摘要
背景:上颌窦内提升术往往在盲视下操作,很难判断上颌窦黏膜的完整性,也不清楚上颌窦底形态是否会影响上颌窦内提升窦底冲顶过程。目的:通过建立不同上颌窦底形态的上颌窦区域及冲顶器的三维有限元模型,了解窦底形态对上颌窦内提升术窦底提升安全性与效率的影响。对象:男性志愿者1名,45岁,全口牙列完整,牙周组织健康,上颌窦底形态为浅凹形。采用16排螺旋CT获取数据重建三维有限元模型。设计、时间及地点:重复观察测量,于2007-05/10在上海大学快速制造中心完成。方法:利用逆向工程建立了浅凹形、深凹形和凸形窦底形态的上颌窦区域三维有限元模型。模拟上颌窦内提升手术,在窦底部位施加动态冲击载荷进行窦底提升。主要观察指标:分析窦底冲顶时冲顶器、窦底骨质及黏膜的应力和位移情况。结果:深凹形的上颌窦底进行提升时效率最高、风险较小,而凸形上颌窦底形态应力分散的作用较强,提升效率最低,而且黏膜上张力增加,不利于上颌窦底的提升。结论:三种不同的上颌窦底形态中,凹形上颌窦底提升时黏膜上张力增加对内提升术有着不利的影响,凸形上颌窦底提升效率最低。
BACKGROUND： Internal sinus floor elevation is always performed blindly, so it is difficult to identify the integrity of maxillary sinus mucosa, or whether the appearance of sinus floor may influence the surgery process. OBJECTIVE： To establish 3D finite element model of maxillary sinus and bone condenser, and to investigate the influence of different configurations of maxillary sinus floor on the security and efficiency during internal sinus floor elevation. DESIGN, TIME AND SETTING： Repetitive observation and measurements were performed at Rapid Prototyping Center of Shanghai University from May to October 2007. PARTICIPANT： One 45-year-old male volunteer with intact dentition, healthy dental capsule, and dimple maxillary sinus floor. Sixteen-lead spiral CT was used to acquire the data for reconstruction of 3D finite element models. METHODS： 3D finite element models of maxillary sinus with shallow concave floor, deep concave floor and convex floor were created by reverse engineering software. The operation of internal sinus floor elevation was simulated by accomplishing the dynamic loading process of osteotome technique under different configurations of maxillary sinus floor conditions. MAIN OUTCOME MEASURES： The stress and displacement of bone condenser, bone and mucosa of maxillary sinus. RESULTS： The deep concave floor of sinus showed the highest elevation efficiency and minimal risk of perforation of maxillary sinus mucosa. The convex floor of sinus showed lowest elevation efficiency with higher stress dissipation. In addition, the increased tension on the mucosa was not beneficial to the elevation. CONCLUSION： Of the three configurations of maxillary sinus floor, the convex floor of sinus increases tension on the mucosa, which is not beneficial to the internal sinus floor elevation, and the convex floor of sinus shows the lowest elevation efficiency.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第17期3252-3256,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
