颞下颌关节生物力学建模及下颌升支矢状劈开截骨术的生物力学研究
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摘要
下颌骨与容貌、咀嚼、语言等密切相关,直接影响生活质量、职业、性格、婚姻等,通过颞下颌关节与上颌骨连接在一起。颞下颌关节(TMJ)具有精细的结构和复杂的功能,是人体内唯一的双侧联动关节,共同参与完成咀嚼、吞咽、言语、表情等功能活动。TMJ在功能上为负重关节,下颌运动产生的TMJ负荷对维持关节各组成部分的正常结构和功能具有重要的作用,也与某些TMJ疾病的形成和治疗相关,其中包含了大量的生物力学问题(如TMJ内各结构的相互作用)。TMJ内各结构之间作用的模拟一直是口腔生物力学研究的重点和难点。除了未考虑TMJ或简单地将TMJ内各结构连接在一起形成“死”关节外,一些研究者采用间隙元或接触单元对TMJ内各结构之间的相互作用进行模拟。然而,目前对TMJ的生物力学研究还不系统、全面,没有针对这几种模拟方式的比较研究,究竟哪种方式更符合实际,尚无定论。另外,一些研究者展开了针对关节盘前移位的生物力学研究。除了关节盘前移位外,其它TMJ疾病(如关节盘其他方向的移位、关节盘附着松弛、关节盘穿孔、颞下颌关节强直)也与TMJ内的应力分布相关,而目前还没有针对这些病变的生物力学研究。
下颌升支矢状劈开截骨术(SSRO)是最早被提出的口内进路正颌外科手术,已成为矫治各类牙颌面畸形的常规术式。大量的研究集中在临床观察和测量以及统计学分析,近年来国内外一些学者展开了对该手术的生物力学研究,包括固定方式的比较及骨愈合后下颌骨的应力分析。由于下颌骨形态结构的变化,包括TMJ在内的整个下颌骨的力学环境不同于术前,以至术后复发和TMJ疾
The temporomandibular joint (TMJ) is between the condyle of the mandible and the mandibular fossa and articular eminence of the temporal bone. The TMJs are the only bilateral linked joints in human body. The bilateral TMJs can do many actions together, such as chew, swallow, speech, expression. The TMJ loads produced by mandibular movement play an important part in the normal configuration and function of the parts in the TMJ, and have relations to the cause and cure of some TMJ diseases. It is obvious that biomechanical researches need to be done on TMJ. So far, simulating the interaction of the parts in the TMJ is still difficult in oral biomechanics. The TMJs were not established or were treated with inactive joints in many mandibular finite element models. In the past 15 years, some researchers established mandibular finite element models, in which the interaction of the parts in the TMJs was simulated using gap elements or contact elements. Nevertheless, there is no comparison among these simulations on the TMJs. Besides, some biomechanical researches on anterior disk displacement were done. Other TMJ diseases, such as disk displacements in other directions, disk perforation and ankylosis of TMJ, also have relations to the stress distributions in TMJs, but few biomechanical researches have been done on them.
Sagittal split ramus osteotomy (SSRO) is the first intraoral orthognathic surgery, which is used to treat various mandibular malformations, such as mandibular prognathism, retrognathia and micrognathia. Many clinical observations and
下颌升支矢状劈开截骨术(SSRO)是最早被提出的口内进路正颌外科手术,已成为矫治各类牙颌面畸形的常规术式。大量的研究集中在临床观察和测量以及统计学分析,近年来国内外一些学者展开了对该手术的生物力学研究,包括固定方式的比较及骨愈合后下颌骨的应力分析。由于下颌骨形态结构的变化,包括TMJ在内的整个下颌骨的力学环境不同于术前,以至术后复发和TMJ疾
The temporomandibular joint (TMJ) is between the condyle of the mandible and the mandibular fossa and articular eminence of the temporal bone. The TMJs are the only bilateral linked joints in human body. The bilateral TMJs can do many actions together, such as chew, swallow, speech, expression. The TMJ loads produced by mandibular movement play an important part in the normal configuration and function of the parts in the TMJ, and have relations to the cause and cure of some TMJ diseases. It is obvious that biomechanical researches need to be done on TMJ. So far, simulating the interaction of the parts in the TMJ is still difficult in oral biomechanics. The TMJs were not established or were treated with inactive joints in many mandibular finite element models. In the past 15 years, some researchers established mandibular finite element models, in which the interaction of the parts in the TMJs was simulated using gap elements or contact elements. Nevertheless, there is no comparison among these simulations on the TMJs. Besides, some biomechanical researches on anterior disk displacement were done. Other TMJ diseases, such as disk displacements in other directions, disk perforation and ankylosis of TMJ, also have relations to the stress distributions in TMJs, but few biomechanical researches have been done on them.
Sagittal split ramus osteotomy (SSRO) is the first intraoral orthognathic surgery, which is used to treat various mandibular malformations, such as mandibular prognathism, retrognathia and micrognathia. Many clinical observations and
引文
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