磨牙正锁[牙合]患者颞下颌关节形态学及咬合应力下髁突三维有限元分析  

Three-dimensional finite element feature analysis of the mandible and morphology and position of temporomandibular joint in patients with unilateral and bilateral molar scissor bite

作　　者：褚天昊 张雪颖 王浩丞 马浩杰 刘媛媛 Chu Tianhao;Zhang Xueying;Wang Haocheng;Ma Haojie;Liu Yuanyuan(School of Stomatology,Shandong Second Medical University,Weifang 261053,China;Dept.of Stomatology,Affiliated Hospital of Shandong Second Medical University,Weifang 261000,China)

机构地区：[1]山东第二医科大学口腔医学院,潍坊261053 [2]山东第二医科大学附属医院口腔科,潍坊261000

出　　处：《华西口腔医学杂志》2025年第1期114-125,共12页West China Journal of Stomatology

基　　金：潍坊市卫生健康委员会项目(WFWSJK-2023-377)。

摘　　要：目的 通过测量单、双侧磨牙正锁[牙合]患者的双侧颞下颌关节的形态及位置并模拟咬合时下颌骨受力变形情况,旨在为单、双侧磨牙正锁[牙合]患者的颞下颌关节紊乱病的诊断提供依据。方法 本研究为回顾性研究,根据纳入标准,选择成人安氏Ⅰ类错患者20例作为对照组,10例单侧磨牙正锁[牙合]患者(单侧组)、10例双侧磨牙正锁[牙合]患者(双侧组)作为实验组。患者拍摄锥形束CT,通过测量关节窝宽度、关节窝高度、关节结节倾斜度、髁突长轴、髁突短轴、髁突水平角及颞下颌关节间隙的大小,比较颞下颌关节形态和位置。利用软件模拟患者咬合情况,进行下颌骨形态三维有限元分析,评估下颌骨的受力变形情况,进一步探讨下颌骨形态受力与患者可能存在的颞下颌关节紊乱症状的关系。结果 比较对照组左侧、单侧组锁[牙合]侧、双侧组左侧颞下颌关节,结果显示关节上间隙单侧组小于对照组(P<0.05);髁突长轴单、双侧组均小于对照组(P<0.05),且单侧组大于双侧组(P<0.05);髁突短轴双侧组小于对照组(P<0.05);髁突水平角单、双侧组均大于对照组(P<0.05)。对比对照组右侧、单侧组正常侧、双侧组右侧关节形态和位置,结果显示关节上间隙单、双侧组均小于对照组(P<0.05),髁突长轴双侧组小于对照组(P<0.05),髁突短轴单侧组正常侧大于双侧组。三维有限元分析:后牙正锁[牙合]患者的髁突是咬合变形集中区域,锁[牙合]侧第一磨牙咬合时,X轴与Z轴方向上,变形最大区位于髁突。X轴方向上,髁突变形量锁[牙合]侧大于正常侧,在Z轴方向,正常侧大于锁[牙合]侧。X轴方向局部变形最大值点在锁[牙合]侧髁突内极横嵴前后,而局部变形最小值点在正常侧髁突内极中1/3前斜面处;Z轴方向局部变形最大值点位于正常侧髁突外极及外极下方;对不同咬合情况进行模拟发现,髁突X轴变形值在�Objective The objective of this study is to measuring the morphology and position of bilateral temporomandibular joints in patients with unilateral and bilateral molar scissor bite and simulating the deformation of the mandible during occlusion,in order to provide thesis for the diagnosis of temporomandibular joint disease in patients with unilateral and bilateral molar scissor bite.Meth⁃ods This study was a retrospective study.A total of 10 patients with unilateral molar scissor bite(the unilateral molar scissor bite group)and 10 patients with bilateral molar scissor bite(the bilateral molar scissor bite group)were selected as the experimental group,and 20 adult patients with classⅠof angle classification of similar ages were selected as the control group.All patients underwent cone beam computed tomography scans,by measuring the width of the fossa,height of the fossa,articular eminence inclination,long axis of the condyle,minor axis of the condyle,horizontal angle of the condyle and the space of the temporomandibular joint,compare temporomandibular joint morphology and position.The three-dimensional finite element analysis of the mandible morphology was carried out to evaluate the force and deformation of the mandible by using software to simulate the occlusion of the patients.It was further explored the relationship between the force of the mandible morphology and the possible temporomandibular joint disorder symptoms of the patients.Results Intergroup comparisons for the unilateral molar scissor bite group and left sides of the other groups revealed that the superior articular space in the group with unilateral molar scissor bite was shorter than that in the control group(P<0.05);the long axis of the condyle in the unilateral and bilateral molar scissor bite group were both shorter than that of the control group(P<0.05);among which the unilateral group was larger than the bilateral group,and the minor axis of the condyle in bilateral molar scissor bite group was smaller than in the control group(P<0.05),a

关 键 词：正锁[牙合] 颞下颌关节 形态 有限元分析 

分 类 号：R782.6[医药卫生—口腔医学]