Biomechanical study on the effect of different traction directions on temporomandibular joint in mandible distraction osteogenesis
10.3760/cma.j.cn114453-20210228-00089
- VernacularTitle:双侧下颌骨牵引成骨术不同牵引方向对颞下颌关节影响的三维有限元分析
- Author:
Yingqiu CUI
1
;
Na ZHANG
;
Siyin ZHOU
;
Yunyan ZHANG
;
Shufan ZHAO
;
Zhe MAO
Author Information
1. 广州市妇女儿童医疗中心口腔颌面外科 510000
- Keywords:
Temporomandibular joint;
Finite element analysis;
Osteogenesis, distraction;
Mandible;
Mandibular distraction vector
- From:
Chinese Journal of Plastic Surgery
2021;37(5):476-485
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the direction of traction that has the least influence on temporomandibular joint (TMJ) during mandibular distraction osteogenesis(MDO).Methods:(1) The three-dimensional finite element model was established after the mandible data were obtained by cone beam computed tomography (CBCT) scanning, and the validity of the model was verified. (2) Based on the verified three-dimensional finite element model, the distraction osteogenesis of mandible was carried out with six different directions. (3) The effects of different traction directions on disc pressure, osteotomy displacement, temporal bone pressure and condylar pressure were measured.Results:(1)In the thinnest area of the articular disc, the direction of the minimum stress on the upper and lower surfaces of the disc was "along the direction of the mandible, parallel to the surface of the mandible" . (2) Under the same load, the displacement of each osteotomy surface along the traction direction was different, but the difference was not big, and the effect was basically the same. (3) "Along the direction of the mandible, parallel to the surface of the mandible" and "along the direction of the mandible and parallel to the sagittal plane" had less pressure on the temporal bone than other situations, and the two directions of traction were parallel to the mandible. After the force decomposition, the direction of the condyle was the smallest, so the pressure on the condyle was smaller.Conclusions:A satisfactory TMJ model can be obtained by DICOM. The traction force of "along the direction of the mandible body, parallel to the surface of the mandible body" and "along the direction of the mandible body and parallel to the sagittal plane" had the least effect on the TMJ. When designing the traction direction of MDO, we should not only consider the influence of surgery on the shape of jaw and upper respiratory tract, but also weigh in the influence of traction direction on the TMJ, and determine the direction of traction which has the least influence on the TMJ.
