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目的建立颅颌面三维有限元模型,分析前牵引角度顺时针增大时其反作用力在颞下颌关节（TMJ）和颌骨的应力及位移变化,为正畸临床更好地治疗骨性Ⅲ类错铪,避免对TMJ和颌骨的损伤提供实验依据。方法本研究于2010---2012年在山东大学机械工程学院机械制造及其自动化实验室完成。选择1名健康青年男性志愿者作为研究对象,建立完整的包含TMJ的颅颌面三维有限元模型,模拟前牵引矫治器反作用力,直接在颏部施以一定大小的力并顺时改变施力的方向,测定TMJ和颌骨应力及位移的变化情况。结果（1）应力方面：从不同角度加载节点力之后产生最大应力点出现在加栽部位颏部,关节窝、髁突头颈部等部位应力也比较集中;从不同角度施加相同载荷时,上下颌骨均产生接触应力,40°时最小。（2）位移方面：以一定力值不同角度施加节点力后,该模型产生微小的位移变化,位移最大部位产生在加栽部位;下颌发生了顺时针旋转。结论（1）前牵引矫治器在牵引上颌向前的同时,确实对TMJ及颌骨产生反作用力,临床上在保证上颌牵引效果的同时,要考虑将其不利的反作用力降到最低;（2）传统加力方式中的角度（37°）似乎并不是最佳的选择,从作用力与反作用力两方面考虑40°要优于37°。     

前牵方向逆时针改变反作用力的有限元分析

目的建立并使用颅颌面三维有限元模型,分析前牵引角度逆时针减小时其反作用力在颌骨特别是颞下颌关节（TMJ）的应力及位移变化,为正畸临床更好地治疗骨性Ⅲ类错矜,避免对TMJ的损伤提供实验依据。方法建立完整的包含TMJ的颅颌面三维有限元模型,模拟前牵引矫治器反作用力,直接在颏部施以一定大小的力并逆时针改变施力的方向,测定颌骨和TMJ区应力及位移的变化情况。结果应力方面：①从不同角度加载节点力之后产生最大应力点出现在加载部位颏部,关节窝、髁突头颈部等上下颌接触部位应力也比较集中,且随角度的逆时针变化,最大应力增大;②接触部位（TMJ）应力变化规律：从不同角度施加相同载荷时,上颌骨产生接触应力,角度由37°逆时针减小到22。时,接触应力呈逐渐增大的趋势;下颌骨同样产生接触应力,下颌头处节点的等效应力（如节点24757）随牵引角度的逆时针减小呈增大趋势,下颌颈处的节点（如．4,24301）也是如此。位移方面：①以一定力值不同角度施加载荷后,该模型产生微小的位移变化,位移最大部位产生在加载部位,下颌骨位移沿x轴正方向逐渐减小。牵引角度小于等于37°时,上颌骨位移沿Y轴由底部到顶部逐渐减小;②5个节点在x,Y方向的位移可以看出：X轴位移值均为正值,且随着角度由37°逆时针减小,位移基本呈上升趋势（31°位移值最小）;Y轴位移值大部分为负值（只有37°时关节窝内节点和34°时关节窝内个别节点为正值）说明37°时下颌即发生了后下方（顺时针）旋转,随着角度逆时针减小,上下颌均发生了后下方（顺时针）旋转,且位移值基本呈增大趋势。结论①颅颌面三维有限元模型成功建立;②前牵引矫治器在牵引上颌向前的同时,确实对颌骨及TMJ产生反作用力,如下颌的后下旋转,颏部的应力变形等,因此临床上在保证上颌牵引效果的同时,要考虑将其不利的反作用力降到最低;③从作用力反作用力两方面考虑,传统加力方式中的（500g,37°斜向下）角度37°应该是不错的选择,但临床上具体选择哪个角度,还要根据患者情况具体问题具体分析,全面考虑可能出现的情况。     

