中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (34): 5516-5520.doi: 10.12307/2024.822

• 口腔组织构建 oral tissue construction • 上一篇    下一篇

正畸减数患者后牙前移对颞下颌关节应力影响的三维有限元分析

商永慧1,李  帅1,刘义琮2,赵启航1,刘  文3   

  1. 1大连医科大学,辽宁省大连市  116000;2青岛市崂山区青岛恩典嘉美口腔门诊部,山东省青岛市  266100;3康复大学青岛医院/青岛市市立医院口腔医学中心,山东省青岛市  266000
  • 收稿日期:2023-11-27 接受日期:2024-01-13 出版日期:2024-12-08 发布日期:2024-03-14
  • 通讯作者: 刘文,博士,副主任医师,康复大学青岛医院/青岛市市立医院口腔医学中心,山东省青岛市 266000
  • 作者简介:商永慧,女,1998年生,山东省淄博市人,汉族,大连医科大学在读硕士,主要从事口腔正畸学研究。

Three-dimensional finite element study on the effect of posterior tooth forward movement on temporomandibular joint stress in orthodontic reduction patients

Shang Yonghui1, Li Shuai1, Liu Yicong2, Zhao Qihang1, Liu Wen3   

  1. 1Dalian Medical University, Dalian 116000, Liaoning Province, China; 2Qingdao Grace Jiamei Stomatology Clinic, Qingdao 266100, Shandong Province, China
  • Received:2023-11-27 Accepted:2024-01-13 Online:2024-12-08 Published:2024-03-14
  • Contact: Liu Wen, PhD, Associate chief physician, Center of Stomatology, Qingdao Hospital of Rehabilitation University/Qingdao Municipal Hospital, Qingdao 266000, Shandong Province, China
  • About author:Shang Yonghui, Master candidate, Dalian Medical University, Dalian 116000, Liaoning Province, China; 3Center of Stomatology, Qingdao Hospital of Rehabilitation University/Qingdao Municipal Hospital, Qingdao 266000, Shandong Province, China

摘要:


文题释义:

正畸减数:在正畸过程中,因考虑面型、拥挤度的需求需要减少牙齿数目来达到美观、排齐整平牙列的目的。通常减数的牙齿以双尖牙为主,也存在特殊减数如拔除前牙或者磨牙。
颞下颌关节:为下颌骨与颅骨颞骨接合的区域,具有较强的终身改建能力。颞下颌关节的主要功能是支持复杂的下颌运动,并且在运动中承受一定的负荷。关节所承受的负荷是促进关节组织发生相应改建的重要因素,而改建的重要结果之一是关节形态发生相应变化,变化后的形态又会影响关节的运动特征。


背景:颞下颌关节紊乱病与颞下颌关节内有高应力密切相关。减数拔牙后伴随着磨牙位置的改变,建立新的咬合关系往往会导致颞下颌关节内应力环境发生改变。

目的:在牙尖交错位时,利用三维有限元模型分析正畸减数拔牙后不同程度磨牙前移下颞下颌关节的应力分布。
方法:选择在山东青岛市市立医院口腔正畸科就诊的正常牙合患者1例,收集其锥形束CT和MRI数据,分别建立减数前、减数后上下磨牙前移1/3拔牙间隙(拔除4颗第二前磨牙)及减数后上下磨牙前移2/3拔牙间隙(拔除4颗第二前磨牙)的有限元模型,通过建模软件分析牙尖交错位时颞下颌关节各部位的应力分布。

结果与结论:①减数前后模型中髁突、关节盘、骨关节窝的受力分布基本一致,髁突的应力主要分布于髁突的前部及顶部,关节盘的应力主要分布于关节盘的中带及外侧,颞骨关节窝的应力主要集中分布在关节窝的前部及顶部。与减数前相比,减数后模型中髁突、关节盘及关节窝的等效应力值减小;正畸减数拔牙后,上下磨牙前移1/3拔牙间隙模型中髁突及关节盘的等效应力值小于上下磨牙前移2/3拔牙间隙模型。②从生物力学角度上讲,正畸减数拔牙可以降低颞下颌关节的应力,进而提供良好的生物力学环境。

https://orcid.org/0009-0002-5902-6451(商永慧)

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程

关键词: 组织构建, 骨组织工程, 正畸减数, 颞下颌关节, 有限元分析, 磨牙前移

Abstract: BACKGROUND: Temporomandibular joint disorders are closely related to high stress in temporomandibular joint. With the change of molar position after tooth reduction extraction, the establishment of new occlusal relationship often leads to the change of internal stress environment of the temporomandibular joint.
OBJECTIVE: To analyze the stress distribution of temporomandibular joint in patients undergoing orthodontic reduction tooth extraction with different degrees of molar forward movement using the three-dimensional finite element model of the maxillary complex and temporomandibular joint.
METHODS: A case of individual normal occlusal patient was selected from the Orthodontics Department of Qingdao Municipal Hospital, Shandong Province, and the finite element models of 1/3 anterior molar space (extraction of four second premolar teeth) before and after reduction and 2/3 anterior molar space (extraction of 4 second premolar teeth) after reduction were established based on the cone-beam CT and MRI data. ABAQUS software was used to analyze the stress distribution of various parts of the temporomandibular joint during the interposition of tooth tips.
RESULTS AND CONCLUSION: The stress distribution of the condyle, articular disc, and osteoarticular fossa in the model before and after the reduction was basically the same. The stress of the condyle was mainly distributed in the anterior and apical part of the condyle, the stress of the articular disc was mainly distributed in the middle band and lateral part of the articular disc, and the stress of the articular fossa was mainly concentrated in the anterior and apical part of the articular fossa. However, the equivalent stress value of the condyle, articular disc and articular fossa decreased after reduction. After orthodontic reduction extraction, the equivalent stress values of condyle and articular disc in the 1/3 anterior molar space model were smaller than those in the 2/3 anterior molar space model. From the perspective of biomechanics, orthodontic reduction extraction can reduce the stress of the temporomandibular joint and provide a good biomechanical environment.

Key words: tissue construction, bone tissue engineering, orthodontic reduction, temporomandibular joint, finite element analysis, molar anterior displacement

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