夹板对关节重建术后患者下颌骨应力分布的影响

目的:探讨夹板对关节重建术术后辅助治疗的生物力学作用机制。方法:采用螺旋CT断层扫描技术与三维有限元应力分析方法相结合,对颞下颌关节紊乱病行关节重建术治疗患者夹板戴前与戴后下颌骨应力分布变化进行定量分析。结果:关节重建术术后患者夹板戴前与戴后下颌骨应力分布特征发生改变,两者应力大小、性质均有差别。戴夹板后两侧下颌骨应力大小均降低,以手术侧髁突应力降低最为明显,应力对称性指标D值有升有降,但以非对称性区域缩小、对称性改善为主。结论:夹板具有明显降低包括髁突在内的关节重建术后下颌骨应力的作用,使颞下颌关节(TMJ)在适当的压力下进行愈合和修复;夹板可使关节重建术后手术侧髁突表面应力降低更明显,既减轻了术侧关节压力,又使双侧TMJ承受负荷趋向平衡、对称

An effect of occlusal splint on stress distribution of the mandible with temporomandibular joint disorder after joint reconstruction operation

Objective:The purpose of this study is to investigate the biomechanical mechanism of the occlusal splint as an assistant therapy for the temporomandibular joint disorders (TMD) after joint reconstruction operation. Methods:The changes of stress distribution in the mandible of a patient with TMD after joint reconstruction operation during occlusal splint put on or not were analyzed quantitatively by combining spiral CT tomographic scanning technology with three dimensional finite element method. Results:Occlusal splint could evidently improve the distribution of maximum principal stress and minimum principal stress in each location in the mandible after joint reconstruction operation. The stress value in operated and nonoperated side of the mandible is reduced, in which the stress in the operated condyle is lowered more distinctly and effectively, and the stress symmetry of its each position is improved slightly also. Conclusion:Occusal splint can drop joint pressure ,as well as obtain the symmetric load in bilateral temporomandibular (TMJ) in clinical application of postoperation. It is beneficial to restore the consistency in the function state of bilateral TMJ in order to assure the repair and reconstruction of the TMJ in a new normal condition.