腓骨重建小钛板及重建板固定下颌骨体部缺损的生物力学比较分析  

Comparative Biomechanical Analysis of Fixation of Mandibular Body Defect with Small Titanium Plate and Reconstruction Plate of Fibula

作　　者：刘雄 胡超 欧阳嘉杰 LIU Xiong;HU Chao;OUYANG Jiajie(Department of Stomatology,Shunde Hospital,Southern Medical University(the First People's Hospital of Shunde),Foshan 528308,Guangdong,China)

机构地区：[1]南方医科大学顺德医院(佛山市顺德区第一人民医院)口腔科,广东佛山528308

出　　处：《中国美容医学》2024年第9期49-52,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:利用三维有限元方法比较小钛板及重建板固定的下颌骨体部缺损腓骨修复后的应力分布特点及位移情况,为临床上内固定选择提供力学依据。方法:建立下颌骨体部缺损腓骨修复及小型四孔钛板与重建板固定的三维有限元模型,模拟健侧磨牙咬合加载,对比分析钛板、钉孔周围骨质的最大应力值以及腓骨前后端的最大应力值和位移情况。结果:建立了小钛板与重建板固定的下颌骨体部缺损腓骨重建的三维有限元模型。钛板最大应力值均出现在下颌角区域,且均位于钛板上缘或后上方钛板(小钛板组),重建板31.645 MPa,小钛板37.031 MPa,均低于钛合金材料的破坏极限。钉孔周围皮质骨最大应力值均在最靠近前部下颌骨残端与腓骨交界处的第一个钉孔处,重建板4.712 MPa,小钛板8.243 MPa,也都低于皮质骨的屈服强度。总体位移腓骨前端均大于后端且两种钛板组结果相近。结论:重建板和小钛板均能满足下颌骨体部缺损腓骨固定修复的生物力学要求。Objective The three-dimensional finite element method was used to compare stress distribution and displacement of mandibular body defect reconstructed with fibula fixed with miniplates and the reconstruction plate and to provide mechanical reference for selection of internal fixation in clinical practice.Methods Three-dimensional finite element model of mandibular body defect reconstructed with fibula fixed with miniplates or reconstruction plate was established,and simulation contralateral molar vertical loading.Maximum stress of plate,the bone around screw and maximum displacement of the front and rear ends of the fibula were compared and analylsed.Results Finite element model of mandibular body defect reconstructed with fibula fixed with miniplates or reconstruction plate was established.Maximum stress of plate occurred in the region of mandibular angle,all located on the upper edge of the plate or the upper rear titanium plate(miniplates group).Maximum stress of reconstruction plate was 31.645 MPa,while that of miniplates was 37.031 MPa.and they were all lower than the failure limit of titanium alloy materials.Maximum stress values of bone around screw occurred in the nail hole closest to anterior mandibular stumps/fibula junction,value in reconstruction plate group was 4.712 MPa,while that in miniplates group was 8.243 MPa.They are also lower than the yield strength of cortical bone.The total displacement of the anterior end of the fibula was greater than that of the posterior end,and the results of the two titanium plate groups were similar.Conclusion Both reconstruction plate and miniplates can meet the biomechanical fixation requirements of mandibular body defect reconstructed with fibula.

关 键 词：下颌骨 体部缺损 腓骨 固定修复 小钛板 重建板 生物力学 

分 类 号：R782.4[医药卫生—口腔医学]