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下颌角缺损桥接重建钢板的机械应力分析

Analysis of mechanical stress in reconstruction plates for bridging mandibular angle defects.

作者信息

Knoll Wolf-Dieter, Gaida Andreas, Maurer Peter

机构信息

Department of Engineering Sciences, Institute of Environmental Technology, Martin Luther University, Halle-Wittenberg, Germany.

出版信息

J Craniomaxillofac Surg. 2006 Jun;34(4):201-9. doi: 10.1016/j.jcms.2006.01.004. Epub 2006 Apr 27.

Abstract

INTRODUCTION

The objective of the present study was to evaluate the mechanical stress in reconstruction plates and the screw-plate-bone interface used in bridging a mandibular angle defect by means of the finite element method (FEM). The influence of plate geometry as well as the configuration and the diameter of the screws on the mechanical stress distribution was to be determined at the same time and was used as the basis for developing suggestions to optimize the design of the reconstruction plates.

MATERIAL

Based on the geometrical data of a human mandible, an angle defect bridged by a titanium reconstruction plate was generated and exposed to chewing force. First a reconstruction plate was tightly fixed with M2.7 titanium screws. Then, plate design, screw configuration and screw diameter were varied. The mechanical stress was calculated according to von Mises stress hypothesis.

RESULTS

In the standard reconstruction plate, the result of the finite element analysis revealed stress resulting from the simulated functional loadings which far exceeded the strengths of the components. Possible clinical consequences could be a fatigue fracture of the plate itself, gradual loosening of the osteosynthesis screws and loss of bone. The stress can be reduced to less than half by increasing the diameter of the screw threads 1.5 fold.

CONCLUSION

Maximizing the interface between bone and reconstruction plate had a favourable effect. As a consequence of the large interface and a triangular or square configuration of the screws, the stresses could be substantially reduced, the plate could be made thinner and thus better adapted to the mandible. As a preliminary result, the newly designed reconstruction plate could be thinned in areas subject to less mechanical stress.

摘要

引言

本研究的目的是通过有限元方法(FEM)评估用于修复下颌角缺损的重建钢板及螺钉 - 钢板 - 骨界面的机械应力。同时确定钢板几何形状以及螺钉的构型和直径对机械应力分布的影响,并以此为基础提出优化重建钢板设计的建议。

材料

基于人类下颌骨的几何数据,构建一个由钛重建钢板修复的角部缺损模型,并使其承受咀嚼力。首先用M2.7钛螺钉将一块重建钢板牢固固定。然后改变钢板设计、螺钉构型和螺钉直径。根据冯·米塞斯应力假设计算机械应力。

结果

在标准重建钢板中,有限元分析结果显示,模拟功能载荷产生的应力远远超过部件的强度。可能产生的临床后果包括钢板本身的疲劳骨折、接骨螺钉逐渐松动以及骨质流失。将螺纹直径增加1.5倍可使应力降低至不到原来的一半。

结论

最大化骨与重建钢板之间的界面具有良好效果。由于界面大且螺钉为三角形或方形构型,应力可大幅降低,钢板可做得更薄,从而更好地贴合下颌骨。作为初步结果,新设计的重建钢板在机械应力较小的区域可以做得更薄。

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