扩弓器种类及位置对双侧完全性唇腭裂扩弓生物力学影响的有限元分析

doi:10.13591/j.cnki.kqyx.2025.11.011

摘要/Abstract

摘要：

目的采用有限元分析法比较扩弓器种类及位置对替牙期双侧完全性唇腭裂(bilateral complete cleft lip and palate, BCCLP)牙弓狭窄患者扩弓效果的影响,并探讨上颌复合体的生物力学效应。方法收集双侧完全性唇腭裂患者头颅三维螺旋CT数据信息,构建含骨缝结构的双侧完全性唇腭裂有限元模型,在SolidWorks中绘制扇形扩弓器及传统Hyrax扩弓器,并装配至有限元模型中。工况如下:工况1、2,扇形扩弓器分别置于上腭前部、后部;工况3、4,Hyrax扩弓器分别置于上腭前部、后部。在扩弓器螺簧顶点沿X轴方向加载5 N的力,比较4种工况中上颌牙槽骨前中后段的应力分布及位移规律。结果 ①工况1、2、3均可为牙弓前部提供大于后部的扩弓量;工况4前后扩弓量基本一致;②均在2种扩弓器放置对应的牙冠处观察到最大应力和位移;③骨性扩弓效应表现为从牙槽区向上呈逐渐递减的形变趋势。结论与传统Hyrax扩弓器相比,扇形扩弓器对于前部牙弓严重狭窄(矫治器无足够放置空间)而后部牙弓基本正常的替牙期双侧完全性唇腭裂患者具有优势;对于传统Hyrax扩弓器,位置对扩弓效果影响较大;在本研究模型中,使用牙支持式扩弓器可对替牙期双侧完全性唇腭裂患者上颌骨产生一定的骨性扩弓效应。

关键词: 有限元分析, 上颌扩弓, 双侧完全性唇腭裂, 扇形扩弓器, Hyrax扩弓器

Abstract:

Objective To investigate the different biomechanical effects of two types of palatal expanders and expansion sites on a bilateral complete cleft lip and palate (BCCLP) in mixed dentition with a finite element analysis (FEA). Methods The CBCT data of a patient with BCCLP were collected to construct a FEA model containing craniomaxillary suture structure. The fan-shaped and traditional Hyrax expanders were drawn and assembled into the FEA model in SolidWorks software according to the working conditions as follows: condition 1 and 2, the fan-shaped expander was placed at the anterior/posterior part of the palate respectively;condition 3 and 4, the Hyrax expander was placed at the anterior/posterior part of the palate respectively. A 5 N force in X axis direction was loaded at the apex of the expander coil spring. The stress distribution and initial displacement of craniomaxillary complex in four working conditions were compared. Results ①In working condition 1, 2 and 3, the displacement of anterior part was larger than the posterior part of the dental arch. Under condition 4, the displacement of anterior, middle and posterior parts of dental arch were basically the same. ②The maximum stress and displacement were observed at crowns in all working conditions. ③There was a certain skeletal enlargement effect, which showed a gradually decreasing deformation trend from alveolar region to the upward region. Conclusion The expansion effect of fan-shaped expander is more suitable for BCCLP patients with extremely narrow anterior arch and normal posterior arch. For the traditional Hyrax expander, the position has a great influence on expansion effect. It is showed that the dental support expander could produce skeletal dilation effect in BCCLP patients during mixed dentition.

Key words: finite element analysis, palatal expansion, bilateral complete cleft lip and palate, fan-shaped expander, Hyrax expander

中图分类号:

R783.5

姚品伊, 王宏扬, 王明月, 张红闯. 扩弓器种类及位置对双侧完全性唇腭裂扩弓生物力学影响的有限元分析[J]. 口腔医学, 2025, 45(11): 858-864.

YAO Pinyi, WANG Hongyang, WANG Mingyue, ZHANG Hongchuang. A finite element analysis of bilateral complete cleft lip and palate during expansion with variable types and locations of the expander[J]. Stomatology, 2025, 45(11): 858-864.

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参考文献 34

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材料	杨氏模量/MPa	泊松比
松质骨	8.00×10³	0.30
密质骨	1.36×10⁴	0.30
骨缝	10.00	0.49
牙	2.07×10⁴	0.30
牙周膜	0.49	0.45
不锈钢装置	2.14×10⁵	0.30

观测点		总位移				X轴方向位移绝对值				Y轴方向位移绝对值				Z轴方向位移绝对值
观测点		工况1	工况2	工况3	工况4	工况1	工况2	工况3	工况4	工况1	工况2	工况3	工况4	工况1	工况2	工况3	工况4
牙弓	DC	2.41	2.04	3.15	3.41	2.37	2.01	2.75	3.15	0.31	0.26	1.31	0.86	0.31	0.23	0.80	0.98
	FP	2.15	1.79	2.71	3.44	2.11	1.72	2.69	3.19	0.24	0.31	0.25	0.87	0.34	0.39	0.21	0.95
	DM	2.04	1.65	2.65	3.47	1.96	1.62	2.61	3.22	0.35	0.21	0.16	0.91	0.44	0.23	0.43	0.91
	PM	1.44	1.24	2.16	3.52	1.38	1.18	2.10	3.18	0.35	0.24	0.28	0.96	0.22	0.30	0.42	1.16
牙槽	DCB	2.01	1.98	3.05	3.11	1.92	1.89	2.68	2.99	0.35	0.27	1.11	0.59	0.48	0.52	0.94	0.62
	DCL	2.08	2.01	3.11	3.16	2.04	1.93	2.73	2.86	0.30	0.31	0.89	0.72	0.27	0.47	1.19	1.13
	FPB	2.08	1.70	2.64	3.18	1.90	1.67	2.34	2.79	0.54	0.26	0.69	0.94	0.65	0.18	1.01	1.20
	FPL	2.09	1.73	2.67	3.19	1.96	1.65	2.41	2.83	0.58	0.31	0.58	0.91	0.44	0.41	0.99	1.16
	DMB	1.93	1.58	2.23	3.17	1.85	1.49	2.12	2.84	0.27	0.33	0.54	0.86	0.48	0.41	0.43	1.12
	DML	1.98	1.60	2.25	3.18	1.89	1.58	2.18	2.71	0.38	0.22	0.28	1.11	0.45	0.12	0.48	1.24
	PMB	1.35	1.16	2.08	2.94	1.26	1.14	2.01	2.78	0.31	0.18	0.22	0.48	0.37	0.12	0.49	0.83
	PML	1.39	1.21	2.11	2.97	1.34	1.16	1.86	2.78	0.25	0.26	0.56	0.37	0.27	0.22	0.82	0.98