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各种厚度咬合稳定夹板治疗单侧不可复性关节盘前移位的有限元分析。

Finite element analysis of various thickness occlusal stabilization splint therapy on unilateral temporomandibular joint anterior disc displacement without reduction.

机构信息

Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China.

Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China.

出版信息

Am J Orthod Dentofacial Orthop. 2022 Mar;161(3):e277-e286. doi: 10.1016/j.ajodo.2021.09.011. Epub 2021 Nov 11.

Abstract

INTRODUCTION

Occlusal stabilization splint is the most common treatment modality for temporomandibular joint disorders, but the optimal thickness is still uncertain. This study investigated the effect of the occlusal splint with different thicknesses on the stress distribution of the temporomandibular joint.

METHODS

Cone-beam computed tomography and magnetic resonance images were used to reconstruct the maxillofacial and disc, and the unilateral anterior disc displacement without reduction was established manually as the basic model. Occlusal splint with 5 different thickness levels (2, 3, 4, 5, and 6 mm) was added to the basic model as the study models. The displacement and stress distribution of the disc were evaluated.

RESULTS

The maximum von Mises stress of the condylar cartilage was the largest on the affected side, whereas the maximum von Mises stress of the disc was the largest on the unaffected side. The disc stress on the affected side was mainly distributed on the posterior zone and the intermediate zone for the unaffected side. The maximum von Mises stress of the bilaminar region on the affected side was greater than the unaffected side. The stress of the disc and bilaminar region was the lowest on the affected side in the 2 mm model. The disc displacement on the affected side gradually increased, whereas, on the unaffected side, it fluctuated.

CONCLUSIONS

These results showed that occlusal stabilization splint could decrease the stress of disc and bilaminar region, and 2 mm was considered the optimal thickness for the treatment of unilateral temporomandibular joint anterior disc displacement without reduction.

摘要

简介

咬合稳定夹板是治疗颞下颌关节紊乱最常见的方法,但最佳厚度仍不确定。本研究探讨了不同厚度的咬合夹板对颞下颌关节应力分布的影响。

方法

使用锥形束计算机断层扫描和磁共振成像重建颌面和盘,并手动建立单侧前盘移位无复位的基本模型。在基本模型上添加 5 种不同厚度(2、3、4、5 和 6 毫米)的咬合夹板作为研究模型。评估盘的位移和应力分布。

结果

髁突软骨的最大 von Mises 应力在患侧最大,而未受影响侧的盘的最大 von Mises 应力最大。患侧盘的应力主要分布在后区和中区,而未受影响侧则主要分布在前区。患侧双板区的最大 von Mises 应力大于未受影响侧。2 毫米模型中,患侧盘和双板区的应力最低。患侧盘的位移逐渐增加,而未受影响侧的盘的位移则波动。

结论

这些结果表明,咬合稳定夹板可以降低盘和双板区的应力,2 毫米被认为是治疗单侧颞下颌关节前盘移位无复位的最佳厚度。

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