Patient specific indibidual computational bio-mechanics of temporomandibular joint system and application to temporomandibular disorder examination

1. 基于医学检查中可用的磁共振图像，开发了针对颞下颌关节建立患者特异性个体模型的方法，并为临床牙科研究人员演示了原型建模系统。利用磁共振成像观察到的不同张口阶段的颌骨位置，重建了个体受试者的颌骨运动。这为我们确定用于颞下颌关节计算生物力学分析的典型颌骨运动条件提供了理论依据。对关节盘软组织组成部分及周围结缔组织的应力分析表明，正常颞下颌关节在关节盘前内侧部分表现出高应力区，而永久性椎间盘前移位的颞下颌关节在椎间盘后结缔组织中表现出相对较高的应力区，其中组织结缔组织为韧带。关节盘的应力重分布和暂时性移位不仅与颞下颌关节前盘移位部位的不规则空间排列密切相关，还与关节盘和椎间盘后结缔组织的生物力学特性密切相关。这一事实提示我们椎间盘后端结缔组织和关节盘生物力学试验的重要性。个体计算生物力学分析显示，在正常颞下颌关节的情况下，由于开口导致的关节盘前方向的暂时性位移取决于关节盘的弹性模量，而在永久性前盘移位的关节的情况下，椎间盘的位移取决于椎间盘后组织的弹性模量。这表明通过比较图像分析和计算生物力学分析的暂时性椎间盘位移来估计软组织部件力学特性的可能性。少

1. The methodology for establishing patient-specific individual modeling was developed for temporomandibular joints based on magnetic resonance images available at medical examination, and a prototype modeling system has been demonstrated for the clinical dental researchers.2. The jaw bone movement was reconstructed interpolating the jaw bone position observed by magnetic resonance images at different mouth opening stages of individual subject. It gives us a rationale to determine the typical jaw movement condition used for the computational biomechanics analysis of temporomandibular joints.3. Stress analysis concerning on the soft tissue components of articular disc and surrounding connective tissue have showed that normal temporomandibular joints exhibited the high stress region at the anteromedial portion of the articular disc and that permanently anterior-disc-displaced temporomandibular joint resulted the relatively high stress in retrodiscal connective tissue in which tissue liga … More mentization was observed.4. Stress redistribution and tentative displacement in articular disc was very dependent not only on irregular spatial arrangement of components of anterior-disc-displaced temporomandibular joint but also on biomechanical property of articular disc and retrodiscal connective tissue. This fact suggested us the importance of biomechanical tests of retorodiscal connective tissue as well as articular disc.5. Indiyidual computational biomechanics analysis revealed that the tentative articular disc displacement in anterior direction due to the mouth opening was dependent on the elastic modulus of the articular disc in the case of normal temporomandibular joints, while the disc displacement was dependent on the elastic modulus of the retrodiscal tissue in the case of permanently anterior-disc-displaced joints. This feet showed the possibility to estimate the mechanical property of soft tissue components by comparing tentative disc displacement by image analysis and that by computational biomechanics analysis. Less