The Dynamic Role of Buttress Reconstruction after Maxillectomy
The Dynamic Role of Buttress Reconstruction after Maxillectomy
复制标题
上颌骨切除术后支撑重建的动态作用
DOI：
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发表时间：
2005
影响因子：
3.6
通讯作者：
T. Tamaki
中科院分区：
文献类型：
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作者：
T. Nagasao;T. Nakajima;Akiko Kimura;T. Kaneko;Hongmei Jin;T. Tamaki
背景：本研究的目的是探讨上颌骨部分切除后上颌骨重建的动态效果。方法：在个人计算机上，根据10个无牙颌颅骨模型的CT数据设计上颌骨的三维模型。对每个模型进行模拟手术，建立10对上颌骨半切除模型和肋骨重建后的相应模型。在10个模型中看到的三种不同的模式分别是正常上颌骨、半切除的上颌骨和重建的上颌骨。将种植体固定在每个模型的磨牙区后，分别施加300N的垂直载荷和50N的水平载荷。利用有限元分析软件计算各模型在不同模型模式下的偏差和应力，并进行比较。结果：在垂直载荷作用下，上颌骨畸形在三种模型间差异无统计学意义。然而，在对水平载荷的反应中观察到的不同之处在于有发生变形的趋势，其中去除一半的上颌骨的变形最大，其次是重建的和正常的上颌骨。对于种植体周围的应力，当施加垂直和水平载荷时，三种模型在种植体周围的最大应力没有显著差异。结论：支撑体重建能有效提高上颌骨在水平载荷作用下的稳定性。然而，无论是否进行移除或重建，磨牙区种植体周围的最大应力都不受影响。
Background: The purpose of this study was to investigate the dynamic effect of maxillary reconstruction after partial resection of the maxilla. Methods: On a personal computer, three-dimensional maxilla models were designed based on computed tomographic data obtained from 10 edentulous skull models. Simulation surgery was performed on each model, creating 10 pairs of half-removed maxilla models and corresponding models after reconstruction with a rib. The three different patterns seen in the 10 models were termed normal maxilla, half-removed maxilla, and reconstructed maxilla. After an implant was fixed on the molar region of each model, a 300-N vertical load and a 50-N horizontal load were applied. Using finite element analysis software, the deviation and stress on each model were calculated and compared between different model patterns. Results: Regarding deformity of the maxilla, when a vertical load was applied, no significant difference was observed among the three model patterns. However, a difference was observed in response to a horizontal load in that there was a tendency for deformation to occur, with that of half-removed maxilla being the greatest followed by reconstructed and normal maxilla. Regarding stresses around the implant, when the vertical and horizontal loads were applied, no significant difference was observed among the three model patterns in maximum stress around the implant. Conclusions: A buttress reconstruction is effective in increasing the stability of the maxilla against a horizontal load. However, the maximum stress around the implant in the molar region is unaffected whether or not removal or reconstruction is performed.