增大,提示对于临床成人患者或适应能力较差的患者一定要使用柔和力,避免出现医源性损害。Objective Through establishment of a three-dimensional finite element model includingtemporomandibular joint（ TMJ）,maxilla and mandible,upper and lower dentition,we simulate different working conditions by using clinical class Ⅱ and class Ⅲ intermaxillary tractions and loading different force values for the analysis of stress distribution and displacement changes at the TMJ area. This is aimed to provide a reference for clinical choices of appropriate intermaxillary traction values. Methods A clinical sample was selected and spiral CT scanning was performed on the sample to obtain original data. A complete structure is established by 3D reconstruction. Force and displacement conditions at each part of the condyle were analyzed by finite element analysis software when forces of 100 g,200 g and 300 g were loaded respectively. Results During the class Ⅱ intermaxillary traction,the front of the condylar was under compressive stress,and the back of the condylar was subjected to tensile stress. Von-Mises stress was highest at the top of the condyle,and the stress in the front is slightly higher than in the back,the lateral side higher than the medial side. With the increase of load,the Von-Mises around the condyle increased linearly. With respect to displacement,the condylar tended to move forward and downward.The displacement of the condylar also gradually increased with the increase of load. During the intermaxillary class Ⅲ traction,the compressive stress was concentrated at the back of the condylar,and the front of the condylar was under tensile stress. The Von-Mises stress at the top of the condyle was the largest,followed by that at the front and back. The Von-Mises stress on the lateral side was higher than that on the medial side. The Von-Mises stress around the condyle increased linearly with the increase of load. The condyle showed a backward-upward displacement,and the displacement increased gradually with the increase of load. Conclusions As the load increases,the stress and the displacement of

关 键 词：颌间牵引 颞下颌关节 应力 位移 三维有限元分析 

分 类 号：R783.5[医药卫生—口腔医学]