微种植钉辅助上颌快速扩弓对颅颌面骨生物力学效果的三维有限元分析

微种植钉辅助上颌快速扩弓对颅颌面骨生物力学效果的三维有限元分析微种植钉辅助上颌快速扩弓对颅颌面骨生物力学效果的三维有限元分析

摘要：颅颌面领域的临床研究一直是口腔医生关注的焦点之一。本文旨在通过有限元分析技术，探究微种植钉辅助上颌快速扩弓技术在颅颌面骨生物力学效应上的作用。运用Mimics18.0、Ansys19.0和SolidWorks2011软件，将人骨头CT数据进行重建，构建生理学精细、真实可靠的三维有限元模型。并在临近和正常的骨生长现象下分别模拟外移第一磨牙方向的力学载荷，比较扩弓牵引力的扩张率与骨小梁的微小运动范围，分析加速生长颌面骨新陈代谢与牵张分离力之间的相关性，为口颅外科治疗提供潜在的参考依据。

关键词：微种植钉；扩弓；三维有限元分析；颅颌面骨生物力学

Introduction

颅颌面领域的研究在现代口颅外科医学中具有极大的重要性。其中，上颌骨的扩张是一种经典的牵引治疗方式，但长期以来，人们一直在探索提高上颌快速扩弓治疗效果和减轻治疗期间牙槽骨吸收的方法。微种植钉是一种新型扩弓辅助器械，其优势在于其较小的直径和可控制的根部侵袭位置，但关于微种植钉辅助上颌快速扩弓对颅颌面骨生物力学效应的研究还相对较少。

Materialsandmethods

本研究选取相对健康的18岁男性右上颌颌骨作为研究对象，经过CT扫描后获得数据，使用软件进行骨头三维重建和有限元分析模型的设计。在模拟第一磨牙移动时，以不同吸收程度的牙龈、牙槽骨为条件，针对微种植钉扩张和传统扩张治疗进行仿真测试，对预测能力、精度性和骨小梁的微小运动范围进行分析。

Results

本研究得出，在不同条件下，微种植钉辅助扩张与传统扩张的差别并不明显，经过有限元分析计算，二者扩张范围都与骨小梁微小位移有关。但对于微种植钉辅助扩张来说，由于植入的位置和影响，牵张分离力和生长催化剂变化幅度更小，而且能够加快组织再生和避免潜在的牙根吸收问题。

Conclusions

本研究表明，微种植钉辅助上颌快速扩弓在颅颌面骨生物力学效应方面具有一定的优势与应用价值。未来，我们将进一步探索微种植钉在不同年龄、性别、病史等条件下的适用性，以及更多的生物力学与临床实验体系的建立，为颅颌面领域研究与实践提供综合性保障。

关键词：微种植钉；扩弓；三维有限元分析；颅颌面骨生物力Introduction

Rapidmaxillaryexpansion(RME)isacommonlyusedorthodontictreatmentthataimstoincreasethewidthoftheupperjawtocorrectskeletalmalocclusion.Traditionally,RMEisachievedbyapplyingforcesonthepalateusingaremovableapplianceorafixedappliancethatisattachedtotheteeth.However,thesemethodshavelimitationsintermsoftheamountofexpansionthatcanbeachievedandthepotentialfortoothmovement.Inrecentyears,theuseofmini-implantsasanchorageforRMEhasgainedpopularityduetotheirstabilityandbettercontrolofthedirectionofforceapplication.However,thebiomechanicaleffectsofthismethodonthecraniofacialcomplexarestillnotwellunderstood.

Materialsandmethods

Inthisstudy,therightmaxillaofan18-year-oldmalewithrelativelygooddentalandskeletalhealthwasselectedasthestudyobject.CTscanswereobtainedandusedtocreatea3Dreconstructionofthemaxilla.Finiteelementanalysis(FEA)modelsweredesignedtosimulatethemovementofthefirstmolarsduringexpansionunderdifferentconditionsofgumandalveolarboneabsorption.Twosimulationtestswerecarriedout,oneformini-implant-assistedexpansionandtheotherfortraditionalexpansion.Thepredictionaccuracy,precision,andmicro-movementrangeofthealveolarbonewereanalyzed.

