游离腓骨复合组织瓣上颌骨重建的三维有限元分析

目的对游离腓骨复合组织瓣重建上颌骨进行生物力学研究，了解重建上颌骨的承力情况及应力分布。方法应用上颌骨复合体三维有限元模型，模拟上颌骨切除，腓骨瓣修复，分析新的上颌骨复合体在承受咀嚼压力情况下的应力分布特点。结果重建上颌骨的应力传导柬集中在颧牙槽嵴；水平截面上，重建上颌骨模型的平均等效应力、最大等效应力和正应力较正常上颌骨模型有显著增加，而矢状截面上的应力增加幅度不及水平截面。结论颧牙槽嵴是腓骨瓣上颌骨重建后咀嚼压力的主要受力部位，腓骨瓣上颌骨重建时要加强颧牙槽嵴的固定，重建骨性颧突支柱。

Three-dimensional finite element analysis on the maxilla reconstructed by free fibula composite flap

Objective To analyse the biomechanical effects of stress distribution on the maxilla reconstructed by free fibula composite flap. Methods Imitative maxillectomy and maxillary reconstruction with fibula flap were performed on the three-dimensional finite element model. The characteristics of stress distribution were analyzed when the model was pressured by bite force. Results Three - dimensional finite element model analysis showed that the bite force was mainly distributed on the zygomaticoalveolar crest. On the horizontal section, the average equivalent stress, maximum equivalent stress and normal stress of the reconstructed model increased obviously. However, on the vertical section, the increase was not obvious as on the horizontal section. Conclusion Zygomaticoalveolar crest is the major site to sustain stress, which indicates that the fixation of zygomaticoalveolar crest should be strengthened and bony zygomatic process support should be rebuilt.