微型钛板与生物可吸收板在下颌骨骨切开术固定中的应力比较

doi:10.19439/j.sjos.2020.03.003

上海口腔医学 ›› 2020, Vol. 29 ›› Issue (3): 237-241.doi: 10.19439/j.sjos.2020.03.003

微型钛板与生物可吸收板在下颌骨骨切开术固定中的应力比较

韩婧¹, 解东平², 王慧珊¹, 周子疌¹, 刘剑楠¹

1.上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011;
2.江苏时间环三维科技有限公司,江苏南通 226005

收稿日期:2019-09-26 修回日期:2019-12-20 出版日期:2020-06-25 发布日期:2020-07-29
通讯作者: 刘剑楠,E-mail: laurence_ljn@163.com
作者简介:韩婧（1985-）,女,博士,E-mail: hanjing0808@163.com
基金资助:
国家自然科学基金（8190030324）; 上海市卫生系统优秀人才培养计划（2018YQ34）

Comparison of the stress distribution of microtitanium and bioresorbable plates in fixation of mandibulotomy

HAN Jing¹, XIE Dong-ping², WANG Hui-shan¹, ZHOU Zi-jie¹, LIU Jian-nan¹

1. Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Disease; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology. Shanghai 200011;
2. Jiangsu Ouring 3D Technology Co. ,Ltd. . Nantong 226005, Jiangsu Province, China

Received:2019-09-26 Revised:2019-12-20 Online:2020-06-25 Published:2020-07-29

摘要/Abstract

摘要： 目的比较微型钛板和生物可吸收板在下颌骨骨切开术固定中的应力分布。方法建立下颌骨切开术不同内固定系统三维模型,进行三维有限元分析,比较相同加载力条件下,不同植入物的应力分布以及骨折段位移的改变情况。结果钛板上受的最大应力值为49.8 MPa,可吸收板的最大应力值为4.42 MPa;钛板的最大应力值远远超过可吸收板的最大应力值,但所受应力均小于各自的屈服极限。相对移位对比可见,微型钛板固定下颌骨时,最大位移值为0.1 mm;应用可吸收板固定时,最大位移值为0.2 mm,两者的相对位移均较小。结论生物可吸收固定系统的刚度和内部强度足以支持下颌骨切开术部位的骨愈合。

关键词: 钛板, 可吸收板, 下颌骨切开术, 有限元分析

Abstract: PURPOSE: The aim of this study was to compare the stress distribution of microtitanium plate and bioresorbable plates in fixation of mandibulotomy. METHODS: Three dimensional models of different internal fixation systems in mandibular resection were established, and three dimensional finite element analysis was carried out to compare the displacement changes of fracture segments and stress distribution of titanium plates under the same stress conditions. RESULTS: The maximum stress value of titanium plate was 49.8 MPa, and that of absorbable plate was 4.42 MPa. The maximum stress value of titanium plate was far greater than that of absorbable plate. However, all the stresses were less than their yield limits. It can be seen from the relative displacement comparison that when the mini-titanium plate was fixed on the mandible, the maximum displacement value was 0.1 mm; when absorbable plate was used for fixation, the maximum displacement value was 0.2 mm, and the relative displacement of both plates was small. CONCLUSIONS: These results suggest that the stiffness and internal strength of bioabsorbable fixation system are sufficient to support bone healing at the mandible site.

Key words: Titanium plate, Bioresorbable plates, Mandibulotomy, Finite element analysis

中图分类号:

R739.8

韩婧, 解东平, 王慧珊, 周子疌, 刘剑楠. 微型钛板与生物可吸收板在下颌骨骨切开术固定中的应力比较[J]. 上海口腔医学, 2020, 29(3): 237-241.

HAN Jing, XIE Dong-ping, WANG Hui-shan, ZHOU Zi-jie, LIU Jian-nan. Comparison of the stress distribution of microtitanium and bioresorbable plates in fixation of mandibulotomy[J]. Shanghai Journal of Stomatology, 2020, 29(3): 237-241.

