上唇压力对单侧牙槽嵴裂上颌骨形态结构影响的三维有限元分析  

3D finite element analysis of the influence of upper lip pressure on the maxilla for patients with unilateral alveolar cleft

作　　者：王晓宇 王昊[1] 厉松[2] WANG Xiaoyu;WANG Hao;LI Song(Department of Stomatology,Beijing Tian Tan Hospital,Capi-tal Medical University,Beijing 100070,China;Department of Orthodontics,Beijing Stomatological Hospital,Capi-tal Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京天坛医院口腔科,北京100070 [2]首都医科大学附属北京口腔医院正畸科,北京100050

出　　处：《口腔疾病防治》2023年第5期352-358,共7页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：首都卫生发展科研专项(首发2022-2-2142)。

摘　　要：目的 探讨不同上唇压力对单侧牙槽嵴裂上颌骨形态结构的生物力学作用,为临床诊疗提供依据。方法 选取1名11岁女性左侧完全性牙槽嵴裂患者的锥形束CT(cone beam CT,CBCT)数据,利用Ansys软件建立独立的上颌骨三维有限元模型,并分别对其施加唇裂术后(唇裂术后组)和正常对照(正常对照组)两种上唇压力,对比分析各观察节点在三维方向上的位移及应力分布特征。结果 双侧牙槽嵴均向缺损区域旋转、向后、向下位移,位移值健侧大于患侧,且由前向后逐渐减小;双侧牙槽嵴前段出现应力集中区,应力值健侧大于患侧,且由前向后逐渐减小,最大应力集中区位于缺损后方硬腭转折区域;唇裂术后组的位移值和应力值均大于正常对照组,差异具有统计学意义(P<0.05)。结论 单侧牙槽嵴裂上颌骨在上唇压力的作用下,在三维方向上出现形态结构的不对称,减小上唇压力可减轻其对上颌骨的不利影响。Objective To investigate the biomechanical effects of upper lip pressure on the maxilla in patients with a unilateral alveolar cleft and provide evidence for clinical diagnosis and treatment.Methods A 3D finite element maxillary model was generated based on cone beam CT (CBCT) data from an 11-year-old female patient with a unilateral alveolar cleft.Two different kinds of upper lip pressure,postsurgery pressure and normal pressure,were applied to the model.The displacement and stress of each reference node were compared and analyzed.Results By loading upper lip pressure,the maxillary alveolar crest rotated toward the defect and was displaced downward and backward.The displacement of the noncleft side was greater than that of the cleft side and it decreased gradually from the anterior to the posterior.The stress was concentrated on the anterior portion of the alveolar crest.The stress on the noncleft side was greater than that on the cleft side and it decreased gradually from the anterior to the posterior.The maximum stress was concentrated on the palate around the defect.The displacement and stress in the postsurgery group were greater than those of the normal group (P<0.05).Conclusion By loading upper lip pressure,the maxilla demonstrated asymmetry three-dimensionally.The adverse effects on the maxilla could be mitigated by reducing the upper lip pressure.

关 键 词：牙槽嵴裂 唇腭裂 锥形束CT 唇裂术后 上唇压力 上颌骨 牙槽嵴 三维有限元分析 

分 类 号：R78[医药卫生—口腔医学]