摘要
背景:目前国内外制作的颞下颌关节假体在置换过程中需要依靠螺钉固定假体中的髁突部分,通过预留固位孔方便术中进行操作,但由于缺少个性化的颌骨设计,可能存在固位板与颌骨不贴合导致螺钉松动、脱位。因此,个性化髁突假体置换在修复颞下颌关节中具有重要的应用价值。目的:设计一种内部为GYROID结构的个性化髁突假体,用于下颌骨髁突的修复重建。方法:在Rhinoceros 7软件中选择GYROID结构,单胞为6 mm,设置壁厚分别为0.2,0.3,0.4,0.5,0.6,0.7,0.8 mm,利用有限元分析GYROID结构的力学性能。3D打印不同壁厚(0.2,0.3,0.4,0.5,0.6,0.7,0.8 mm)的GYROID结构实验试件,通过室温压缩实验检测试件的力学性能。通过有限元分析与室温压缩实验结果筛选符合下颌骨力学性能范围的一个壁厚值,对1名成年男性下颌骨CT数据进行逆向建模,设计内部为GYROID结构的髁突假体,采用有限元分析模拟髁突假体置换后牙尖交错颌位与对刃颌位的运动。结果与结论:(1)有限元分析与室温压缩实验结果显示,随着壁厚的增大,GYROID结构的弹性模量增大,其中壁厚0.5-0.7 mm GYROID结构的弹性模量位于下颌骨的弹性模量(1.5-4.0 GPa)范围内,因此选取壁厚值0.6 mm的6 mm单胞GYROID结构模型进行髁突假体的设计;(2)有限元分析结果显示,下颌骨模型的应力分布呈左右对称,两种咬合时的应力分布大致相同,应力峰值无较大差距,应力集中于髁突假体颈部,置换侧受力较健侧略大;内固定模型整体的最大等效应力为269.34 MPa,螺钉的最大等效应力为20.14 MPa,牙尖交错颌位时假体的等效应力和等效应变值均大于对刃颌位时,牙尖交错颌位时螺钉的等效应力和等效应变值均小于对刃颌位时;(3)结果显示个性化GYROID结构髁突假体的设计与固位效果良好,符合下颌骨力学传导。
BACKGROUND:Currently,the mandibular joint prosthesis manufactured at home and abroad needs to rely on screws to fix the condylar part of the prosthesis during the replacement process,and the retention hole is reserved to facilitate the operation during the operation.However,due to the lack of personalized jaw design,the reattachment plate may not fit the jaw,resulting in screw loosening and dislocation.Therefore,personalized condylar prosthesis replacement is of great value in the repair of the temporomandibular joint.OBJECTIVE:To design a personalized condylar prosthesis with an internal GYROID for mandibular condylar repair and reconstruction.METHODS:The GYROID structure was selected in the Rhinoceros 7 software with the single cell size of 6 mm and the wall thickness of 0.2,0.3,0.4,0.5,0.6,0.7,0.8 mm.The mechanical properties of the GYROID structure were analyzed by finite element method.3D printing of GYROID structural test specimens with different wall thickness(0.2,0.3,0.4,0.5,0.6,0.7,and 0.8 mm)was performed to test the mechanical properties of the specimens through room temperature compression experiments.A wall thickness value conforming to the range of mandibular mechanical properties was selected through finite element analysis and room temperature compression test results.An adult male mandibular CT data were used for inverse modeling to design a condylar prosthesis with an internal GYROID.Finite element analysis was used to simulate the movement of the apical staggered position and the opposite-blade jaw position after condylar prosthesis replacement.RESULTS AND CONCLUSION:(1)The results of finite element analysis and room temperature compression experiment showed that the elastic modulus of the GYROID structure increased with the increase of wall thickness.The elastic modulus of the GYROID structure with wall thickness of 0.5-0.7 mm was within the range of the elastic modulus of the mandible(1.5-4.0 GPa).Therefore,the 6 mm monocellular GYROID structural model with a wall thickness of 0.6 mm was selected for the design of the condylar prosthesis.(2)The results of finite element analysis showed that the stress distribution of mandibular model was symmetrical.The stress distribution of the two types of occlusion was roughly the same,and the stress peak was not significantly different.The stress concentrated in the neck of the condylar prosthesis,and the stress on the replacement side was slightly larger than that on the healthy side.The maximum equivalent stress of the whole internal fixation model was 269.34 MPa,and the maximum equivalent stress of the screw was 20.14 MPa.The equivalent stress and equivalent strain values of the prosthesis were greater than that of the opposite edge jaw position when the tooth tip was interlaced.The equivalent stress and equivalent strain values of the screw were smaller than that of the opposite edge jaw position when the tooth tip was interlaced.(3)The results showed that the design and retention of the personalized GYROID condylar prosthesis were good,which was consistent with the mechanical conduction of the mandible.
作者
刘丹瑜
姜婷婷
姜至秀
季俣辰
曹怡琳
王磊
宿玉成
王心彧
Liu Danyu;Jiang Tingting;Jiang Zhixiu;Ji Yuchen;Cao Yilin;Wang Lei;Su Yucheng;Wang Xinyu(Jiamusi University,Jiamusi 154000,Heilongjiang Province,China;Stomatological Hospital,Jiamusi University,Jiamusi 154000,Heilongjiang Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2025年第17期3548-3556,共9页
Chinese Journal of Tissue Engineering Research
基金
黑龙江省自然科学基金项目(LH2022H098)
项目负责人:王心彧。
关键词
髁突置换
髁突假体
GYROID结构
三周期极小曲面
有限元分析
condylar replacement
condylar prosthesis
GYROID structure
three-cycle minimal surface
finite element analysis
