牙槽突裂植骨前后上颌扩弓对上颌牙槽骨位移影响的三维有限元分析  

Comparative study on the effect of maxillary expansion on the displacement of maxillary alveolar bone before and after alveolar bone graft:a three-dimensional finite element analysis

作　　者：袁玮 侯彦[2] 宋鹏[2] 张晓焕 黄威 Yuan Wei;Hou Yan;Song Peng;Zhang Xiaohuan;Huang Wei(Handan Stomatological Hospital,Handan 056000,China;School and Hospital of Stomatology,Hebei Medical University,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Disease,Shijiazhuang 050017,China;Dept.of Stomatology,Luannan County Hospital in Tangshan,Tangshan 063500,China)

机构地区：[1]邯郸市口腔医院,邯郸056000 [2]河北医科大学口腔医学院•口腔医院,河北省口腔医学重点实验室,河北省口腔疾病临床医学研究中心,石家庄050017 [3]唐山市滦南县医院口腔科,唐山063500

出　　处：《华西口腔医学杂志》2022年第4期451-456,共6页West China Journal of Stomatology

基　　金：河北省医学科学研究课题计划(20211075)。

摘　　要：目的模拟比较牙槽突裂植骨前后上颌扩弓对上颌牙槽骨位移影响。方法在已建立的植骨前上颌骨有限元模型上,采用ANSYS软件模拟牙槽突裂植骨,形成植骨后上颌骨模型。在2组模型上分别施加相同上颌扩弓力,观察比较牙槽骨区域三维方向位移形变情况。结果三维方向位移量比较,植骨前扩弓组均显著大于植骨后扩弓组(P<0.05)。水平向位移:植骨前扩弓,由前向后牙槽骨区域位移量逐渐降低;植骨后扩弓,由前向后牙槽骨区域位移量逐渐升高;植骨前后扩弓健侧牙槽骨位移量均显著大于患侧(P<0.05)。垂直向位移:植骨前后扩弓,牙槽骨前内侧均向下移动,牙槽骨后外侧均向上移动。矢状向位移:植骨前扩弓,牙槽骨前内侧向前移动,后外侧向后移动,植骨后扩弓移动趋势相反。结论单侧完全性唇腭裂患者植骨前扩弓三维方向移动均较植骨后明显,植骨前扩弓建议扩弓器适当向后移动,植骨后扩弓建议扩弓器适当向前移动并配合前牵引治疗,同时治疗中需警惕不对称扩弓及前牙开的发生。Objective This paper aimed to simulate and compare the effect of maxillary expansion on the displacement of maxillary alveolar bone before and after alveolar bone graft.Methods On the established finite element model of the maxilla before bone grafting,ANSYS was used to simulate alveolar bone graft to form the model of maxilla after bone grafting.The same expansion force was applied to the two models,and the three-dimensional displacement of alveolar bone was observed and compared between them.Results Comparison of the three-dimensional displacement showed that expansion before bone grafting was significantly larger than that after bone grafting(P<0.05).For horizontal displacement,in the expansion group before bone grafting,the displacement was gradually decreased from anterior to posterior alveolar bone.In the expansion group after bone grafting,the displacement was gradually increased from anterior to posterior alveolar bone.Displacement of noncleft side alveolar bone was significantly larger than that of cleft side alveolar bone with maxillary expansion before and after alveolar bone graft(P<0.05).In terms of vertical displacement,the anteromedial alveolar bone moved downward and the posterolateral alveolar bone moved upward with maxillary expansion before and after alveolar bone graft.For sagittal displacement,the anteromedial alveolar bone moved forward and the posterolateral alveolar bone moved backward with maxillary expansion before alveolar bone graft.However,the movement trend was opposite with maxillary expansion after alveolar bone graft.Conclusion The three-dimensional movement with maxillary expansion before alveolar bone graft is more obvious than that after bone grafting for patients with unilateral complete cleft lip and palate.Expander should be moved backward properly with maxillary expansion before alveolar bone graft and moved forward properly and cooperated with maxillary protraction with maxillary expansion after alveolar bone graft.Meanwhile,precaution must be taken in terms of asymmetric

关 键 词：牙槽突裂植骨 上颌扩弓 牙槽骨三维方向位移 有限元分析 

分 类 号：R782.2[医药卫生—口腔医学]