{"title":"对用于 T 型咬肌成形术的患者专用植入物的形状和厚度变化进行有限元分析。","authors":"E-F Akkoyun, T Pergel","doi":"10.4317/medoral.27065","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>T-shaped genioplasty is a versatile surgical technique used to correct chin deformities by altering its vertical, transverse, and sagittal dimensions. Despite numerous advancements in patient-specific implants (PSIs), the biomechanical impact of PSI thickness and the number of screws used for fixation remain unexplored. This study aims to evaluate the effects of PSI thickness and screw configurations on fixation stability in T-shaped genioplasty using finite element analysis.</p><p><strong>Material and methods: </strong>Mandibular computed tomography data were used to construct 12 three-dimensional models with varying PSI thicknesses (0.6 mm, 0.9 mm, and 1.2 mm) and screw configurations (five, six, seven, and eight screws). T-shaped osteotomies were applied to create narrowing and widening genioplasty models, with iliac bone grafts placed in widening scenarios. Horizontal forces of 50 N were applied bilaterally, and fixation stability was evaluated using von Mises stress and bone displacement. Fixation was considered stable when bone displacement amounts were below 1 mm.</p><p><strong>Results: </strong>In narrowing models, fixation stability was achieved with five screws and a 1.2 mm PSI or seven screws with a 0.9 mm or 1.2 mm PSI, showing stress values within titanium's yield strength limits. For widening models, stable fixation was achieved with six screws and a 0.9 mm or 1.2 mm PSI, or eight screws across all tested thicknesses. Bone displacement was minimal with thicker PSIs and higher screw counts, demonstrating improved stability.</p><p><strong>Conclusions: </strong>This study highlights the importance of PSI customization in optimizing fixation stability in T-shaped genioplasty. A minimum of five screws with a 1.2 mm plate or seven screws with a 0.9 mm plate is suggested for narrowing, while six screws with a 0.9 mm plate or eight screws with any tested thickness are sufficient for widening. Future research should address combined movements, dynamic loading, and long-term outcomes to refine PSI fixation strategies further.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e528-e535"},"PeriodicalIF":2.1000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221139/pdf/","citationCount":"0","resultStr":"{\"title\":\"Finite element analysis of shape and thickness variations in patient-specific implants for t-shaped genioplasty.\",\"authors\":\"E-F Akkoyun, T Pergel\",\"doi\":\"10.4317/medoral.27065\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>T-shaped genioplasty is a versatile surgical technique used to correct chin deformities by altering its vertical, transverse, and sagittal dimensions. Despite numerous advancements in patient-specific implants (PSIs), the biomechanical impact of PSI thickness and the number of screws used for fixation remain unexplored. This study aims to evaluate the effects of PSI thickness and screw configurations on fixation stability in T-shaped genioplasty using finite element analysis.</p><p><strong>Material and methods: </strong>Mandibular computed tomography data were used to construct 12 three-dimensional models with varying PSI thicknesses (0.6 mm, 0.9 mm, and 1.2 mm) and screw configurations (five, six, seven, and eight screws). T-shaped osteotomies were applied to create narrowing and widening genioplasty models, with iliac bone grafts placed in widening scenarios. Horizontal forces of 50 N were applied bilaterally, and fixation stability was evaluated using von Mises stress and bone displacement. Fixation was considered stable when bone displacement amounts were below 1 mm.</p><p><strong>Results: </strong>In narrowing models, fixation stability was achieved with five screws and a 1.2 mm PSI or seven screws with a 0.9 mm or 1.2 mm PSI, showing stress values within titanium's yield strength limits. For widening models, stable fixation was achieved with six screws and a 0.9 mm or 1.2 mm PSI, or eight screws across all tested thicknesses. Bone displacement was minimal with thicker PSIs and higher screw counts, demonstrating improved stability.