CAJ | 학술논문

目的运用三维有限元的方法对应用不同数目的"L"形、直形四孔小型接骨板在上颌骨LeFort Ⅰ型骨折不同部位固定的稳定性进行生物力学分析,为临床治疗提供指导.方法建立LeFort Ⅰ型骨折小型钛板四种固定方式的三维有限元模型;计算不同固定方法在三种咬合情况下上颌骨的应力、内固定系统的应力以及骨折段的位移,对比其固定效果以及不同咬合情况对固定稳定性的影响.结果在相同咬合情况下,内固定系统的应力与骨折段位移从小到大的排列顺序均为:颧上颌和鼻上颌支柱以"L"形钛板固定,颧上颌和鼻上颌支柱以直形钛板固定,颧上颌支柱以"L"形钛板固定,鼻上颌支柱以"L"形钛板固定;相同固定方式下,骨折处位移从大到小排列顺序为:磨牙咬合、前磨牙咬合、前牙咬合.结论上颌骨LeFortⅠ型骨折应用"L"形钛板固定稳定性好于直形钛板;颧上颌支柱固定效果好于鼻上颌支柱固定;仅应用2块小型钛板固定存在隐患;磨牙咀嚼不利于骨折的愈合.
목적 운용삼유유한원적방법대응용불동수목적"L"형、직형사공소형접골판재상합골LeFort Ⅰ형골절불동부위고정적은정성진행생물역학분석,위림상치료제공지도.방법 건립LeFort Ⅰ형골절소형태판사충고정방식적삼유유한원모형;계산불동고정방법재삼충교합정황하상합골적응력、내고정계통적응력이급골절단적위이,대비기고정효과이급불동교합정황대고정은정성적영향.결과 재상동교합정황하,내고정계통적응력여골절단위이종소도대적배렬순서균위:권상합화비상합지주이"L"형태판고정,권상합화비상합지주이직형태판고정,권상합지주이"L"형태판고정,비상합지주이"L"형태판고정;상동고정방식하,골절처위이종대도소배렬순서위:마아교합、전마아교합、전아교합.결론 상합골LeFortⅠ형골절응용"L"형태판고정은정성호우직형태판;권상합지주고정효과호우비상합지주고정;부응용2괴소형태판고정존재은환;마아저작불리우골절적유합.
Objective To biomechanically study the fixation stability of different numbers and shapes of the titanium miniplates (L-shaped and straight four-hole miniplates) in the treatment of maxillary LeFortⅠ fracture by using three-dimensional finite element method so as to provide reference for clinical treatment of the fractures. Methods Three-dimensional finite element model of maxillary LeFortⅠ fracture was established with four kinds of rigid internal fixation (RIF) methods to calculate the stress of the maxilla and the RIF as well as the displacement of the fracture segment under three kinds of occlusion.Then, the fixation stability of different methods was compared. Results Under the same occlusion condition, the decreasing order of the displacement of the fracture segment was the L-shaped plate fixation at both buttress of the maxillary and nasal maxillary zygomatic, the straight four-hole miniplates fixation at both buttress of the maxillary and nasal maxillary zygomatic, the L-shaped plate fixation at the zygomatic maxillary buttress and the L-shaped plate fixation at naso-maxillary buttress. Under the same fixation method, the decreasing order of the displacement of the fracture segment was molar occlusion, premolar oeclusion and incisor occlusion. Conclusions The fixation stability of the L-shaped plate fixation is better than the straight four-hole miniplate fixation for the treatment of LeFortⅠ fracture. Fixation at the zygomaticmaxillary buttress is better than at the naso-maxillary buttress. Use of only two miniplates to fix the LeFort Ⅰ fracture may not be stable. Molar occlusion is not good for fracture healing.