下颌骨颏部骨折联合双侧髁突囊内骨折致伤机制的三维有限元分析  

Three-dimensional finite element analysis of traumatic mechanism of mandibular symphyseal fracture combined with bilateral intracapsular condylar fractures

作　　者：周伟 安金刚[1] 荣起国[2] 张益[1] ZHOU Wei;AN Jin-gang;RONG Qi-guo;ZHANG Yi(Department of Oral and Maxillofacial Surgery,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Laboratory for Digital and Material Technology of Stomatology,Beijing 100081,China;Department of Mechanics and Engineering Science,College of Engineering,Peking University,Beijing 100871,China)

机构地区：[1]北京大学口腔医学院·口腔医院,口腔颌面外科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔数字化医疗技术和材料国家工程实验室,北京100081 [2]北京大学工学院力学与工程科学系,北京100871

出　　处：《北京大学学报（医学版）》2021年第5期983-989,共7页Journal of Peking University:Health Sciences

摘　　要：目的:通过三维有限元方法模拟和分析下颌骨颏部骨折联合双侧髁突囊内骨折的致伤机制,提高此类骨折的预防和诊断水平。方法:获取1名下颌骨发育正常、无第三磨牙、无颞下颌关节病史的青年男性的颌面部CT和颞下颌关节MRI数据,通过Mimics和ANSYS软件建立三维有限元模型。采取不同角度的外力作用于下颌骨颏部,分析下颌骨及髁突关节面的应力分布。同时,比较有无关节盘、咬合与非咬合状态下下颌骨的应力分布差异。结果:准确建立了包含颞下颌关节结构的三维有限元模型。当外力作用于下颌骨颏部时,髁突、升支前缘及颏部受力区是主要的应力集中区,其中应力最大值位于髁突顶部。随着外力方向与水平面夹角由0°逐渐增大直至60°,下颌骨上的应力由分散逐渐集中至颏部与双侧髁突三个部位;超过60°时,应力又出现分散的趋势。当对关节盘进行模拟后,髁突关节面及髁颈部的应力分布明显减小。与非咬合状态相比,咬合状态下下颌骨上的应力集中于咬合面,而其他部位无明显的应力分布。结论:外力方向与水平面呈60°时,应力分布主要集中于颏部及双侧髁突顶部,即三点骨折发生的部位;在下颌骨颏部受力过程中,关节盘的存在以及稳定的咬合状态下,髁突部位(包括颈部和关节面)的应力分布明显减小。Objective:To analyze the biomechanical mechanism of mandibular symphyseal fracture combined with bilateral intracapsular condylar fractures using finite element analysis(FEA).Methods:Maxillofacial CT scans and temporomandibular joint(TMJ)MRI were performed on a young male with normal mandible,no wisdom teeth and no history of TMJ diseases.The three-dimensional finite element model of mandible was established by Mimics and ANSYS based on the CT and MRI data.The stress distributions of mandible with different angles of traumatic loads applied on the symphyseal region were analyzed.Besides,two models with or without disc,two working conditions in occlusal or non-occlusal status were established,respectively,and the differences of stress distribution between them were compared.Results:A three-dimensional finite element model of mandible including TMJ was established successfully with the geometry and mechanical properties to reproduce a normal mandibular structure.Following a blow to the mandibular symphysis with different angles,stress concentration areas were mainly located at condyle,anterior border of ramus and symphyseal region under all conditions.The maximum equivalent stress always appeared on condylar articular surface.As the angle between the external force and the horizontal plane gradually increased from 0°to 60°,the stress on the mandible gradually concentrated to symphysis and bilateral condyle.However,when the angle between the external force and the horizontal plane exceeded 60°,the stress tended to disperse to other parts of the mandible.Compared with the condition without simulating the disc,the stress distribution of articular surface and condylar neck decreased significantly when the disc was present.Compared with non-occlusal status,the stress on the mandible in occlusal status mainly distributed on the occlusal surface,and no stress concentration was found in other parts of the mandible.Conclusion:When the direction of external force is 60°from the horizontal plane,the stress distribution ma

关 键 词：颏部骨折 髁突囊内骨折 下颌骨 有限元分析 

分 类 号：R782.6[医药卫生—口腔医学]