前牵引颏部反作用力对颞下颌关节应力及位移的影响

目的 建立颅颌面骨的三维有限元模型,分析前方施加反作用力牵引颏部对颞下颌关节应力及位移产生的影响。方法 以健康成年男性作为研究对象,采集螺旋CT原始图像数据,利用Mimics、MSC、Magics、Marc图像处理软件建立三维有限元模型,在颏部施加大小为5 N的作用力,并改变施力方向,测定颞下颌关节及颌骨的应力及位移变化情况。结果 三维有限元模型包括上颌骨、下颌骨、颞下颌关节、颅骨,共包括颅骨三维有限元模型节点28760个和110790个单元,上颌骨20487个节点、76982个单元,下颌骨8273个节点、33080个单元。施加载荷为5 N时,方向与平面呈37°时,上颌骨20487个节点的等效Mises应力值为0.143 N,下颌骨8273个节点的等效Mises应力值为0.111N,髁突头部14305个节点的等效Mises应力值为0.829 N。施加载荷为5 N时,颞下颌关节位移从颏部至髁突部位逐渐递减,位移方向与载荷施加方向一致。颏部位移最大,约为0.015 mm;髁突位移最小,约为0.006 mm。结论 本研究成功建立的颅颌面骨三维有限元模型,与生物实体有高度相似性,可用于前方牵引反作用力的相关研究,并可高度模拟牵引力在颞下颌关节的分布情况。     

前方牵引反作用力对颞下颌关节区受力状况影响的有限元研究

目的：建立并使用颅颌面三维有限元模型,研究前方牵引反作用力对颞下颌关节区以及整个下颌骨的应力分布和位移变化状况的影响。方法：选择1例健康成年男性志愿者,采用薄层螺旋CT扫描获取其颅颌面复合体二维图像原始DICOM数据,利用Mimics、Magics、MSC．Marc等图像处理软件建立颅颌面复合体三维有限元模型。利用AN-SYSIO．0软件,在下颌骨颏顶点处施加与耠平面成37。角,大小为5N的力并分析其受力状况。结果：①获得了精确细致的颅颌面复合体三维几何模型,其网格划分准确合理,与重建生物模型的形态相似性好,力学特性体现准确性高。②下颌骨的应力集中区域位于髁突顶部及颈部,髁突表面最大受力区域位于髁突前斜面。上颌骨表面应力集中区域位于关节窝,其中关节窝表面受力最大区域位于关节结节后斜面。③下颌骨的位移图显示位移大小从颏部至髁突逐级递减,其方向与施力方向一致。下颌骨位移变化最大处位于节点力加载部位,髁突部位位移变化量最小。结论：成功建立了包括颞下颌关节在内的颅颌面三维有限元模型,该模型具有很高的精确性,可用于前方牵引反作用力的相关研究。前方牵引反作用力会对颞下颌关节区以及下颌骨的应力分布和位移状况产生影响,但其是否会造成颞下颌关节紊乱还有待进一步研究。     

包含颞下颌关节的颅面三维有限元模型建立

目的　建立包括颞下颌关节在内的颅面三维有限元模型。为日后通过前方牵引矫治力的加载,探讨前牵引矫治力及反作用力在颅上颌复合体、下颌骨、髁状突和关节窝内的应力分布。方法　通过螺旋CT扫描正常志愿者颅面部,将所获得的DICOM格式的图像导入Mimics软件,对包含颞下颌关节的颅面部进行网格划分。结果　成功建立起包括下颌骨颞下颌关节在内的颅骨三维有限元模型。所建立颅骨三维有限元模型共包含110 770个节点和28 740个单元,其中中上颌骨由76892个节点和20 387个单元构成,下颌骨由33 878个节点8 353个单元构成。该模型结构相对比较完整,网格质量良好,与生物实体真实结构具有良好的几何相似性。结论　成功建立了包括颞下颌关节在内的颅颌面三维有限元模型,所建模型具有很高的精确性,为日后进行模拟加载试验奠定了基础。     