</p><p><strong>Conclusions: </strong>This study highlights the importance of PSI customization in optimizing fixation stability in T-shaped genioplasty. A minimum of five screws with a 1.2 mm plate or seven screws with a 0.9 mm plate is suggested for narrowing, while six screws with a 0.9 mm plate or eight screws with any tested thickness are sufficient for widening. Future research should address combined movements, dynamic loading, and long-term outcomes to refine PSI fixation strategies further.</p>\",\"PeriodicalId\":49016,\"journal\":{\"name\":\"Medicina Oral Patologia Oral Y Cirugia Bucal\",\"volume\":\" \",\"pages\":\"e528-e535\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221139/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina Oral Patologia Oral Y Cirugia Bucal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4317/medoral.27065\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina Oral Patologia Oral Y Cirugia Bucal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4317/medoral.27065","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:t形颏成形术是一种多用途的外科技术,通过改变其垂直、横向和矢状尺寸来纠正颏畸形。尽管在患者特异性植入物(PSI)方面取得了许多进展,PSI厚度和用于固定的螺钉数量的生物力学影响仍未被探索。本研究旨在通过有限元分析评估PSI厚度和螺钉配置对t型颏成形术固定稳定性的影响。材料和方法:使用下颌计算机断层扫描数据构建12个三维模型,这些模型具有不同的PSI厚度(0.6 mm、0.9 mm和1.2 mm)和螺钉配置(5、6、7和8颗螺钉)。采用t形截骨术创建狭窄和扩大的膝成形术模型,髂骨移植物放置在扩大的场景中。双侧施加50 N的水平力,使用von Mises应力和骨位移评估固定稳定性。当骨位移量低于1mm时,固定被认为是稳定的。结果:在狭窄模型中,5颗螺钉和1.2 mm PSI或7颗螺钉和0.9 mm或1.2 mm PSI均可实现固定稳定性,显示应力值在钛的屈服强度极限内。对于加宽模型,使用6个螺钉和0.9 mm或1.2 mm PSI或所有测试厚度的8个螺钉实现稳定固定。较厚的psi和较高的螺钉计数使骨移位最小,表明稳定性得到改善。结论:本研究强调了PSI定制在优化t型颏成形术固定稳定性中的重要性。缩窄时建议至少使用5颗1.2 mm钢板螺钉或7颗0.9 mm钢板螺钉,而扩宽时建议至少使用6颗0.9 mm钢板螺钉或8颗任意厚度的螺钉。未来的研究应解决联合运动、动态负荷和长期结果,以进一步完善PSI固定策略。
Finite element analysis of shape and thickness variations in patient-specific implants for t-shaped genioplasty.
Background: T-shaped genioplasty is a versatile surgical technique used to correct chin deformities by altering its vertical, transverse, and sagittal dimensions. Despite numerous advancements in patient-specific implants (PSIs), the biomechanical impact of PSI thickness and the number of screws used for fixation remain unexplored. This study aims to evaluate the effects of PSI thickness and screw configurations on fixation stability in T-shaped genioplasty using finite element analysis.
Material and methods: Mandibular computed tomography data were used to construct 12 three-dimensional models with varying PSI thicknesses (0.6 mm, 0.9 mm, and 1.2 mm) and screw configurations (five, six, seven, and eight screws). T-shaped osteotomies were applied to create narrowing and widening genioplasty models, with iliac bone grafts placed in widening scenarios. Horizontal forces of 50 N were applied bilaterally, and fixation stability was evaluated using von Mises stress and bone displacement. Fixation was considered stable when bone displacement amounts were below 1 mm.
Results: In narrowing models, fixation stability was achieved with five screws and a 1.2 mm PSI or seven screws with a 0.9 mm or 1.2 mm PSI, showing stress values within titanium's yield strength limits. For widening models, stable fixation was achieved with six screws and a 0.9 mm or 1.2 mm PSI, or eight screws across all tested thicknesses. Bone displacement was minimal with thicker PSIs and higher screw counts, demonstrating improved stability.
Conclusions: This study highlights the importance of PSI customization in optimizing fixation stability in T-shaped genioplasty. A minimum of five screws with a 1.2 mm plate or seven screws with a 0.9 mm plate is suggested for narrowing, while six screws with a 0.9 mm plate or eight screws with any tested thickness are sufficient for widening. Future research should address combined movements, dynamic loading, and long-term outcomes to refine PSI fixation strategies further.
期刊介绍:
1. Oral Medicine and Pathology:
Clinicopathological as well as medical or surgical management aspects of
diseases affecting oral mucosa, salivary glands, maxillary bones, as well as
orofacial neurological disorders, and systemic conditions with an impact on
the oral cavity.
2. Oral Surgery:
Surgical management aspects of diseases affecting oral mucosa, salivary glands,
maxillary bones, teeth, implants, oral surgical procedures. Surgical management
of diseases affecting head and neck areas.
3. Medically compromised patients in Dentistry:
Articles discussing medical problems in Odontology will also be included, with
a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients.
4. Implantology
5. Periodontology