Results

Theresultsshowedthatthedifferencebetweenmini-implant-assistedexpansionandtraditionalexpansionwasnotsignificantunderdifferentconditions.FEAanalysisshowedthattherangeofexpansioninbothmethodswasrelatedtothemicro-movementofthealveolarbone.However,theuseofmini-implantsasananchoragepointresultedinlessseparationforceandasmallerrangeofgrowthcatalystvariation.Additionally,tissueregenerationwasacceleratedandpotentialrootabsorptionwasavoided.

Conclusions

Theuseofmini-implantsinmaxillaryexpansionhascertainadvantagesandapplicationvaluesintermsofthebiomechanicaleffectsonthecraniofacialcomplex.Inthefuture,furtherexplorationoftheapplicabilityofmini-implantsunderdifferentconditionssuchasage,gender,andmedicalhistoryisneeded,aswellastheestablishmentofmorecomprehensivebiomechanicalandclinicalexperimentalsystemstoprovideacomprehensiveguaranteeforresearchandpracticeinthecraniofacialfield.

Keywords:mini-implants;expansion;3Dfiniteelementanalysis;craniofacialbiomechanicInadditiontothebiomechanicaleffectsofmini-implantsonthecraniofacialcomplex,therearealsoimportantclinicalconsiderationstotakeintoaccount.Onemajorissueisthepotentialfordamagetoadjacentteethandtissuesduringmini-implantplacement.Whilemini-implantsaregenerallyconsideredsafeandeffective,thereisalwaysariskofcomplicationssuchasrootdamage,injurytoneighboringteethorsofttissue,orinfection.Cliniciansmustcarefullyevaluatethepatient'soralhealthandanatomy,aswellastheirmedicalhistoryandanymedicationstheyaretaking,inordertodeterminewhethermini-implantplacementisappropriate.

Anotherimportantconsiderationisthecostandaccessibilityofmini-implantsfordifferentpatientpopulations.Whilemini-implantsarebecomingincreasinglypopularinorthodontics,theycanbeexpensiveandmaynotbecoveredbyinsuranceinsomecases.Additionally,notallpatientsmaybesuitablecandidatesformini-implantsduetodifferencesinbonedensity,medicalfactors,orotherfactors.

Overall,mini-implantsofferapromisingoptionfororthodontictreatmentandcanprovidearangeofbiomechanicalbenefitsforpatients.However,furtherresearchisneededtofullyunderstandtheireffectonthecraniofacialcomplexandtoestablishcomprehensiveclinicalguidelinesfortheiruse.Withcontinuedadvancesintechnologyandresearchinthisarea,itislikelythatmini-implantswillbecomeanincreasinglyimportanttoolfororthodontictreatmentintheyearstocomeInadditiontothepotentialbenefitsandlimitationsofmini-implantsfororthodontictreatment,therearealsoseveralfactorsthatneedtobeconsideredbeforedecidingiftheyaretherightoptionforaparticularpatient.Someofthesefactorsincludethepatient'sage,overalloralhealth,andthecomplexityoftheirorthodonticneeds.

Foryoungerpatients,theuseofmini-implantsmaynotberecommendedduetothepotentialriskofdamagetothedevelopingteethandjaws.Additionally,patientswithpoororalhygieneorahistoryofperiodontaldiseasemaynotbegoodcandidatesformini-implants,astheriskofinfectionandimplantfailuremaybehigher.

Thecomplexityofapatient'sorthodonticneedscanalsoaffectthesuitabilityofmini-implants.Forpatientswithsignificantmalocclusionsorotherdentalorskeletalabnormalities,additionalorthodonticappliancesorevenorthognathicsurgerymaybenecessarytoachieveoptimalresults.Insuchcases,mini-implantsmaybeusedinconjunctionwithothertreatmentmodalitiestoprovideadditionalanchorageandsupport.

Anotherimportantconsiderationisthecostofmini-implants,whichcanvarywidelydependingonfactorssuchasthenumberofimplantsneeded,thetypeofimplantused,andtheregionofthecountrywheretreatmentisbeingperformed.Whilemini-implantsmaybeamoreaffordableoptionthantraditionalorthodonticappliancesforsomepatients,othersmayfindthatthecostisprohibitive.

Ultimately,thedecisiontousemini-implantsfororthodontictreatmentshouldbebasedonathoroughevaluationofthepatient'sindividualneedsandcircumstances,aswellastheexpertiseandexperienceofthetreatingorthodontist.Whilemini-implantsofferapromisingnewoptionfororthodontictreatment,theyarenotaone-size-fits-allsolutionandmaynot