不同上颌快速扩张技术对颅面结构影响的比较:有限元分析研究。

IF 4.8 2区 医学 Q1 Dentistry Progress in Orthodontics Pub Date : 2023-03-06 DOI:10.1186/s40510-023-00459-2
Nihal Kaya, Elif Dilara Seker, Türker Yücesoy
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引用次数: 1

摘要

目的:采用有限元法比较3种不同上颌扩展器、5种不同扩展方式对上颌及其邻近颅面结构应力分布和位移的影响。材料与方法:将1例上颌横断缺损患者的锥束计算机断层数据绘制成三维颅颌结构模型。扩展器具包括牙载、混合型和骨载扩展器。每个扩张器采用五种不同的扩张方式[常规快速上颌扩张(RME)(1型),中腭缝合皮质穿刺辅助RME(2型),LeFort 1皮质穿刺辅助RME(3型),手术辅助RME (SARME)不分离翼颌交界处(PMJ)(4型)和双侧PMJ分离的SARME(5型)]。对数值和视觉数据进行了分析。结果:牙源性组和杂交组牙体应力积累量最大。另一方面,骨载组在上颌骨上观察到更多的应力集中。在所有组中,经PMJ分离的SARME切口通过减少对中腭缝线的压力而增加了总运动。类型1、2和3的位移量相似,而类型4和5在所有组中都增加了总位移量。前、后上颌移位总量由最大值到最小值依次为骨载组、牙载组和杂交组。结论:SARME切口能有效降低牙体应力,但皮质穿刺不影响牙体应力值,也不影响牙体扩张器的横向位移。外科手术如SARME和皮质切开术应与骨载装置一起使用,以改善上颌扩张手术的结果。
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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Comparison of the effects of different rapid maxillary expansion techniques on craniofacial structures: a finite element analysis study.

Aim: To compare the effects of three different maxillary expansion appliances with five different types of expansion modalities on stress distribution and displacement on the maxilla and its adjacent craniofacial structures using the finite element method (FEM).

Materials and methods: Cone-beam computed tomography data of a patient with maxillary transverse deficiency were rendered into a three-dimensional model of craniomaxillary structures. The expansion appliances included tooth-borne, hybrid, and bone-borne expanders. Five different expansion modalities were applied to each expander [conventional Rapid Maxillary Expansion (RME) (type 1), midpalatal suture cortico-puncture-assisted RME (type 2), LeFort l cortico-puncture-assisted RME (type 3), surgically assisted RME (SARME) without pterygomaxillary junction (PMJ) separation (type 4), and SARME with bilateral PMJ separation (type 5)]. The numerical and visual data were analyzed.

Results: The highest amount of stress accumulation on teeth was found in the tooth-borne and hybrid groups. On the other hand, more stress concentration on the maxilla was observed in the bone-borne group. SARME cuts with PMJ separation increased total movement by reducing the stress on the midpalatal suture in all groups. While types 1, 2, and 3 were similar in terms of the amounts of displacement, types 4 and 5 increased the total amount of displacement in all groups. The total amounts of displacements from the highest value to the lowest value for the anterior and posterior maxilla were in the bone-borne, tooth-borne, and hybrid groups.

Conclusions: SARME cuts were effective in reducing stress on the teeth, but the cortico-puncture application affected neither the stress values on the teeth nor the transverse displacement in the tooth-borne expanders. Surgical procedures such as SARME and corticotomy should be used with bone-borne devices to improve the outcomes of maxillary expansion procedures.

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来源期刊
Progress in Orthodontics
Progress in Orthodontics Dentistry-Orthodontics
CiteScore
7.30
自引率
4.20%
发文量
45
审稿时长
13 weeks
期刊介绍: Progress in Orthodontics is a fully open access, international journal owned by the Italian Society of Orthodontics and published under the brand SpringerOpen. The Society is currently covering all publication costs so there are no article processing charges for authors. It is a premier journal of international scope that fosters orthodontic research, including both basic research and development of innovative clinical techniques, with an emphasis on the following areas: • Mechanisms to improve orthodontics • Clinical studies and control animal studies • Orthodontics and genetics, genomics • Temporomandibular joint (TMJ) control clinical trials • Efficacy of orthodontic appliances and animal models • Systematic reviews and meta analyses • Mechanisms to speed orthodontic treatment Progress in Orthodontics will consider for publication only meritorious and original contributions. These may be: • Original articles reporting the findings of clinical trials, clinically relevant basic scientific investigations, or novel therapeutic or diagnostic systems • Review articles on current topics • Articles on novel techniques and clinical tools • Articles of contemporary interest
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