阻塞性睡眠呼吸暂停低通气综合征患者治疗中下颌逐步前伸引起髁状突位置变化的三维有限元研究

Positional changes of condyle with the gradual mandibular forward among OSAHS patients in the three-dimensional finite element study

摘要:

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患者口腔矫治器治疗时下颌逐步前伸对髁状突位置变化的影响。方法：采用CT、Mimics、Imageware及Ansys有限元分析软件建立OSAHS患者颞下颌关节、下颌骨及上气道的三维有限元模型，分别模拟下颌位于最大前伸量的20%、40%、60%、68%、70%、75%、80%、100%时，观测关节间隙（前、上、后）的位置变化。结果：下颌逐步前移不同量时，关节间隙的大小也发生着相应的变化。随着下颌骨水平前移量的增加，关节间隙的大小也不断增大，以关节前间隙的变化最明显，关节上间隙的变化次之，关节后间隙的变化再次之。结论：通过观测OSAHS患者髁状突的位置变化，为临床利用口腔矫治器治疗OSAHS从颞颌关节方面提供理论基础。

Abstract:

Objective：To explore the effects of gradual mandibular forward on condyle position changes among patients with obstruc－tive sleep apnea hypopnea syndrome（OSAHS）. Methods：Three-dimensional finite element model of mandible and temporomandibu－lar joint was constructed using CT，Mimics，Imageware and Ansys software. Changes in positions of joint space（anterior，superior and posterior） were estimated when mandible forward in 20%，40%，60%，68%，70%，75%，80% and 100% of the maximum protrusion. Results：As the mandible gradually forwarding，joint spaces underwent corresponding changes. With the increase in forward level of the mandible，displacement of the joint space was also increased；the most obvious gap was the anterior，followed by the superior and posterior. Conclusions：Observation on condyle position changes in patients with OSAHS provides a theoretical basis for clinical use of oral appliance in the treatment of patient with OSAHS from the temporomandibular joint.