参考文献

[1] 王军, 马世红. 舌癌切除术下颌骨旁正中截开入路的探讨[J]. 口腔颌面外科杂志, 2007, 17(4): 349-350.
[2] 黄乃邦, 达鹏, 卢军, 等. 不同下颌骨截骨方式在咽相关区域肿瘤手术中的应用[J]. 山东大学学报(医学版), 2015, 53(8): 79-82.
[3] Cole PD, Kaufman Y, Hatef DA, et al.Optimizing miniplate fixation for simple mandibular fractures[J]. Plast Reconstr Surg, 2009, 123(2): 691-693.
[4] Allal AS, Richter M, Russo M, et al.Dose variation at bone/titanium interfaces using titanium hollow screw osseointegrating reconstruction plates[J]. Int J Radiat Oncol Biol Phys, 1998, 40(1): 215-219.
[5] Yoshioka I, Igawa K, Nagata J, et al.Comparison of material-related complications after bilateral sagittal split mandibular setback surgery: biodegradable versus titanium miniplates[J]. J Oral Maxillofac Surg, 2012, 70(4): 919-924.
[6] Agnihotry A, Fedorowicz Z, Nasser M, et al. Resorbable versus titanium plates for orthognathic surgery [J]. Cochrane Database Syst Rev, 2017,10: CD006204.
[7] Lee HB, Oh JS, Kim SG, et al.Comparison of titanium and biodegradable miniplates for fixation of mandibular fractures[J]. J Oral Maxillofac Surg, 2010, 68(9): 2065-2069.
[8] Stanton DC, Liu F, Yu JW, et al.Use of bioresorbable plating systems in paediatric mandible fractures[J]. J Craniomaxillofac Surg, 2014, 42(7): 1305-1309.
[9] Liu JN, Ong HS, Wang MY, et al.Randomized control trial comparing the titanium osteosynthesis and the biodegradable osteosynthesis in mandibulotomy access[J]. Head Neck, 2019, 41(4): 915-923.
[10] Bujtár P, Sándor GK, Bojtos A, et al.Finite element analysis of the human mandible at 3 different stages of life[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 110(3): 301-309.
[11] Koc D, Dogan A, Bek B.Bite force and influential factors on bite force measurements: a literature review[J]. Eur J Dent, 2010, 4(2): 223-232.
[12] Langenbach GE, Hannam AG.The role of passive muscle tensions in a three-dimensional dynamic model of the human jaw[J]. Arch Oral Biol, 1999, 44(7): 557-573.
[13] Dziegielewski PT, Mlynarek AM, Dimitry J, et al.The mandibulotomy: friend or foe? Safety outcomes and literature review[J]. Laryngoscope, 2009, 119(12): 2369-2375.
[14] Ong HS, Gokavarapu S, Tian Z, et al.Does a mandibular access osteotomy improve survival in pT2 oral tongue cancers? Retrospective study at a single institution[J]. Int J Oral Maxillofac Surg, 2018, 47(3): 289-295.
[15] 邱勋定. 生物可吸收性微型接骨板与微型钛内固定系统对下颌骨骨折稳定性的影响[J].中国组织工程研究, 2015, 19(38): 6155-6160.
[16] 颜光启, 啜文钰, 张然, 等. 可吸收内固定材料在正颌外科中的应用[J]. 中国实用口腔科杂志, 2019, 12(6): 343-346.
[17] Ketola-Kinnula T, Suuronen R, Kontio R, et al.Bioabsorbable plates and screws for fixation of mandibulotomies in ablative oral cancer surgery[J]. J Oral Maxillofac Surg, 2010, 68(8): 1753-1762.
[18] Takahashi N, Kitagami T, Komori T.Behaviour of teeth under various loading conditions with finite element method[J]. J Oral Rehabil, 1980, 7(6): 453-461.
[19] Liu D, Yan B, Lei F, et al.Different sliding mechanics in space closure of lingual orthodontics: a translational study by three-dimensional finite element method[J]. Am J Transl Res, 2019, 11(1): 120-130.
[20] Liu J, Pan S, Dong J, et al.Influence of implant number on the biomechanical behaviour of mandibular implant-retained/supported overdentures: a three-dimensional finite element analysis[J]. J Dent, 2013, 41(3): 241-249.

