Necmettin Erbakan University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara Cd. No:74A, 42050, Karatay, Konya, Turkey.
Medipol Mega University Hospital, Department Orthodontics, TEM Avrupa Otoyolu Göztepe Çıkışı No:1, 34214, Bağcılar, Istanbul, Turkey.
J Craniomaxillofac Surg. 2019 Mar;47(3):431-437. doi: 10.1016/j.jcms.2018.11.033. Epub 2018 Dec 5.
In this study, we aimed to measure the stresses both on the pterygoid plates and the cranial base during the down-fracture and at the time of pterygomaxillary osteotomy by using the finite element analysis method to have an idea about the possible causes of complications. Three different surgical approaches were applied to the obtained models. In the Model 1, Le Fort I cuts without pterygomaxillary separation was applied. In the Model 2, same standard Le Fort I cuts were applied with pterygomaxillary separation. Then both models were subjected to a force of 150 N over the anterior spina nasalis to simulate down-fracture. In the third model, same standard Le Fort I cuts were applied. Following this procedure, a force of 50 N was applied with a sharp osteotome to the pterygomaxillary junction to simulate osteotomy. According to the results of this experimental study, the cranial base stress values decreased during the down-fracture in the Model 2. Moreover, it was found that the force transmitted to the base of the skull is less when the height of the pterygomaxillary osteotome is limited to 1 cm as we applied in Model 3.
在这项研究中，我们旨在通过有限元分析方法测量翼突板和颅底在向下骨折时以及在翼上颌切开术中的应力，以了解并发症的可能原因。我们将三种不同的手术方法应用于获得的模型中。在模型 1 中，应用了不分离翼上颌的 Le Fort I 截骨术。在模型 2 中，应用了相同标准的 Le Fort I 截骨术并进行了翼上颌分离。然后，两个模型均在前鼻棘上施加 150N 的力以模拟向下骨折。在第三个模型中，应用了相同标准的 Le Fort I 截骨术。在此操作后，用锋利的骨刀在翼上颌连接处施加 50N 的力以模拟切开术。根据这项实验研究的结果，在模型 2 中，向下骨折时颅底的应力值降低。此外，我们在模型 3 中应用了将翼上颌切开术的高度限制在 1cm 的情况下，发现传递到颅底的力较小。
