增材制造颞下颌关节陶瓷假体材料与结构设计研究进展  

Research Progress in Materials and Structural Design of Temporomandibular Joint Ceramic Prosthesis under Additive Manufacturing

作　　者：李延阁 唐晓朋[2,3] 邢宏宇 赵红宇 姜文轩 姜小琛 来庆国 LI Yan'ge;TANG Xiaopeng;XING Hongyu;ZHAO Hongyu;JIANG Wenxuan;JIANG Xiaochen;LAI Qingguo(School of Mechanical and Electrical Engineering,Shandong Jianzhu University,Jinan 250101,China;Center of Stomatological,The Second Hospital,Cheeloo College of Medicine,University,Jinan 250033,China;Jinan Key Laboratory of Oral Materials,Jinan 250033,China)

机构地区：[1]山东建筑大学机电工程学院,济南250101 [2]山东大学第二医院口腔医学中心,济南250033 [3]济南市口腔材料重点实验室,济南250033

出　　处：《精密成形工程》2024年第12期91-107,共17页Journal of Netshape Forming Engineering

基　　金：山东省自然科学基金(ZR2021QE286);山东省自然科学基金重大基础研究(ZR2023ZD24);国家重点研发计划项目课题(2022YFB4601404)。

摘　　要：颞下颌关节(TMJ)负责连接人体下颌骨与颧骨,是咀嚼、语言、表情活动时不可或缺的关节。针对关节严重组织缺损和功能障碍,假体置换法重建关节是当前临床研究的主要方向之一。Al_(2)O_(3)、ZrO2及Si3N4等陶瓷材料凭借出色的生物稳定性和耐磨性在关节重建领域具有广阔的应用前景。但TMJ空间狭小、结构精密,陶瓷材料脆硬难加工的特性制约了定制化陶瓷TMJ假体的发展;此外,致密陶瓷与骨骼间弹性模量不匹配易引发局部骨吸收,局部区域多孔结构设计可以调节假体弹性模量,但常规均匀多孔结构难以有效缓解受力应力集中等问题。可见,材料性能、结构设计及精准制造技术是陶瓷TMJ假体研究的关键。鉴于此,综述了3D打印技术在TMJ重建领域的应用现状,分析了关节重建用陶瓷材料及其3D打印致密件与多孔件的性能特征,总结了仿骨组织的梯度多孔结构设计方法,提出了局部多孔特征定制化陶瓷TMJ假体增材制造研究方向。旨在以3D打印技术实现患者假体制备的“量体裁衣”,促进陶瓷TMJ假体的研究与临床应用发展。The temporomandibular joint(TMJ)is responsible for connecting the mandible to the zygomatic bone and is es-sential for activities such as chewing,speaking,and facial expressions.In cases of severe tissue damage and dysfunction of the joint,prosthetic replacement is one of the main focuses of current clinical research for joint reconstruction.Al_(2)O_(3),ZrO2,and Si3N4 ceramic materials show great potential for application in the field of joint reconstruction due to their exceptional biocompatibility and wear resistance.However,the TMJ space is narrow and its structure is intricate.The brittle and hard-to-process characteristics of ceramic materials have limited the development of customized ceramic TMJ prosthesis.Additionally,the mismatch in elastic modulus between dense ceramics and bones can easily lead to local bone resorption.The design of a locally porous structure can adjust the elastic modulus of the prosthesis,but the conventional uniform porous structure is difficult to effectively alleviate issues such as stress concentration under force.It is evident that material properties,structural design,and precision manufacturing technology are key factors in researching ceramic TMJ prosthesis.In light of this,the work aims to provide an overview on current application status of 3D printing technology in TMJ reconstruction.The performance characteristics of ceramic materials for joint reconstruction and their 3D printed dense and porous components are analyzed.The design method of gradient porous structures imitating bone tissue is summarized and the customized ceramic TMJ prosthesis with local porous features with additive manufacturing is put forward.The goal is to achieve"tailor-made"prosthesis preparation for patients with 3D printing technology while also promoting research and clinical application development of ceramic TMJ prosthesis.

关 键 词：颞下颌关节 陶瓷假体 增材制造 多孔结构 生物学性能 

分 类 号：R782[医药卫生—口腔医学]