Dominiak Sebastian, Majer Jennifer, Bourauel Christoph, Keilig Ludger, Gedrange Tomasz
Department and Institute of Oral Surgery, Wroclaw Medical University, Krakowska 26 Street, 50-425 Wrocław, Poland.
Poliklinik für Kieferorthopädie Dresden, Trefftz-Bau Zellescher Weg 16, 01069 Dresden, Germany.
J Funct Biomater. 2024 Dec 24;16(1):1. doi: 10.3390/jfb16010001.
The impact of tongue protrusion forces on the formation of malocclusions is well documented in academic literature. In the case of bone dehiscence of the buccal wall in front of the lower frontal teeth, this process may be even more pronounced. Augmentation with 3D customized allogenic bone blocks (CABB) has been proposed as a potential solution for treating such defects. The objective was to assess the impact of bone block adjustment accuracy on the resistance of teeth to protrusion forces at various stages of alveolar bone loss.
A finite element analysis (FEM) was conducted to ascertain whether augmentation with a CABB will result in increased resilience to tongue protrusion forces. Three-dimensional models of the mandible with dehiscenses were created, based on the dehiscences classification and modification proposed in the journal by the authors of regenerative method. The models feature a CABB positioned at three different distances: 0.1 mm, 0.4 mm, and 1.0 mm. The material parameters were as follows: bone (homogenous, isotropic, E = 2 GPa), teeth (E = 20 GPa), periodontal ligament (E = 0.44 MPa), and membrane between bones (E = 3.4 MPa). A tongue protrusion force within the range of 0-5 N was applied to each individual frontal tooth.
The use of an CABB has been shown to positively impact the stability of the teeth. The closer the bone block was placed to the alveolar bone, the more stable was the result. The best results were obtained with a ¼ dehiscence and 0.1 mm distance.
The protrusive forces produced by the tongue might not be the biggest one, but in a presence of the bone loss they might have serious results. Even shortly after the surgery, CABB has a positive impact on the incisor resilience.
学术文献中充分记载了舌前伸力对错牙合畸形形成的影响。在下前牙前方颊侧骨壁骨缺损的情况下，这一过程可能更为明显。有人提出使用3D定制同种异体骨块（CABB）进行骨增量术是治疗此类缺损的一种潜在解决方案。目的是评估在牙槽骨丧失的各个阶段，骨块调整精度对牙齿抵抗前伸力的影响。
进行有限元分析（FEM），以确定使用CABB进行骨增量术是否会提高对舌前伸力的弹性。根据再生方法的作者在该期刊中提出的骨缺损分类和修正，创建了具有骨缺损的下颌骨三维模型。模型中的CABB位于三个不同距离处：0.1毫米、0.4毫米和1.0毫米。材料参数如下：骨（均质、各向同性，E = 2吉帕）、牙齿（E = 20吉帕）、牙周膜（E = 0.44兆帕）和骨间膜（E = 3.4兆帕）。对每颗单个前牙施加0 - 5牛范围内的舌前伸力。
已证明使用CABB对牙齿稳定性有积极影响。骨块放置得离牙槽骨越近，结果越稳定。在1/4骨缺损和0.1毫米距离时获得了最佳结果。
舌头产生的前伸力可能不是最大的力，但在存在骨质流失的情况下，它们可能会产生严重后果。即使在手术后不久，CABB对切牙弹性也有积极影响。
