하악 이부확장 시 하악골 이동 양상과 응력 분포에 관한 삼차원 유한요소법적 연구

A 3-D finite element analysis on the mandibular movement pattern and stress distribution during symphyseal widening

  • 이도훈 (원광대학교 치과대학 치과교정학교실) ;
  • 홍현실 (원광대학교 치과대학 치과교정학교실) ;
  • 채종문 (원광대학교 치과대학 치과교정학교실) ;
  • 조진형 (원광대학교 치과대학 치과교정학교실) ;
  • 김상철 (원광대학교 치과대학 치과교정학교실)
  • Lee, Do-Hoon (Department of Orthodontics, School of Dentistry, Wonkwang University) ;
  • Hong, Hyun-Sil (Department of Orthodontics, School of Dentistry, Wonkwang University) ;
  • Chae, Jong-Moon (Department of Orthodontics, School of Dentistry, Wonkwang University) ;
  • Jo, Jin-Hyung (Department of Orthodontics, School of Dentistry, Wonkwang University) ;
  • Kim, Sang-Cheol (Department of Orthodontics, School of Dentistry, Wonkwang University)
  • 발행 : 2008.02.28

초록

하악 이부확장에서 골 절단선의 위치 및 종류와 견인 장치의 종류에 따른 차이를 알아보고자 삼차원 유한요소법으로 하악골의 이동 양상 및 응력 분포를 조사하였다. 골 견인장치의 종류로는 치아 의존형과 골 의존형, 혼합형, $30^{\circ}$ 기울여 위치한 치아 의존형의 4가지를, 골절단 위치와 방법으로 하악 중절치 간 수직절단과 하악 정중이부를 관통하는 계단식 골절단 등의 2가지를 설정하였다. 연구 결과, 골절단의 위치 및 방법과 견인장치의 종류에 관계없이 과두를 포함한 하악골의 모든 부위에서 외측방 변위를 보였으며 상하적이나 전후방적 변위는 적은 양이었으나 방향에 있어 군간에 차이를 보였다. 치아 의존형 장치에 의한 골절단면 이개 양태는 V형이었으나 골 의존형 장치는 역V형이고 혼합형 장치는 평행하게 확장되었다. 골 의존형 장치에 의한 하악각의 외측 변위량이 다른 장치에 비해 컸다. $30^{\circ}$ 기울여 위치한 치아 의존형에서의 변위는 측방적, 전후방적 면에서 좌우 차이가 인정되었다.

Objective: The objective of this study was to evaluate the displacement pattern and the stress distribution of the finite element model 3-D visualization during symphyseal widening according to the osteotomy position, osteotomy type, and distraction device. Methods: The kinds of distraction devices used were tooth-borne type, hybrid type, bone-borne type and tooth-borne type $30^{\circ}$ angulated, and the kinds of osteotomy design were vertical osteotomy line between the central incisors and step osteotomy line through the symphysis. Results: All reference points of the mandible including the condyles were displaced laterally irrespective of the osteotomy position, osteotomy method and distraction device. The anteroposterior or vertical displacements showed small differences between the groups. The widening pattern of the osteotomy line in the tooth-borne type of device was v shaped, and that of bone-borne type was a reverse v shape. However, the pattern in the hybrid type was parallel. The lateral displacement of the mandibular angle by the bone-borne device was more remarkable than the other types of devices. The displacement by the $30^{\circ}$ angulated tooth-borne type was different between the left and right sides in both the transverse and anteroposterior aspects. Conclusion: The design of the distraction devices and osteotomy line can influence the displacement pattern and the stress distribution during mandibular symphyseal distraction osteogenesis procedures.

키워드

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