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截骨术和矫治器放置后的下颌力学 II:身体和髁突颈部的骨应变

Mandibular mechanics following osteotomy and appliance placement II: Bone strain on the body and condylar neck.

作者信息

Rafferty Katherine L, Sun Zongyang, Egbert Mark A, Baird Emily E, Herring Susan W

机构信息

Department of Orthodontics, University of Washington, Seattle, WA 98195, USA.

出版信息

J Oral Maxillofac Surg. 2006 Apr;64(4):620-7. doi: 10.1016/j.joms.2005.12.007.

Abstract

PURPOSE

The purpose of this investigation was to determine if the mechanical environment of the mandible is changed by osteotomy and fixation, as assessed by the measurement of bone strain on the condylar neck and mandibular corpus.

MATERIALS AND METHODS

Immediately following unilateral mandibular osteotomy and distractor placement, strain gauges were attached directly to the corpus and condylar neck in a sample of domestic pigs. Bone strains were recorded during mastication and muscle stimulation. Comparisons of principal strain magnitudes and orientations were made between sides and between the osteotomy sample and a control database.

RESULTS

The animals preferred to chew on the non-osteotomy side. Corpus strains were higher for osteotomy-side chewing but were comparable to the control database, regardless of chewing side. For the condyle, compared with the control database and the non-osteotomy side, the osteotomy side was underloaded in compression. Furthermore, the orientation of compressive strain was highly variable and more horizontally oriented than that of control and non-osteotomy condyles. Stimulation of the masseter and medial pterygoid loaded the mandible to normal levels.

CONCLUSION

Masticatory behavior was altered, probably as a combined result of disruption of the occlusion, changes in muscle recruitment, and probable loss of sensory feedback. However, neither these changes nor damage to the muscles explain the decrease and reorientation of compressive strain on the condylar neck. Alternatively, the modified strain pattern could have arisen from positional instability of the proximal bone fragment.

摘要

目的

本研究的目的是通过测量髁突颈部和下颌骨体部的骨应变,来确定截骨术和固定是否会改变下颌骨的力学环境。

材料与方法

在对家猪样本进行单侧下颌骨截骨术并放置牵张器后,立即将应变片直接附着于下颌骨体部和髁突颈部。在咀嚼和肌肉刺激过程中记录骨应变。对主要应变大小和方向在两侧之间以及截骨术样本与对照数据库之间进行比较。

结果

动物更喜欢在非截骨术侧咀嚼。截骨术侧咀嚼时下颌骨体部的应变较高,但无论咀嚼侧如何,均与对照数据库相当。对于髁突,与对照数据库和非截骨术侧相比,截骨术侧在压缩时负荷不足。此外,压缩应变的方向高度可变,且比对照和非截骨术髁突的方向更水平。咬肌和翼内肌的刺激使下颌骨负荷达到正常水平。

结论

咀嚼行为发生了改变,可能是咬合破坏、肌肉募集变化以及感觉反馈可能丧失的综合结果。然而,这些变化和肌肉损伤都无法解释髁突颈部压缩应变的降低和方向改变。另外,改变的应变模式可能是由于近端骨块的位置不稳定所致。

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