Derin Ahmet Faruk, Alan Hilal
Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, İnönü University, 44280 Campus, Malatya, Turkey.
Private clinic, Tecde, Altın Kayısı Blv No:49 D:1B, Yeşilyurt/Malatya, 44090, Turkey.
Oral Maxillofac Surg. 2025 Jun 20;29(1):127. doi: 10.1007/s10006-025-01422-7.
This study aims to evaluate the effect of impacted third molars in different positions on stress distribution in the proximal and distal segments during sagittal split ramus osteotomy (SSRO) using finite element analysis.
Finite element stress analysis was used to create models with impacted third molars in different positions. In SSRO-applied models, a 20 N force was applied in opposite directions to the proximal and distal segments along the sagittal osteotomy line. The von Mises, Pmax, and Pmin stress values induced by the applied force in the proximal and distal segments were analyzed to assess their potential impact on the risk of unfavorable fractures.
Compared to the control model, the highest stress values were observed on the buccal side of the proximal segment in the distoangular model and on the lingual side of the distal segment in the horizontal model. Analyzing the von Mises, Pmax, and Pmin stress values in all models, it was found that the highest stress concentrations occurred predominantly on the buccal side of the proximal segment.
During SSRO, horizontally positioned impacted third molars may increase stress values in the distal segment, potentially elevating the risk of unfavorable fractures. In all models, higher stress concentrations were observed in the buccal region of the proximal segment. These findings highlight the clinical importance of patient-specific evaluation of third molars prior to SSRO.
本研究旨在通过有限元分析评估不同位置的阻生第三磨牙对矢状劈开下颌支截骨术（SSRO）过程中近远中节段应力分布的影响。
采用有限元应力分析创建不同位置有阻生第三磨牙的模型。在应用SSRO的模型中，沿矢状截骨线向近远中节段施加相反方向的20 N力。分析施加力在近远中节段引起的von Mises、Pmax和Pmin应力值，以评估其对不良骨折风险的潜在影响。
与对照模型相比，在远角模型的近中节段颊侧以及水平模型的远中节段舌侧观察到最高应力值。分析所有模型中的von Mises、Pmax和Pmin应力值发现，最高应力集中主要出现在近中节段的颊侧。
在SSRO过程中，水平位置的阻生第三磨牙可能会增加远中节段的应力值，潜在地增加不良骨折的风险。在所有模型中，近中节段的颊侧区域观察到更高的应力集中。这些发现突出了在SSRO之前对第三磨牙进行个体化评估的临床重要性。
