单侧完全性唇腭裂不同材料植骨前后对上颌扩弓效应影响的生物力学分析  

Biomechanical analysis of maxillary expansion in patient with unilateral cleft lip and palate before and after alveolar bone grafting with different biomaterials

作　　者：王晓宇 王昊[1] 厉松[2] WANG Xiao-yu;WANG Hao;LI Song(Department of Stomatology,Beijing Tian Tan Hospital,Capital Medical University,Beijing 100070,China;不详)

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]首都医科大学口腔医学院正畸科

出　　处：《北京口腔医学》2024年第2期92-96,共5页Beijing Journal of Stomatology

摘　　要：目的探讨模拟采用不同材料进行单侧完全性唇腭裂植骨前后,对上颌扩弓效应的生物力学影响。方法选取1名11岁女性右侧完全性唇腭裂患者的CBCT数据,利用Ansys软件建立独立的上颌骨三维有限元模型以及模拟使用不同材料植骨后的上颌骨模型,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。结果植骨前扩弓效果显著、牙槽嵴前段扩弓量大于后段;而植骨后可产生扩弓效果,但扩弓幅度明显小于植骨前,且牙槽嵴后段扩弓量大于前段。植骨后各组的扩弓量随着材料弹性模量的减小而增加。植骨前扩弓应力主要集中于双侧牙槽嵴后段,并沿颧牙槽嵴支柱分布;植骨后扩弓牙槽嵴前段出现应力集中区并与后段相延续。植骨后各组的应力值随着材料弹性模量的升高而增加。结论单侧完全性唇腭裂患者植骨前的扩弓效应优于植骨后,植骨前扩弓可将施加的扩弓力后移,而植骨后扩弓可将施加的扩弓力前移。在满足植骨要求的前提下,选择弹性模量小的材料可使上颌获得更大的扩弓量且承受较小的应力。Objective To investigate the biomechanical effects of maxillary expansion in the patient with unilateral cleft lip and palate(UCLP)before and after alveolar bone grafting(ABG)with different biomaterials.Methods A 3D finite element maxillary model was generated based on CBCT data from an 11-year-old female patient with UCLP.The expansion force was applied to the maxillary models before and after ABG with different biomaterials.The displacement and stress of each reference node were compared and analyzed.Results By loading expansion force,the transverse displacement before ABG was significantly larger than that after ABG.The transverse displacement after ABG increased from the anterior to the posterior region in each group and it increased with the decrease of the elastic modulus of different biomaterials.The stress was concentrated on the posterior region of the alveolar crest before ABG,while the stress after ABG was distributed more evenly on the alveolar crest,and it also increased with the increase of the elastic modulus of different biomaterials.Conclusions The maxillary expansion before ABG was more obvious than that after ABG in patients with UCLP.The expansion force should be loaded backward before ABG and loaded forward after ABG.The biomaterial with lower elastic modulus could obtain more maxillary expansion and bear less maxillary stress.

关 键 词：唇腭裂 上颌扩弓 牙槽嵴植骨 三维有限元分析 

分 类 号：R783.5[医药卫生—口腔医学]