上颌骨功能性修复中骨性支柱重建的生物力学分析

Biomechanical analysis of skeletal buttress reconstruction in maxillary functional reconstruction

目的:建立以腓骨重建上颌骨的三维有限元模型,进行生物力学分析,研究骨性支柱重建在上颌骨功能性修复中的作用。方法:应用MedGraphics、Unigraphics和Ansys8.0软件建立4种腓骨重建上颌骨的三维有限元模型,于双侧后牙区垂直加载,研究上颌骨的应力分布。结果:建立了上颌骨Brown3类缺损的3段式腓骨、2段式腓骨+重建钛板、2段式腓骨+钛网和2段式腓骨+颧种植体重建的三维有限元模型。3段式腓骨重建的应力分布图和应力矢量图与正常上颌骨最为接近,应力分布比较均匀。另3种应力主要位于重建侧上颌骨,并集中于重建结构转折和颧种植体植入颧骨处。结论:有效的上颌骨骨性支柱重建,能使重建后的上颌骨处于比较合理的应力分布状态,更接近于正常的上颌骨。

PURPOSE： To study the role of skeletal buttress reconstruction in maxillary functional reconstruction by constructing three-dimensional finite element model of neomaxilla reconstructed with fibula and performing biomeehanieal analysis. METHODS： Four three-dimensional finite element models of neomaxilla reconstructed with fibula were eonstrneted by softwares of MedGraphies, Unigraphies, and Ansys8.0. Stress distributions and values of reeonstrueted maxilla were studied by application of vertical load on bilateral molar regions. RESULTS： Three-dimensional finite element models of neomaxilla reconstructed with three segment fibula, two-segment fibula and reconstruction plate, two segment-fibula and titanium mesh, and two-segment fibula and zygomatie implant were constructed, respeetively. Stress distribution pattern and stress vector diagram of neomaxilla reconstructed with three-segment fibula were similar to those of normal maxilla. Stress distribution of neomaxilla reconstructed with three-segment fibula was relatively uniform. Stress distributions of neomaxilla reeonstrueted with other three methods were located in reconstructed maxilla and were limited to kick point of reconstruction materials and the anchoring point of zygomatie implant. CONCLUSION： Stress distribution of reconstructed maxilla after effective skeletal buttress reconstruction is relatively reasonable and similar to normal maxilla.