河北医科大学学报 ›› 2023, Vol. 44 ›› Issue (10): 1196-1204,1221.doi: 10.3969/j.issn.1007-3205.2023.10.014

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解剖牙合型与舌侧集中牙合型对下颌Ⅳ类无牙颌的牙槽骨和黏膜影响的三维有限元分析

  

  1. 1.河北医科大学口腔医学院，河北医科大学口腔医院修复科，河北省口腔医学重点实验室，河北省口腔疾病临床医学
    研究中心，河北 石家庄 050017；2.河北医科大学口腔医学院，河北省口腔医学重点实验室，
    河北省口腔疾病临床医学研究中心，河北 石家庄 050017

  • 出版日期:2023-10-25 发布日期:2023-11-03
  • 作者简介:张晶（1997-），女，河北宁晋人，河北医科大学口腔医院医师，医学学士，从事先天缺牙致病基因的筛查及致病机制研究。
  • 基金资助:
    河北省财政厅老年病项目（361029）；河北省财政厅老年病项目（361029）；河北省科技厅卫生健康创新专项（21377716D）

Three-dimensional finite element analysis of the effects of anatomical occlusion and lingualized occlusion on alveolar bone and mucosa of Class Ⅳ edentulous jaw

  1. 1.School of Stomatology, Hebei Medical University, Department of Prosthodontics, Stomatological 
    Hospital, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Medical 
    Research Center of Stomatological Diseases, Shijiazhuang 050017, China; 2.School of 
    Stomatology, Hebei Medical University, Key Laboratory of Stomatology of 
    Hebei Province, Clinical Medical Research Center of Stomatology of 
    Shijiazhuang 050017, China

  • Online:2023-10-25 Published:2023-11-03

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摘要： 目的 研究解剖牙合型、舌侧集中牙合型在正中及侧方咬合时对下颌Ⅳ类无牙颌的黏膜与下方牙槽骨的生物力学特性变化。
方法 创建下颌Ⅳ类无牙颌下颌骨有限元模型，在下颌骨上使用解剖牙合型、舌侧集中牙合型，人工牙分别进行正中咬合、侧方咬合仿真模拟，分析黏膜及牙槽骨的生物力学变化。
结果 正中咬合时，黏膜压应力舌侧集中牙合型比解剖牙合型降低0.6%~31.2%；牙槽骨表面压应力，左侧磨牙区和前牙区牙舌侧集中牙合型比解剖牙合型下降19.0%~35.1%，而右侧磨牙区舌侧集中牙合型比解剖牙合型上调53.3%；左侧侧方咬合状态下黏膜及牙槽骨应力分布：舌侧集中牙合型较解剖牙合型下降41.1%~70.2%；右侧侧方咬合状态下黏膜及牙槽骨应力分布：舌侧集中牙合型较解剖牙合型下降24.4%~63.8%。
结论 下颌Ⅳ类牙槽骨无牙颌修复在正中咬合时，舌侧集中牙合型比解剖牙合型降低左侧及前牙区低平牙槽骨上的黏膜与牙槽骨压应力；在侧方咬合时，降低前牙区及两侧磨牙区黏膜与牙槽骨压应力，为临床下颌牙槽骨吸收严重患者选择合适人工牙合型提供理论参考。


关键词: 三维有限元, 舌侧集中牙合型, 解剖牙合型

Abstract: Objective  To compare the changes of biomechanical properties of mucosa and inferior alveolar bone of Class Ⅳ edentulous jaw of complete denture corresponding to anatomical occlusion and lingualized occlusion under two different load conditions of median occlusion and lateral occlusion. 
Methods The finite element model of the Class Ⅳ edentulous mandible was established, anatomical occlusion and lingualized occlusion were supplemented to the mandible, to simulate the median occlusion and lateral occlusion respectively. The biomechanical changes of the mucosa and alveolar bone were analyzed. 
Results Under the condition of median occlusion, the mucosal compressive stress of lingualized occlusion was smaller than of anatomic occlusion, and the decrease of mucosal compressive stress was about 0.6%-31.2%. The compressive stress on the upper surface of alveolar bone in the left molar area and anterior tooth area of lingualized occlusion was smaller than that of anatomic occlusion, and the decrease of alveolar bone stress was about 35.1%-19.0%, On the contrary, the alveolar bone compressive stress in the right molar area was 53.3% higher than that of anatomic occlusion. In the left lateral occlusal state, the compressive stress of lingualized occlusal on mucosa and alveolar bone decreased by 70.2%-41.1%. In the right lateral occlusal state, the compressive stress of lingualized occlusal on mucosa and alveolar bone decreased by 63.8%-24.4%. 
Conclusion In the restoration of Class Ⅳ edentulous jaw, the lingualized occlusion reduces the mucosal and alveolar bone compressive stress in the anterior tooth area and left molar area of the low flat alveolar bone of median bite compared with the anatomic occlusion type. And it is reduced in the anterior tooth area and bilateral molar area in the lateral bite, so as to provide a theoretical reference for clinical patients with severe mandibular alveolar bone resorption.


Key words: three-dimensional finite element, lingualized occlusion, anatomic occlusion

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