[唇腭裂患者不同类型上颌骨截骨术后面中部内牵张成骨的生物力学研究]

[Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate].

作者信息

Hou Min, Shi Guang-Yu, Pu Li-Chen, Song Da-Li, Zhang Xi-Zhong, Liu Chun-Ming

机构信息

Department of Orthognathic Surgery, Stomatological Hospital Affiliated to Nankai University, Tianjin Stomatological Hospital, Tianjin 300041, China.

出版信息

Zhonghua Zheng Xing Wai Ke Za Zhi. 2009 Sep;25(5):368-72.

PMID:20030117

Abstract

OBJECTIVE

To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP).

METHODS

3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied.

RESULTS

The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy.

CONCLUSION

3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

摘要

目的

探讨唇腭裂患者不同类型上颌骨截骨术后面中部牵张成骨的生物力学变化。

方法

采用三维有限元分析。建立了Le Fort I、II、III型截骨及软组织的三维模型。基于新型面中部牵张器，模拟上颌复合体牵张向前推进10mm，研究力学变化。

结果

唇腭裂患者上颌复合体牵张后向前移动。Le Fort I型截骨术后牙槽嵴和腭部出现缩窄，而Le Fort II型和III型截骨术后未出现。Le Fort III型截骨术后上颌复合体整体向前移动，但Le Fort I型和II型截骨术后牵张过程中观察到上颌复合体有一定程度的旋转。在垂直方向上，Le Fort II型截骨术后上颌复合体逆时针旋转更多。