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目的仿真分析不同工况下推杆式矫治器(Forsus)前导下颌后髁突应力、位移的分布变化,为Forsus临床应用提供参考。方法经Abaqus6.5软件构建Forsus前导下颌三维有限元模型,模拟下颌水平前伸距离分别为3、4、5、6、7 mm,对应下颌垂直打开距离为4、3.5、3、2.5、2 mm的5种重建工况,分析“下颌骨-颞下颌关节”的应力、位移变化和旋转趋势,以评估髁突生长改建的重建方式。结果 5种工况下,最大应力分布在下颌骨髁突、乙状切迹区和髁突颈后份区域。随下颌水平前导的位移量增加,髁突乙状切迹区和髁突颈后份区域应力较缓增大,但仍处于相同数量级(30 MPa);髁突区域应力分布较稳定且没有明显的应力集中。从工况1～5髁突水平方向位移逐渐增大,方向皆向前;髁突垂直向位移平均值也逐渐增大,方向皆向下;下颌骨直接拉伸到指定重建位置时,髁突运动方向也为前下。结论生理性咬合重建的范围,不同程度地前导下颌不会改变髁突软骨附近的应力分布趋势。考虑颞下颌关节生理承受性,严重下颌后缩时可分段前伸以利于髁突生长改建。
Objective To simulate and analyze the distribution of stress and displacement of the mandibular condylar mandibular foramen under different working conditions in order to provide a reference for the clinical application of Forsus. Methods The Forsus mandibular three-dimensional finite element model was constructed by Abaqus 6.5 software. The simulation results showed that the mandibular horizontal advancement distances were 3, 4, 5, 6 and 7 mm respectively, corresponding to the vertical open distances of 4, 3.5, 3, 2.5 and 2 mm Of the five kinds of reconstruction conditions, analysis of the “mandible - temporomandibular joint,” the stress, displacement and rotation trends in order to assess the reconstruction of the condylar reconstruction of reconstruction method. Results Under the five conditions, the maximum stress was distributed in mandibular condyles, sigmoid notch and posterior condyles. With the increase of mandibular horizontal displacement, the stress in the condylar sigmoid notch area and the posterior condylar neck area increased slowly, but still in the same order of magnitude (30 MPa). The stress distribution in the condylar area was stable with no significant Stress concentration. From the condition 1 to 5, the displacement of condyles gradually increased in the direction of forward; the average vertical condylar displacement also gradually increased, the direction is downward; mandibular direct stretching to the designated reconstruction position, the condylar Movement is also front and down. Conclusions Physiological occlusion reconstruction range, leading to different degrees of mandibular mandibular condylar cartilage will not change the stress distribution trends. Consider the temporomandibular joint physiological tolerance, severe mandibular retrusion can be segmented to facilitate condylar growth reconstruction.