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下颌前伸和回缩运动时颞下颌关节的生物力学分析:三维有限元模拟。

Biomechanical analysis of temporomandibular joints during mandibular protrusion and retraction motions: A 3d finite element simulation.

机构信息

Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China; Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.

State Key Laboratory of Oral Diseases, National Clinical Research Center of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

出版信息

Comput Methods Programs Biomed. 2021 Sep;208:106299. doi: 10.1016/j.cmpb.2021.106299. Epub 2021 Jul 23.

Abstract

BACKGROUND AND OBJECTIVE

Temporomandibular disorders (TMDs) represent a wide range of musculoskeletal disorders associated with the maxillofacial system, which negatively affect the daily activities of patients. TMD symptoms are caused by the temporomandibular joint (TMJ) overloading. TMJ motions are frequent and can trigger overloading and imbalanced loads on the TMJs, which are assumed to be dangerous. The condyles move forward a lot during mandibular protrusion, which is possibly harmful to the biomechanical environment of the TMJs. The aim of this study was to investigate the biomechanical behavior of TMJs during mandibular protrusion and retraction.

METHODS

Six three-dimensional maxillofacial system models from asymptomatic subjects were established through computed tomography (CT) and magnetic resonance imaging (MRI). The mandibular protrusion and retraction were recorded using an optical tracking system. Finite element analysis was used to simulate the biomechanical behaviors of the TMJs during the movements.

RESULTS

The simulation results were validated to be effective by comparison with the MRIs. The results indicated that the stresses during the protrusion and retraction were approximately equal at the same condylar displacement. Meanwhile the discal stresses, relatively correlated with the condylar displacement, increased as the condylar displacement increased during the protrusion and decreased as the condylar displacement decreased in the retraction. In addition, the average peak maximum and minimum principal stresses of the discs were 0.186 and -0.192 MPa, respectively.

CONCLUSIONS

The models were reasonable for the investigation of the TMJs motion. Based on the results, three quadratic polynomials were proposed to describe the relationship between the stresses and the condylar displacements. In clinical diagnosis, the functions are helpful in the prediction of the discal stresses by measuring the condylar displacement.

摘要

背景与目的

颞下颌关节紊乱症(TMD)是一类与颌面系统相关的肌肉骨骼疾病,会对患者的日常生活造成负面影响。TMD 症状是由颞下颌关节(TMJ)过载引起的。TMJ 运动频繁,可能会导致 TMJ 过载和不平衡的负荷,这被认为是危险的。下颌前伸时髁突会大幅度向前移动,这可能对 TMJ 的生物力学环境造成损害。本研究旨在探讨下颌前伸和回缩过程中 TMJ 的生物力学行为。

方法

通过计算机断层扫描(CT)和磁共振成像(MRI)建立了 6 例无症状受试者的三维颌面系统模型。使用光学跟踪系统记录下颌前伸和回缩运动。采用有限元分析模拟 TMJ 在运动过程中的生物力学行为。

结果

模拟结果与 MRI 对比验证有效。结果表明,在相同髁突位移下,前伸和回缩时的应力大致相等。同时,与髁突位移相关的盘内应力在髁突前伸时随髁突位移的增加而增加,在回缩时随髁突位移的减少而减少。此外,盘的平均最大和最小主应力峰值分别为 0.186 和-0.192 MPa。

结论

该模型适用于 TMJ 运动的研究。根据结果,提出了三个二次多项式来描述应力与髁突位移之间的关系。在临床诊断中,通过测量髁突位移,这些函数有助于预测盘内应力。

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