Three-dimensional finite element feature analysis of the mandible and morphology and position of temporomandibular joint in patients with unilateral and bilateral molar scissor bite

doi:10.7518/hxkq.2024.2024169

Abstract

Abstract:

Objective The objective of this study is to measuring the morphology and position of bilateral temporomandibular joints in patients with unilateral and bilateral molar scissor bite and simulating the deformation of the mandible during occlusion, in order to provide thesis for the diagnosis of temporomandibular joint disease in patients with unilateral and bilateral molar scissor bite. Methods This study was a retrospective study. A total of 10 patients with unilateral molar scissor bite (the unilateral molar scissor bite group) and 10 patients with bilateral molar scissor bite (the bilateral molar scissor bite group) were selected as the experimental group, and 20 adult patients with classⅠ of angle classification of similar ages were selected as the control group. All patients underwent cone beam computed tomography scans, by measuring the width of the fossa, height of the fossa, articular eminence inclination, long axis of the condyle, minor axis of the condyle, horizontal angle of the condyle and the space of the temporomandibular joint, compare temporomandibular joint morphology and position. The three-dimensional finite element analysis of the mandible morphology was carried out to evaluate the force and deformation of the mandible by using software to simulate the occlusion of the patients. It was further explored the relationship between the force of the mandible morphology and the possible temporomandibular joint disorder symptoms of the patients. Results Intergroup comparisons for the unilateral molar scissor bite group and left sides of the other groups revealed that the superior articular space in the group with unilateral molar scissor bite was shorter than that in the control group (P<0.05); the long axis of the condyle in the unilateral and bilateral molar scissor bite group were both shorter than that of the control group (P<0.05); among which the unilateral group was larger than the bilateral group, and the minor axis of the condyle in bilateral molar scissor bite group was smaller than in the control group (P<0.05), and the unilateral and bilateral condylar groups were larger than the control group (P<0.05); and the condylar horizontal angle in the unilateral and bilateral groups were larger than that in the control group (P<0.05). The normal sides of the unilateral molar scissor bite group and right sides of the other groups had smaller superior articular space than the control group (P<0.05); and the condylar long-axis in bilateral group was smaller than the control group (P<0.05); and the normal side of the condylar short-axis unilateral group was larger than that of the bilateral condylar group. Three-dimensional finite element analysis: the condyle of patients with molar scissor bite was a concentrated area of deformation during the bite of the mandible, when the first molar occlusion of the scissors bite side was simulated, the maximum deformation was located in the condyle in the X-axis and Z-axis directions. The amount of deformation was greater than that of the scissor bite side in the X-axis direction, while in the Z-axis direction, the normal side was greater than the scissor bite side. The maximum sites of local deformation in the X-axis direction were located in anterior and posterior the transverse crest of scissor bite side, and the minimum sites of local deformation was at 1/3 of the anterior slope of the inner pole of the normal side, the maximum local deformation sites in the Z-axis direction were located in the outer pole and below the outer pole of the normal side. The X-axis deformation value was the largest in the molars occlusion on the normal side, the Y-axis deformation value was in the premolars occlusion on the normal side, and the Z-axis deformation value was the largest in the centric occlusion, the deformation value of the condyle was not most significant in molar scissor bite. Conclusion Unilateral and bilateral molar scissor bite resulting in a short condyle morphology, and the bilateral group had a shorter condylar morphology than the unilateral group. The condyle of the patient with molar scissor bite is a concentrated area of poor occlusal deformation, and the largest sites of deformation are distributed near the transverse ridge of the inner and outer poles of the condyle. Different occlusion conditions have an effect on condylar deformation values, but do not indicate whether there is a clear association between them.

Key words: scissor bite, temporomandibular joint, morphology, finite element analysis

CLC Number:

R782.6

Chu Tianhao, Zhang Xueying, Wang Haocheng, Ma Haojie, Liu Yuanyuan. Three-dimensional finite element feature analysis of the mandible and morphology and position of temporomandibular joint in patients with unilateral and bilateral molar scissor bite[J]. West China Journal of Stomatology, 2025, 43(1): 114-125.

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名称	英文	测量项目含义
关节窝宽度	width of the fossa，WF	在垂直于髁突长轴的矫正斜矢状位下，连接关节窝后壁最下点和关节结节最下点，此连线位于关节窝内的部分为关节窝宽度
关节窝高度	height of the fossa，HF	在垂直于髁突长轴的矫正斜矢状位下，连接关节窝后壁最下点和关节结节最下点，关节窝最上点到此连线的垂直距离为关节窝高度
关节结节倾斜度	articular eminence inclination，AEI	关节结节最下点与关节窝最上点连线与关节结节最下点与关节窝后壁最下点连线的交角
髁突长轴	long axis of the condyle，LAC	在髁突面积最大的横断面上测量髁突的最大内外径
髁突短轴	minor axis of the condyle，MAC	在髁突面积最大的横断面上测量髁突的最大前后径
髁突水平角	horizontal angle of the condyle，HAC	髁突长轴与冠状水平线间的夹角
关节前间隙	anterior joint space，AJS	过关节窝顶点向髁突前斜面作切线，切点与关节结节后斜面的最短距离
关节上间隙	superior joint space，SJS	关节窝顶点与髁突顶点连线的距离
关节后间隙	posterior joint space，PJS	过关节窝顶点向髁突后斜面作切线，切点与关节窝后壁的最短距离

组别	安氏Ⅰ类	安氏Ⅱ类	安氏Ⅲ类	其他
单侧组	7/70.0	2/20.0	0/0.0	1/10.0
双侧组	5/50.0	3/30.0	1/10.0	1/10.0.

组别	骨性Ⅰ类	骨性Ⅱ类	骨性Ⅲ类
单侧组	7/70.0	3/30.0	0/0.0
双侧组	4/40.0	6/60.0	0/0.0
对照组	9/45.0	11/55.0	0/0.0

项目	左侧	右侧	P值
关节上间隙/mm	3.91±1.12	3.92±0.92	0.975
关节前间隙/mm	2.61±0.96	2.95±1.50	0.435
关节后间隙/mm	1.97±0.39	2.09±0.43	0.639
髁突长轴/mm	20.94±2.11	20.97±2.17	0.943
髁突短轴/mm	8.66±1.01	8.35±0.76	0.111
关节窝高度/mm	5.82±1.43	5.57±0.95	0.503
关节窝宽度/mm	15.29±1.86	16.47±0.80	0.180
关节结节斜度/°	35.86±7.37	35.57±10.78	0.948
髁突水平角/°	15.23±4.95	17.94±6.36	0.374

项目	锁侧	正常侧	P值
关节上间隙/mm	2.48±0.44	2.64±0.20	0.234
关节前间隙/mm	2.48±0.85	2.24±0.61	0.603
关节后间隙/mm	1.80±0.44	1.76±0.38	0.852
髁突长轴/mm	18.76±2.11	18.55±3.57	0.807
髁突短轴/mm	8.02±1.43	7.99±1.49	0.932
关节窝高度/mm	6.33±1.08	5.85±1.08	0.157
关节窝宽度/mm	16.73±1.73	16.74±2.79	0.984
关节结节斜度/°	35.60±6.48	36.02±7.80	0.872
髁突水平角/°	23.32±7.93	21.71±7.66	0.421