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Biomechanical Analysis of the Forces Exerted during Different Occlusion Conditions following Bilateral Sagittal Split Osteotomy Treatment for Mandibular Deficiency.
Applied Bionics and Biomechanics ( IF 2.2 ) Pub Date : 2019-06-02 , DOI: 10.1155/2019/4989013
Yuan-Han Chang,Man-Yee Chan,Jui-Ting Hsu,Han-Yu Hsiao,Kuo-Chih Su

The bilateral sagittal split osteotomy (BSSO) technique is commonly used to correct mandibular deficiency. If the patient is exposed to excessive external forces after the procedure, occlusal changes or nonunion may occur. However, previous studies only focused on single external forces on the mandible and did not conduct relevant research on the forces exerted by different occlusion conditions. The main purpose of this study was to use finite element analysis methods to determine the biomechanics of four common occlusion conditions after BSSO surgical treatment. This study constructed a finite element analysis computer model of a miniplate implanted in the lower jaw. The structure of the model consisted of the mandible, miniplate, and screws. In addition, external forces were applied to the superficial masseter, deep masseter, medial pterygoid, anterior temporalis, middle temporalis, and posterior temporalis muscles to simulate the incisal clench, intercuspal position (ICP), right unilateral molar clench (RMOL), and right group function occlusion conditions. Subsequently, this study observed the effects of these conditions on the miniplate, screws, and mandible, including the von Mises stress values. The results showed that all of the different occlusion conditions that this study evaluated placed high stress on the miniplate. In the ICP and RMOL occlusion conditions, the overall mandibular structure experienced very high stress. The screw on the proximal segment near the bone gap experienced high stress, as did the screw on the buccal side. According to the present analysis, although the data were not directly obtained from clinical practice, the finite element analysis could evaluate the trend of results under different external forces. The result of this study recommended that patients without intermaxillary fixation avoid the ICP and RMOL occlusion conditions. It can be used as a pilot study in the future for providing clinicians more information on the biomechanics of implantation.

中文翻译:

双侧矢状劈开截骨术治疗下颌骨缺损后在不同咬合条件下施加的力的生物力学分析。

双侧矢状劈开截骨术(BSSO)技术通常用于纠正下颌骨缺损。如果患者在手术后受到过大的外力,可能会发生咬合改变或骨不连。但是,以前的研究仅关注下颌骨上的单个外力,而没有对不同咬合条件所施加的力进行相关研究。这项研究的主要目的是使用有限元分析方法确定BSSO手术治疗后四种常见咬合情况的生物力学。这项研究构建了植入下颌的微型钢板的有限元分析计算机模型。模型的结构由下颌骨,小板和螺钉组成。此外,外力作用于浅口咬肌,深咬肌,翼状肉,颞前肌,颞中肌和后颞肌模拟to门切牙、,间位置(ICP),右单侧磨牙咬合(RMOL)和右组功能闭塞情况。随后,这项研究观察了这些条件对微型板,螺钉和下颌骨的影响,包括冯·米塞斯应力值。结果表明,该研究评估的所有不同咬合条件都在微型板上施加了高应力。在ICP和RMOL咬合条件下,整个下颌结构承受了很高的应力。靠近骨间隙的近端节段的螺钉承受较高的应力,颊侧的螺钉也承受较高的应力。根据目前的分析,尽管这些数据并非直接从临床实践中获得,有限元分析可以评估不同外力作用下的结果趋势。这项研究的结果建议没有颌间固定的患者应避免使用ICP和RMOL闭塞症。可以将其用作将来的试点研究,以为临床医生提供有关植入生物力学的更多信息。
更新日期:2019-06-02
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