微型钛板与生物可吸收板在下颌骨骨切开术固定中的应力比较

Comparison of the stress distribution of microtitanium and bioresorbable plates in fixation of mandibulotomy

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	毛懿, 陈旭卓, 覃海艺, 甄锦泽, 邱亚汀, 霍亮, 张善勇. 双侧冠突切除对肋骨-肋软骨移植重建颞下颌关节受力影响的有限元分析[J]. 上海口腔医学, 2022, 31(2): 126-131.
[2]	高远, 陈杰, 王高琦, 李云凯, 卞翠荣. 种植体-基台连接设计对基台与基台螺丝受力影响的三维有限元分析[J]. 上海口腔医学, 2021, 30(5): 481-487.
[3]	邱晓键, 肖善社, 谷雪莲, 朱来宽, 蒋倩. 不同锥度根管锉对根管壁抗折强度的影响[J]. 上海口腔医学, 2020, 29(5): 471-475.
[4]	左书玉, 王璇, 吴海威, 张东升. 不同种植体外形设计对上颌窦提升术后种植体周围应力分布的影响[J]. 上海口腔医学, 2020, 29(4): 355-358.
[5]	陈伟, 房睿. 微型钛板在内固定治疗下颌骨粉碎性骨折中的应用：21例临床分析[J]. 上海口腔医学, 2020, 29(3): 333-336.
[6]	王诗哲, 潘晓岗, 周可拓. 拔牙病例隐形矫治器设计的有限元分析[J]. 上海口腔医学, 2019, 28(3): 264-267.
[7]	朱远兵, 赖光云, 汪俊. 外力方向对防护牙托性能影响的有限元分析[J]. 上海口腔医学, 2018, 27(6): 574-578.
[8]	顾美珍, 徐宏鸣, 陈芳, 李晓艳, 蒋钰钢, 李克勇. 不完全腭裂咽腔三维有限元模型的建立[J]. 上海口腔医学, 2018, 27(6): 591-595.
[9]	韩菡, 许雅芬, 段余峰, 雷勇华. 2种前方牵引装置前牵引唇腭裂患者上颌骨的三维有限元分析[J]. 上海口腔医学, 2017, 26(1): 1-6.
[10]	何淞，陈周艳，杨四维，黄跃. 唇舌侧弓丝力学性能差异的三维有限元分析[J]. 上海口腔医学, 2015, 24(6): 660-666.
[11]	董晶,张哲湛,周国良. 上颌第一磨牙远中移动时牙周膜应力分布的非线性三维有限元分析[J]. 上海口腔医学, 2015, 24(3): 315-320.
[12]	韩丽会,邱晓霞,邢旭娜,蔡留意. 上颌前牙区种植方案中角度设计的三维有限元分析[J]. 上海口腔医学, 2015, 24(2): 157-163.
[13]	张珑,逯宜,杨柏松,郭妍,李芳萍. 不同大小MO洞型复合树脂嵌体修复应力分布的有限元分析[J]. 上海口腔医学, 2015, 24(2): 170-176.
[14]	欧阳少波, 王军, 张洪斌, 廖岚, 朱洪水. 不同肩台宽度的下前牙全瓷联冠的有限元分析[J]. 上海口腔医学, 2014, 23(2): 160-165.
[15]	赵莉, 李丽君, 赵克, 邓旭亮. 不同桩核系统修复上颌第一磨牙的有限元分析[J]. 上海口腔医学, 2013, 22(6): 607-612.