3种提升材料对闭合式上颌窦底提升术上颌窦黏膜形变影响的力学分析

The finite element analysis of deformation of maxillary sinus mucosa when elevated by three lift materials

目的：比较3种提升材料对闭合式上颌窦底提升术上颌窦黏膜形变的影响。方法：在ANSYS有限元分析软件的SHELL 63单元中分别建立0.3 mm厚度上颌窦黏膜与纯钛种植体、自体松质骨、羟基磷灰石骨粉有限元模型,分别计算3种材料提升上颌窦黏膜1-5 mm时黏膜表面Von mises应力值,并进行对照分析。结果：通过对0.3 mm厚度上颌窦黏膜提升1-5 mm的形变与应力分析,发现应用纯钛种植体、自体松质骨与人工羟基磷灰石骨粉3种材料提升上颌窦黏膜,黏膜表面的应变相似,应力值曲线高度重叠,随着高度增加,应力增加的趋势亦基本一致,3种材料对上颌窦黏膜表面应变与应力的影响几乎没有差别。结论：使用松质骨、人工羟基磷灰石骨粉、纯钛种植体抬高上颌窦黏膜对黏膜形变是没有影响的,行闭合式上颌窦底提升手术应用种植体直接提升上颌窦黏膜是相对简易及微创的手术方式,推荐在临床工作中使用。

Objective： To compare the maxillary sinus mucosa＇s stress distribution when elevated by three lift materials. Methods：Three Finite element models of maxillary sinus mucosa with 0. 3 mm thickness elevated by implant,grafting autogenous cancellous bone and hydroxyapatite respectively were established in the specific units. ANSYS finite element analysis software was used to evaluate maxillary sinus mucosa deformation by the simulated closed sinus lift surgery. Differences of Von Mises stress values of mucosa surface were calculated when maxillary sinus mucosa lift height was increased from 1 mm to 5 mm according to the a large deformation theory.Results： The Von Mises stress values on membrane surface elevated by implant,grafting autogenous cancellous bone and hydroxyapatite bone substitute materials showed no difference within 5 mm elevation. Conclusion： Closed maxillary sinus floor lifting operation with implant elevating the maxillary sinus membrane directly is a simple and minimally invasive way for sinus floor elevation.