在上颌骨牵引中,颧牙槽嵴处放置微型钢板与外侧鼻壁之间的应力与位移:三维有限元分析。
Stress and displacement between maxillary protraction with miniplates placed at the infrazygomatic crest and the lateral nasal wall: a 3-dimensional finite element analysis.
机构信息
Assistant professor, Department of Orthodontics, Section of Dentistry, Seoul National University, Bundang Hospital, Seongnam, Gyeonggi Province, Republic of Korea.
Professor, Department of Orthodontics, School of Dentistry, Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
出版信息
Am J Orthod Dentofacial Orthop. 2012 Mar;141(3):345-351. doi: 10.1016/j.ajodo.2011.07.021.
INTRODUCTION
The purpose of this study was to compare the pattern and amount of stress and displacement between maxillary protraction with miniplates placed at the infrazygomatic crest and the lateral nasal wall.
METHODS
Three-dimensional finite element models for the skull and the curvilinear type of miniplate were constructed. After a protraction force (500 g/side) was applied to the distal end of the miniplate with a forward and 30° downward vector to the maxillary occlusal plane, stress distributions in the circummaxillary sutures and displacements of the surface landmarks were analyzed.
RESULTS
There was a difference in the maximum stress distribution area according to the site of the miniplate: infrazygomatic crest and middle part of the maxilla in the infrazygomatic crest and paranasal area adjacent to the pyriform aperture in the lateral nasal wall. Stress values of the frontonasal, frontomaxillary, zygomaticomaxillary, and pterygomaxillary sutures were greater in the infrazygomatic crest than in the lateral nasal wall. The site of the miniplate produced differences in the major displacement areas: infrazygomatic crest, maxillary dentition, anterior maxilla, and upper part of the maxillary tuberosity in the infrazygomatic crest and the lateral nasal wall, maxillary dentition, anterior maxilla, and lower part of the maxillary tuberosity in the lateral nasal wall. The lateral nasal wall exhibited forward, downward, and outward displacements of ANS, Point A, and prosthion. However, the infrazygomatic crest showed forward and upward displacements of ANS, Point A, and prosthion, and outward displacement of the zygomatic process of the maxilla and the maxillary process of the zygomatic bone.
CONCLUSIONS
The site of miniplate placement should be considered to obtain proper stress and displacement values in different areas with maxillary hypoplasia.
简介
本研究旨在比较在上颌骨牵引中,微型板分别置于颧牙槽嵴和侧鼻壁时的应力和位移模式及量值。
方法
构建颅骨和曲线型微型板的三维有限元模型。在微型板的远端施加一个 500 克/侧的牵引力,其方向为前下方,与上颌咬合平面成 30°角,分析眶周缝的应力分布和表面标志点的位移。
结果
根据微型板的位置,最大应力分布区域存在差异:颧牙槽嵴处为上颌骨中部和旁正中区域,毗邻梨状孔的侧鼻壁处。额鼻缝、额上颌缝、颧上颌缝和翼上颌缝的应力值在颧牙槽嵴处大于侧鼻壁处。微型板的位置导致主要位移区域的差异:颧牙槽嵴处为上颌骨牙列、前上颌骨和上颌结节的上部,侧鼻壁处为上颌骨牙列、前上颌骨和上颌结节的下部。侧鼻壁表现为前下方和外方的 ANS、A 点和前颅底的位移。然而,颧牙槽嵴处的 ANS、A 点和前颅底表现为前上方的位移,同时上颌骨颧突和颧骨上颌突向外方位移。
结论
在治疗上颌骨发育不全时,应考虑微型板的放置位置,以获得不同区域适当的应力和位移值。