Biomechanical effects of mandibular deviation on the temporomandibular joint in patients with mandibular prognathism under incisal occlusion.

IF 2.2 3区医学 Q2 Dentistry Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-09-30 DOI:10.1016/j.jormas.2024.102100

Fei Chen, Bingmei Shao, Zhan Liu

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Abstract

Purpose: The aim of this study was to investigate the biomechanical effects of mandibular deviation on the TMJ in patients with mandibular prognathism before and after orthognathic surgery using three-dimensional finite element analysis.

Methods: Eight patients with mandibular prognathism without deviation, eight patients with mandibular prognathism with deviation and sixteen normal subjects were recruited. Three-dimensional models of the maxillofacial were reconstructed using MIMICS. Nine muscle forces were used to simulate incisal occlusion and contact was used to simulate fossa-disc-condyle interactions.

Results: Before surgery, the stress in the TMJ was generally greater in the Pre-MD&MP group than in the Pre-MD group; it was much greater in both groups than in the control group, ranging from about 2 to 12 times as great in the Pre-MD group and from about 5 to 64 times as great in the Pre-MD&MP group. After orthognathic surgeries, the stresses in the Post-MP&MD were significantly reduced by approximately 21.7 % to 93.4 %. And in the Post-MP group, the stresses were reduced by approximately 1.4 % to 51.1 %.

Conclusion: Mandibular deviation exacerbated the abnormal stress distribution in the TMJ of patients with mandibular prognathism. Orthognathic surgeries could improve the stress distribution in patients with mandibular prognathism (with and without deviation). TMD was closely related to the stress levels of the TMJ.

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下颌前突患者在切口咬合时下颌偏斜对颞下颌关节的生物力学影响。

目的：本研究旨在使用三维有限元分析法研究下颌前突患者在正颌手术前后下颌偏斜对颞下颌关节的生物力学影响：方法：招募 8 名无偏斜下颌前突患者、8 名有偏斜下颌前突患者和 16 名正常人。使用 MIMICS 重建了颌面部的三维模型。九种肌肉力量用于模拟切牙咬合，接触力用于模拟窝-盘-髁相互作用：手术前，颞下颌关节的应力在MD&MP前组中普遍大于MD前组；两组的应力均远大于对照组，MD前组的应力约为对照组的2至12倍，MD&MP前组的应力约为对照组的5至64倍。正颌手术后，MP&MD 术后组的压力明显降低了约 21.7% 至 93.4%。结论：结论：下颌前突患者的颞下颌关节应力分布异常，而下颌前突偏移会加剧这种异常。正颌手术可以改善下颌前突患者（有偏斜和无偏斜）的应力分布。TMD 与颞下颌关节的应力水平密切相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stomatology Oral and Maxillofacial Surgery Dentistry-Oral Surgery

CiteScore

2.20

自引率

9.10%

发文量

305

期刊介绍： J Stomatol Oral Maxillofac Surg publishes research papers and techniques - (guest) editorials, original articles, reviews, technical notes, case reports, images, letters to the editor, guidelines - dedicated to enhancing surgical expertise in all fields relevant to oral and maxillofacial surgery: from plastic and reconstructive surgery of the face, oral surgery and medicine, … to dentofacial and maxillofacial orthopedics. Original articles include clinical or laboratory investigations and clinical or equipment reports. Reviews include narrative reviews, systematic reviews and meta-analyses. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey Platforms.