口腔医学 ›› 2025, Vol. 45 ›› Issue (11): 832-838.doi: 10.13591/j.cnki.kqyx.2025.11.006

• 基础与临床研究 • 上一篇    下一篇

两种不同方法拔除下颌垂直第三磨牙的三维有限元分析

刘婧怡1,2,3, 朱宇驰1,2,3, 阳胜军1,2,3, 司源1,2,3, 王东苗1,2,3()   

  1. 1 南京医科大学附属口腔医院口腔颌面外科,江苏南京(210029)
    2 口腔疾病研究与防治国家级重点实验室培育建设点,江苏南京(210029)
    3 江苏省口腔转化医学工程研究中心,江苏南京(210029)
  • 收稿日期:2024-12-22 出版日期:2025-11-28 发布日期:2025-11-18
  • 通讯作者: 王东苗 E-mail:wdm9921@njmu.edu.cn
  • 基金资助:
    江苏省社会发展临床前沿科技项目(BE2023833);江苏省科教能力提升工程——江苏省研究型医院建设单位(YJXYYJSDW4);江苏省医学创新中心(CXZX202227);江苏省卫健委科研项目(M2020021)

Two different methods for vertical mandibular third molar extraction: A finite element analysis

LIU Jingyi1,2,3, ZHU Yuchi1,2,3, YANG Shengjun1,2,3, SI Yuan1,2,3, WANG Dongmiao1,2,3()   

  1. Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing 210029, China
  • Received:2024-12-22 Online:2025-11-28 Published:2025-11-18
  • Contact: WANG Dongmiao E-mail:wdm9921@njmu.edu.cn

摘要:

目的 通过构建有限元模型比较小角度旋转脱位法与颊舌向摇晃脱位法在拔除锥形单根高位垂直阻生下颌第三磨牙(智齿)中的生物力学特性差异。方法 选取一位下颌锥形单根高位垂直阻生智齿的志愿者,采集螺旋CT数据,使用MIMICS、Geomagic Wrap、Solidworks等软件构建有限元分析模型,利用ANSYS模拟两种拔牙方法,输出Von-Mises应力以及应变分布,分析比较两种施力方式的生物力学特征。结果 小角度旋转脱位法中,牙、牙周膜、牙槽骨的高应力区及应变区域主要集中在牙颈部及牙根中上1/2,水平向扩散范围广于垂直向扩散范围。颊舌摇晃脱位法中,牙、牙周膜、牙槽骨的高应力区及应变区域主要集中在牙颈部及根尖1/2,尤其是根尖区域,垂直向扩散范围广于水平向扩散范围。小角度旋转脱位法的舌侧骨板及牙槽骨所受的应力远低于颊舌向摇晃脱位法,且牙周膜内部的整体应力值高于颊舌向摇晃脱位法。结论 小角度旋转脱位法较颊舌向摇晃脱位法更易撕裂牙周膜,减少拔牙创伤。

关键词: 有限元, 下颌第三磨牙, 生物力学

Abstract:

Objective To compare the biomechanical characteristics of small-angle rotation force versus traditional buccal-lingual force in the extraction of vertically impacted mandibular third molars with single conical roots by a three-dimensional finite element analysis. Methods A patient with a vertical mandibular third molar featuring a conical single root was selected. Spiral CT data were acquired and three-dimensional finite element analysis models were constructed using software including MIMICS, Geomagic Wrap, and Solidworks. ANSYS was utilized to simulate both the small-angle rotation and buccal-lingual forces for tooth extraction. Comparative analyses of the biomechanical characteristics of these two forces were conducted by measuring Von-Mises stress and strain distribution. Results In the small-anglerotation force, high-stress and strain areas of tooth, periodontal ligament, and alveolar bone were predominantly concentrated at the cervical region and the upper half of the root, with a more uniform distribution and a broader horizontal diffusion range compared to the vertical diffusion range. In the buccal-lingual force, high-stress and strain areas were primarily located at the cervical region and the lower half of the root, particularly at the apical area, with a broader vertical diffusion range compared to the horizontal diffusion range. The lingual cortical plate and alveolar bone experienced significantly lower stress in the small-angle rotation force than that in the buccal-lingual force. The overall stress values within the periodontal ligament were markedly higher in the small-angle rotation force, with a more uniform distribution. Conclusion The small-angle rotation force is more likely to tear the periodontal ligament and reduce trauma associated with tooth extraction compared to the buccal-lingual force in surgical extraction of vertically impacted mandibular third molars with single conical roots.

Key words: finite element analysis, mandibular third molar, biomechanics

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