功能状态下无牙颌患者髁状突的应力分布研究

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1、功能状态下无牙颌患者髁状突的应力分布研究作者：安虹，白乐康，高陶磊，王一兵【摘要】目的构建无牙颌包括下颌骨的颞下颌关节(TMJ)三维有限元模型；探讨戴用全口义齿无牙颌患者在牙尖交错位紧咬牙时颞下颌关节髁状突的应力分布特征。方法以活体人颅为标本，采用螺旋CT断层扫描技术，图像数字化处理等方法在计算机上构建模型，然后在载荷状态下，利用ANSYSV8.0软件进行运算分析。结果建立了无牙颌下颌骨和颞下颌关节三维有限元模型，并在此模型后牙相应位点加载、运算、分析显示：髁突近颈部应力力值明显大于近顶区；前、后斜面由外向内力值逐渐减小；外、内侧由前向后力值逐渐减小，前斜面、外侧上1

2、/2(近髁突顶)区域压应力占主导地位，下1/2(近颈区)区域以拉应力为主，下外侧为主要应力集中区；后斜面及内侧上1/2以拉应力为主，下1/2以压应力为主。结论戴用息止间隙为2mm的全口义齿无牙颌患者，髁状突各区域拉、压应力并存，但每个区域应力分布特征及水平有较大差异；前斜面外侧即关节功能区应力水平明显高于其他区域，符合正常人TMJ功能的特点。【关键词】无牙颌；全口义齿；颞下颌关节；模型；有限元　　ABSTRACT:ObjectiveToconstructatemporomandibularjoint(TMJ)modelincludingmandiblebymeanso

3、f9three-dimensionalfiniteelementmethodsandtoinvestigatethestressdistributionofthecondyleduringclenchingofedentulousjawwithcompletedenture.MethodsThethree-dimensionalmodel(3-DFEM)ofTMJincludingmandibleofedentulousjawpatientwasconstructedbyhelix-CTscannedtransversesections.Thestressdistri

4、butionofthecondylewasanalyzedunderload.ResultsThethree-dimensionalfiniteelementmodelofTMJincludingmandibleofedentulousjawwasestablished,thenloadedandcalculatedonthecorrespondingsitusofposteriortoothofthemodel.Analyticresultsshowedthestressontheneckofcondyleobviouslysurpassedthatonthetop

5、ofcondyle.Thestressdecreasedfromexternaltointerioronanteriorandposteriorincline,anddecreasedfromanteriortoposterioroninteriorandexternalinclineofthecondyle.Compressivestresswasdominantintheanteriorinclineandupper1/2oflateralpart(nearthetopofthecondyle),andtensilestresswasdominantinthein

6、ferior1/2(neartheneck),sothelateralinferiorpartwasfeaturedbyhighstressdistribution.Intheposteriorandinteriorpart,tensilestressoccupiedtheupper1/2andcompressivestresswasmainininferior1/2.ConclusionTheedentulousjawofpatientshadthecompressivestressandtensilestresssimultaneouslyonthe9wholec

7、ondyle.Butthestressisdifferentinlevelandfeatureofdistribution.Theexternalanteriorinclineisfeaturedbythehigheststressdistribution,anditisconsistentwiththefeatureoftheTMJofhealthypeople.　　KEYWORDS:edentulousjaw;completedenture;temporomandibularjoint;model;finiteelement　　颞下颌关节(tem