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目的:分析小型钛板固定下颌体缺损腓骨重建的应力分布特点及位移情况,为下颌体缺损腓骨重建的内固定提供生物力学参考。方法:建立下颌体缺损腓骨重建小型4孔钛板固定的有限元模型,模拟前牙与健侧磨牙垂直加载,分析钛板钛钉应力分布及腓骨前后端位移情况。结果:前牙加载时,相应钛板钛钉应力、腓骨前后端位移值均大于后牙加载时;前牙加载时腓骨前端最大位移值为264.44μm,而后牙加载时为149.02μm。钛板最大应力值出现在后上方钛板处;下颌骨残端钛钉最大应力值位于前上方靠近交界处的第1颗钛钉处,应力沿钉尖方向逐渐减小,在钉尖1/3处应力出现增大现象。结论:在下颌体缺损腓骨重建小钛板固定时,选择双皮质钛钉十分必要;在骨愈合前应避免前牙咬合,减少骨不愈合的风险。
OBJECTIVE: To analyze the stress distribution and displacement of fibula in reconstruction of mandibular body defect with small titanium plate, and to provide a biomechanical reference for the internal fixation of fibular reconstruction with mandibular defect. Methods: The finite element model of mandibular defect fibula reconstruction 4-hole titanium plate was established. The vertical load of anterior teeth and contralateral molars was simulated. The stress distribution of titanium titanium screws and the displacement of anterior and posterior fibula were analyzed. Results: When the anterior teeth were loaded, the corresponding titanium plate stress and fibular anterior and posterior displacement values were greater than those after posterior teeth loading. The maximum displacement of the anterior fibula was 264.44μm while the posterior teeth loaded 149.02μm. The maximum stress value of titanium plate appears at the top of the titanium plate. The maximum stress value of mandibular titanium nail is located at the first titanium nail near the top and near the junction, and the stress decreases along the nail tip direction. 3 stress increased phenomenon. Conclusion: It is very necessary to select the double cortical titanium nail in the reconstruction of the small fibula in the reconstruction of the mandibular defect. To avoid the anterior teeth occlusion before the bone is healed, the risk of nonunion should be reduced.