推杆式矫治器前导下颌三维有限元模型的初步构建与分析

目的 构建推杆式矫治器(Forsus)前导下颌的三维有限元模型,分析下颌短期前导后的应力和位移,以期为临床应用和改良推杆式矫治器提供参考.方法 选择1例处于生长发育高峰期的Ⅱ类错(牙合)下颌后缩患者,用MBT直丝弓矫治器排齐整平上下牙列达安装推杆式矫治器要求后,经螺旋CT扫描,用Mimics 9.0、Abaqus 6.5软件构建推杆式矫治器前导下颌的三维有限元模型(设计时考虑颌骨的黏弹性和黏塑件),分析前导1、15、300 S后下颌的应力和位移.结果 获得包含MBT直丝弓矫治器的推杆式矫治器前导下颌的三维有限元模型,前导下颌15和300 s后应力集中区均位于髁突前缘、下颌切迹及下颌磨牙区,最大应力值分别为34.47 MPa和34.45 MPa;前导下颌1、15、300 S后最大位移区均出现于下切牙和颏部,最大位移量随加载时间延长而增加,由3.30×10-2mm增至1.15 mm;最大位移区沿下颌骨体向后扩大,髁突位移量由加载1 s时的1.65×10-2 mm减少至加载300 s时的3.27×10-5mm.结论 本项研究在考虑颌骨黏弹性和黏塑性的情况下初步构建推杆式矫治器前导下颌的三维有限元模型.研究结果提示,推杆式矫治器加载一定时间后下颌的应力分布趋于稳定,推杆式矫治器具有促进下颌体整体向前向下改建的作用.     

青少年安氏Ⅱ类错牙合畸形戴用AdvanSync功能矫治器时颞下颌关节应力分布有限元分析

目的运用三维有限元法分析AdvanSync矫治器在治疗安氏Ⅱ类青少年错牙合畸形时颞下颌关节的应力分布,探讨颞下颌关节能否在局部刺激作用下发生适应性改建。方法选择一名11岁男性的安氏Ⅱ类1分类错牙合畸形患者为研究志愿者,对其头部行CBCT扫描,通过mimics17等软件建立包含功能矫治器、上颌骨、下颌骨及牙列的3种颌位关系的有限元模型。运用Ansys workbench 15软件对有限元模型进行边界约束,对功能矫治器加载5.7 N的载荷力并进行应力数据分析,观察颞下颌关节应力分布情况。结果建立含有AdvanSync功能矫治器的三维模型;当功能矫治器承受加载力时,颞下颌关节左右侧应力分布基本一致,3种颌位应力值略有差别,应力变化主要表现在髁突。最大主应力集中在髁突颈部、髁突软骨前部,关节盘上腔前带;最小主应力主要集中在髁突顶部,髁突软骨顶部。结论 AdvanSync功能矫治器前导下颌时,髁突及髁突软骨受应力的良性刺激是关节发生适应性改建的基础;关节盘与关节窝受应力影响较小。     

推杆式矫治器前导下颌对颌骨应力和位移的影响

目的 分析推杆式矫治器（Forsus）在不同垂直向分力作用下瞬时前导下颌后下颌骨的应力和位移变化,为Forsus临床应用提供实验基础。方法 经Abaqus 6.5软件构建Forsus导下颌向前三维有限元模型,分别模拟Forsus矫治中水平向分力为4 N,垂直向分力分别为2、4、1 N的3种工况下下颌骨的应力、位移及路径变化。结果 3种工况下,下颌骨均出现较大应力,髁突发生扭转。垂直向分力为4 N时,下颌骨旋转幅度很小,颏部前伸位移只有0.188 mm;垂直向分力为2 N和1 N时,下颌颏部前伸位移分别为1.150 mm和2.141 mm,下颌骨发生前上旋转。结论 随着垂直向分力逐渐减小,颏部前伸位移趋势增大。Forsus前导下颌有利于颌骨生长改建。     

