止鼾器矢向/垂直向比例对阻塞性睡眠呼吸暂停低通气综合征患者髁状突应力影响

Effects of sagittal/vertical ratio of snore stopping device on condylar stress in patients with obstructive sleep apnea hypopnea syndrome

目的:构建颞下颌关节三维有限元模型,探究下颌骨矢向/垂直向不同比例对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者髁状突应力的影响,寻找适合患者的下颌前伸止鼾器矢向/垂直向比例。方法:通过构建OSAHS患者颌面部系统的三维有限元模型,模拟下颌骨不同的前伸量和垂直量,分析髁突的应力分布情况。结果:患者的下颌骨左侧髁突在下颌前伸最大量的64%(7.68 mm),开口垂向距离为7 mm时所受最大主应力最小;右侧髁突在下颌前伸最大量的66%(7.92 mm),开口垂向距离为6 mm时所受最大主应力最小。结论:通过对两侧髁突的仿真分析,考虑到左右髁突受力均衡,建议该患者在佩戴下颌前伸止鼾器时下颌矢向位移为最大前伸量的66%,开口垂直距离为6 mm。

Objective To construct a three-dimensional finite element model of the temporomandibular joint for exploring the effects of different mandibular sagittal/vertical ratios on the condylar stress in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and to find a suitable sagittal/vertical ratio of mandibular advancement snore stopping devices for the patients.Methods A three-dimensional finite element model of the maxillofacial system in the OSAHS patient was established for simulating different mandibular advancements and vertical displacements,thereby analyzing the stress distribution of the condyles.Results The maximum principal stress was the smallest when the vertical displacement of left mandibular condyle of the patient was 7.68 mm(64%of the largest mandibular advancement),and the corresponding vertical distance of the opening was 7 mm.The maximum principal stress was the smallest when the vertical displacement of the right mandibular condyle was 7.92 mm(66%of the largest mandibular advancement),and the corresponding vertical distance of the opening was 6 mm.Conclusion Through simulation analysis of the bilateral condyles,considering the balance of force on the left and right condyles,it is recommended that the vertical displacement of the mandibular in the patient should be 66%of the largest mandibular advancement,and the corresponding vertical distance of the opening should be 6 mm.