上颌扩弓对颞下颌关节应力影响的有限元分析
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1.郑州大学第一附属医院;2.乌鲁木齐大为创新信息科技有限公司

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Finite element analysis on the stress distribution effects of maxillary expansion on the temporomandibular joint
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    摘要:

    目的 通过三维有限元法对比扩弓前和放置扩弓器时颞下颌关节内部各组织应力分布情况。方法 根据1名上颌牙弓狭窄患者的CBCT影像资料,运用软件三维构建出扩弓前和包含扩弓器的颞下颌关节有限元模型,对模型加载相同的肌力和边界约束,观察颞下颌关节髁突、关节盘、关节窝的等效应力、最大主应力和最小主应力。结果 扩弓前颞下颌关节的等效应力主要分布在下颌支前缘、髁突前斜面、关节盘中间带和关节窝顶部。放置扩弓器时颞下颌关节的应力分布特征与扩弓前基本一致,应力值虽然显著增加但应力分布更加均匀;髁突和关节盘的应力向前向外侧移动,髁突后斜面表现出更加均匀的最大主应力分布范围。 结论 上颌扩弓器产生的矫形力能够使颞下颌关节的应力值增加,诱导髁突发生组织改建,协调髁突和关节盘的关系,临床上对于牙弓狭窄的患者应采用合适的手段进行扩弓矫治。

    Abstract:

    Objective: To compare the stress distribution on the temporomandibular joint (TMJ) before maxillary expansion and when expander loading on the maxillary by using the three-dimensional finite element method. Methods: The finite element models before maxillary expansion and when expander loading on the maxillary were reconstructed by image data of CBCT from a patient with maxillary transverse deficiency. The same muscle force and boundary constraint were applied on the two models, and then evaluate the von Mises, the maximum principal stress and the minimum principal stress on the mandibular condylar, joint disc and glenoid fossa. Results: The equivalent stress of TMJ was mainly distributed in the anterior mandibular ramus, the anterior of condyle, the middle of articular disc and the top of articular fossa. Compared with before expansion, there is no significant different of the stress distribution on the TMJ when expander loading on the maxillary. However, the stress of the TMJ was larger than before expansion, there is no significant stress concentration. The stress distribution of condyle and disc are more lateral and anterior. The posterior of the condyle shows a wider distribution of maximum principal stress. Conclusion: The orthopedic force generated by maxillary expander can increase the stress value of temporomandibular joint and stimulate tissue reconstruction of condyle. In clinical practice, the patients with maxillary transverse deficiency should be treated with appropriate means of maxillary expansion.

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  • 收稿日期:2021-10-12
  • 最后修改日期:2022-01-11
  • 录用日期:2022-01-13
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