“颞下颌关节-下颌骨-颏兜矫形系统”三维正交各向异性有限元模型的建立

目的　在计算机上建立包括下颌骨、完整牙列、颏部软组织及颏兜的“颞下颌关节 (TMJ) -下颌骨 -颏兜矫形系统”三维正交各向异性有限元模型。方法　采用活体人颅标本、CT技术离散模型、SuperSAP(93)系统建模 ,采用缆索元、受压间隙元等形式进行边界约束。结果　建立了“TMJ-下颌骨 -颏兜矫形系统”三维正交各向异性有限元模型 ,包括下颌骨的硬组织、颏部软组织及颏兜矫治器 ,同时采用柔索性质的缆索元模拟咀嚼肌、韧带对下颌骨的约束 ,用受压间隙元模拟对牙合牙和关节凹的约束 ;建立的颏兜结构便于模拟临床加载。结论　建立的“TMJ-下颌骨 -颏兜矫形系统”三维正交各向异性有限元模型相似性好 ,为下颌骨受力的进一步研究奠定了基础     

下颌骨受力时颅底的保护因素分析

目的:利用有限元方法分析下颌骨受外力作用时,下颌骨与颞骨的应力分布,推断颅底的保护因素。方法:对1名健康成年男性头部进行CT扫描,根据扫描图像与相关解剖研究,对下颌骨、颞骨以及两者之间的颞下颌关节进行有限元模型重建,同时重建约束下颌骨运动范围的主要附着韧带和肌肉。对此模型颏部正中施加后上方向的力,角度分别为与下颌体水平成0°、30°、54°,施加力为1000N、2000N、3000N,观察施加不同大小与方向的外力作用时下颌骨与颞骨的应力分布情况。结果:无论外力方向与大小如何变化,颞骨应力总是小于下颌骨应力。随着外力方向的变化,下颌骨的应力集中部位亦发生变化,主要集中于髁突与下颌体前部内侧;颞骨的应力集中部位没有发生明显改变,主要集中于外耳道前壁,而不在颞骨关节窝顶。随着外力角度的增大,下颌骨与颞骨应力集中部位的应力与应变均减小。随着施加力值的增大,下颌骨与颞骨应力亦逐渐增大。结论:本模型能真实准确地计算出下颌颏部受矢状方向力作用时,下颌骨与颞骨的应力分布情况。颞下颌关节的缓冲使颞骨应力始终小于下颌骨的应力。在受到正中方向的力打击时,颞骨应力多数集中于外耳道前壁,并非关节窝顶部的薄弱部位,避免了颞骨受到严重破坏。     

Effects of directions of maxillary protraction forces on biomechanical changes in craniofacial complex

The purpose of this study was to investigate the effect of directions of extraoral maxillary protraction forces on biomechanical changes in the craniofacial complex, using the three-dimensional finite element method (FEM). A three-dimensional FEM model was developed on the basis of a young, human dry skull. The model consisted of 2918 nodes and 1776 solid elements. An anteriorly directed 1.0 Kg force was applied to the buccal surface of the maxillary first molar in directions varying from -90 to 90 degrees to the occlusal plane. The displacement pattern of the entire craniofacial complex was evaluated. Further, the stress distributions were determined in three transverse planes associated with parallel, and 30 degrees upward and downward forces. As the force direction was more upward, repositioning of the craniofacial complex became larger in both the horizontal and vertical directions. Displacements were most translatory in loading with the forces applied in the directions ranging from -45 to -30 degrees to the occlusal plane. High stress levels were observed in the nasomaxillary complex and its surrounding structures. However, the patterns of stress distribution within the complex were different for three loading conditions. A downward protraction force produced the most uniform stress distribution. It is shown that the force direction plays an important role in determining the repositioning and the stress distributions in the craniofacial complex.     

Three-dimensional finite-element analysis of maxillary protraction with and without rapid palatal expansion

The aims of this study were to determine the reaction of the craniofacial bones on the protraction force transferred to the maxillary body, and whether or not the midpalatal suture had opened during skeletal Class III treatment. A computerized tomograph was obtained from a dry skull with a normal occlusion to construct a three-dimensional finite-element model (3D.FEM) of the craniofacial bones and the maxillary teeth to simulate actual bone reactions. A protraction force of 500 g was applied at the first premolar region, directed 20 degrees inferior to the occlusal plane. The displacement and the stress distribution of the craniofacial bones and sutures were then calculated using the ANSYS 5.3 program dividing the analysis into two simulations, based on whether or not the midpalatal suture was opened. The results showed that there was less compressive stress and greater tensile stress in the circumaxillary suture areas when the midpalatal suture was opened. The amount of displacement and deformation when the midpalatal suture was opened also demonstrated a decrease in upward-forward rotation of the maxilla and zygomatic arch and greater amounts of displacement in the frontal, vertical, and lateral directions compared with no opening of the midpalatal suture. Analysis of these results showed that maxillary protraction produce similar changes to normal downward and forward growth of the maxilla and was achieved with accompanying opening of the midpalatal suture.     

