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不同下颌畸形患者单侧磨牙咬合时的颞下颌关节应力分析

Temporomandibular joint stress analysis of patients with different mandibular deformities during unilateral molar occlusion.

作者信息

Zheng Chongke, Shu Jingheng, Shao Bingmei, Liu Zhan

机构信息

Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China.

Sichuan University Yibin Park, Yibin Institute of Industrial Technology, Yibin, China.

出版信息

Comput Methods Biomech Biomed Engin. 2024 Jun 4:1-8. doi: 10.1080/10255842.2024.2361778.

Abstract

Mandibular prognathism, retrusion and deviation are common mandibular deformities. They can lead to functional and aesthetic problems due to their important role in the oral system. Different from other occlusions, unilateral molar occlusion often occurs during mastication, which has a deep impact on the functions of temporomandibular joints (TMJs). Therefore, the study of unilateral molar occlusion is of great importance and significance to the daily life of patients with mandibular deformities. A total of 35 individuals were involved in this study, including 11 asymptomatic subjects, 10 patients with mandibular prognathism, 5 patients with mandibular retrusion and 9 patients with mandibular deviation. Finite element (FE) models corresponding to the unilateral molar occlusion were constructed. During unilateral molar occlusion, mandibular deformity increases the pressure on the condyle and articular disc. Compared with mandibular protrusion or retraction, facial asymmetry will significantly increase the stress of TMJ. Chewing on the non-deviated side also will lead to higher stress in the TMJ of patients with mandibular deviation. Therefore, patients with mandibular deviation have the highest risk of temporomandibular disorder (TMD), and it is recommended that patients with mandibular deviation chew bilaterally or with the deviated side.

摘要

下颌前突、后缩及偏斜是常见的下颌骨畸形。由于它们在口腔系统中起着重要作用,可导致功能和美观问题。与其他咬合情况不同,单侧磨牙咬合常在咀嚼时发生,对颞下颌关节(TMJ)的功能有深远影响。因此,研究单侧磨牙咬合对下颌骨畸形患者的日常生活具有极其重要的意义。本研究共纳入35名个体,包括11名无症状受试者、10名下颌前突患者、5名下颌后缩患者和9名下颌偏斜患者。构建了与单侧磨牙咬合相对应的有限元(FE)模型。在单侧磨牙咬合过程中,下颌骨畸形会增加髁突和关节盘上的压力。与下颌前突或后缩相比,面部不对称会显著增加颞下颌关节的应力。在下颌偏斜患者中,在非偏斜侧咀嚼也会导致颞下颌关节的应力更高。因此,下颌偏斜患者患颞下颌关节紊乱病(TMD)的风险最高,建议下颌偏斜患者双侧咀嚼或用偏斜侧咀嚼。

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