下颌升支矢状劈开截骨术对颞下颌关节功能影响的生物力学研究

项目名称： 下颌升支矢状劈开截骨术对颞下颌关节功能影响的生物力学研究

项目编号： No.11202143

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 数理科学和化学

项目作者： 刘展

作者单位： 四川大学

项目金额： 28万元

中文摘要： 颌骨畸形影响容貌，并可引发一些功能性病变。下颌升支矢状劈开截骨术（SSRO）是矫治下颌骨畸形的常规手术，术后稳定性和咀嚼功能都优于其他手术。然而SSRO对颞下颌关节（TMJ）功能的影响存在争议，术后髁突位移、颌骨形状和咬合关系的变化会引起TMJ内力学环境的改变，导致TMJ的适应性改建或引发新的颞下颌关节功能紊乱（TMD）症状，而目前缺少相关的生物力学研究。本项目围绕SSRO对TMJ功能的影响展开生物力学研究，包括：1）通过临床检测，研究手术前、后下颌骨畸形患者TMD的症状；2）通过MRI的三维重建，研究手术对TMJ结构的影响；3）采用有限元方法，研究张口和各种咬合工况下关节盘和关节软骨层的接触区域、面积及最大/最小主应力分布与TMD症状的关系，以及SSRO对这些力学参数的影响；4）采用数值模拟手术和有限元方法，研究以上力学参数的分布规律，预测拟定手术方案对TMJ功能的影响，并可优化截骨线。

中文关键词： 下颌升支矢状劈开截骨术；颞下颌关节；颞下颌关节功能紊乱；有限元分析；数值模拟

英文摘要： Maxillofacial deformities are related with unpretty appearance and oral dysfunction. Sagittal split ramus osteotomy (SSRO) is used to treat mandibular deformities with the superior stability and masticatory function. However the effects of SSRO on the function of the temporomandibular joint (TMJ) were controversial. Condylar displacement and the changes of mandibular shape and occlusion after SSRO caused the changes of biomechanics in the TMJs, which induced the adaptive remodeling of TMJ or the additional temporomandibular joint dysfunction (TMD). This project is a biomechanical study about the influence of SSRO on the function of TMJs, which is divided into four aspects. (1) The TMJs of the volunteer patients will be clinically examined to identify TMD symptoms before and after SSRO. (2) According to remodeling of the MRI of the patients, the influence of SSRO on the structure of the TMJs will be analyzed. (3) The finite element models will be developed according to the MRI images of the patients before and after SSRO. The interaction of the discs and the articular cartilages was treated as contact. The loads corresponding to opening mouth and major occlusions, such as centric occlusion, anterior occlusion and unilateral occlusion, will be applied on the models. The effects of SSRO on the contact region betwee

英文关键词： sagittal split ramus osteotomy (SSRO)；temoromandibular joint (TMJ)；temoromandibular joint dysfunction (TMD)；finite element analysis；numerical simulation