Biomechanical effect of anteriorly directed extraoral forces on the craniofacial complex: a study using the finite element method

This study was designed to investigate the biomechanical effect of protractive maxillary orthopedic forces on the craniofacial complex by use of the three-dimensional finite element method (FEM). The three-dimensional FEM model was developed on the basis of a dry skull of a young human being. The model consisted of 2918 nodes and 1776 solid elements. Eighteen cranial and facial sutural systems were integrated in the model. An anteriorly directed 1.0-kg force was applied on the buccal surfaces of the maxillary first molars in both a horizontal parallel direction and a 30 degree obliquely downward direction to the functional occlusal plane. The nasomaxillary complex showed a forward displacement with upward and forward rotation in a horizontal protraction case, whereas a downward force produced almost translatory repositioning of the complex in an anterior direction. High stress levels were observed in the nasomaxillary complex and its surrounding structures. However, the pattern of stress distributions within the complex was different in two force systems. A downward protraction force produced relatively uniform stress distributions, indicating the importance of the force direction in determining the stress distributions from various orthopedic forces.     

Photoelastic effects of maxillary protraction on the craniofacial complex

The conventional treatment of anterior crossbites has been the application of orthopedic force to the mandible to redirect its growth. However, in the patient with an underdeveloped maxilla, this treatment alone is not sufficient. Therefore, the purpose of this investigation was to study the orthopedic effects of maxillary protraction appliances in the treatment of anterior crossbites. A three-dimensional anatomic model of a human skull was fabricated with birefringent materials for photoelastic analysis. Three maxillary protraction appliances that utilized different anchorage units were used. The protraction forces placed on these appliances were parallel to the occlusal plane, a downward vector 20 degrees to the occlusal plane, and a combination of these two vectors. The resulting stress patterns were observed. The effects of the forces produced by the three appliances were transmitted to the maxilla and distant craniofacial structures. Both a parallel traction and a 20 degrees downward pull to the occlusal plane caused a constriction of the anterior portion of the maxilla. The parallel traction caused a counterclockwise (opening) rotation of the molar tooth and palatal plane. A 20 degrees downward force to the occlusal plane decreased this effect.     

单侧完全性唇腭裂植骨患者上颌前牵引矫治的有限元分析

目的:探讨唇腭裂患者牙槽突裂植骨前、后上颌骨前牵引的生物力学变化特点,研究植骨前、后以及植骨区吸收时前牵引对唇腭裂颅上颌复合体的影响,为临床上应用前牵引治疗唇腭裂患者上颌发育不足提供理论依据。方法:采用三维有限元方法,在已建立的唇腭裂上颌复合体有限元模型中模拟植骨及植骨吸收,利用Ansys12.0软件,分别对各个模型在双侧上颌尖牙牙槽骨处施加与平面呈30°的牵引力,大小为每侧5N(约500g),模拟临床上的上颌前牵引,分析其生物力学变化情况。结果:相同加载条件下,植骨前患侧的水平位移显著大于健侧,且患侧与健侧骨缝的应力分布不均匀。植骨后,患侧与健侧的位移差值减小,患侧与健侧骨缝的应力分布趋于更均匀。在所观察的骨缝中,应力最大值出现在翼腭缝,其次为颧颞缝、颧颌缝和颧额缝。结论:植骨前对上颌骨进行前牵引,裂隙有扩大化趋势;植骨有利于上颌前牵引矫治力分布更均匀,健、患侧位移变化趋于接近;且植骨不吸收时,上颌前牵引效果最佳。在模拟植骨发生吸收的几种情况中,植骨区上方发生吸收的上颌前牵引效果比植骨区下方发生吸收的前牵引效果差。