Biomechanical Stress Analysis in Retrodiscal Tissues of Temporomandibular Joint with Unilateral Disc Displacement Without Reduction: A Finite Element Study

Abstract

Objective: This study aimed to evaluate stress changes in retrodiscal tissues during mandibular movements in temporomandibular joints (TMJ) with unilateral disc displacement without reduction (DDwoR) using finite element analysis (FEA). Materials and Methods: Geometric models were created using CT scan data from two patients: one with bilaterally normal disc positioning and another with DDwoR. DICOM files were segmented, and 3D models were reconstructed and converted into mathematical models following a standardized methodology. Two models were analyzed: a control model with bilaterally normal discs and a DDwoR model, with separate evaluations of the left (normal) and right (DDwoR) joints. TMJ movements during mouth opening and closing were simulated, and stress distribution patterns in the retrodiscal tissues were analyzed. Von Mises stress values were measured and compared between the DDwoR and healthy sides. Results: Both the normal and DDwoR sides demonstrated altered stress patterns compared to the healthy control. The DDwoR side consistently exhibited elevated stress in the superior region during mouth opening, underscoring its mechanical vulnerability. The normal side, while less affected than the DDwoR side, displayed compensatory stress increases, particularly in the intermediate region during mouth opening. Conclusion: These findings underscore the vulnerability of the retrodiscal tissues, especially the superior region, to mechanical stress in the presence of DDwoR. This study highlights the importance of clinical strategies aimed at preserving retrodiscal tissue integrity to prevent progressive joint damage.

Keywords

• Disc displacement without reduction
• Disc displacement without reduction
• finite element analysis
• finite element analysis
• retrodiscal tissue
• retrodiscal tissue
• stress distribution
• stress distribution
• temporomandibular joint
• temporomandibular joint

Project Number

PYO.DIS.1904.20.003

Unilateral Redüksiyonsuz Disk Deplasmanı Olan Temporomandibular Eklemde Retrodiskal Dokuların Biyomekanik Stres Analizi: Bir Sonlu Elemanlar Çalışması

Abstract

Amaç: Bu çalışmanın amacı, unilateral redüksiyonsuz disk deplasmanı (DDwoR) bulunan temporomandibular eklemlerde (TME) mandibular hareketler sırasında retrodiskal dokulardaki stres değişimlerini sonlu elemanlar analizi (FEA) kullanarak değerlendirmektir. Gereç ve Yöntemler: Geometrik modeller, biri bilateral olarak normal disk pozisyonuna sahip, diğeri ise unilateral DDwoRlu iki hastanın BT (Bilgisayarlı Tomografi) tarama verileri kullanılarak oluşturulmuştur. DICOM dosyaları segmentlere ayrılmış, 3D modeller yeniden yapılandırılmış ve standart bir metodoloji izlenerek matematiksel modellere dönüştürülmüştür. İki model analiz edilmiştir: bilateral olarak normal disk pozisyonuna sahip kontrol modeli ve unilateral DDwoR modeli. Bu modellerde sol (normal) ve sağ (DDwoR) eklemler ayrı ayrı değerlendirilmiştir. Ağız açma ve kapama hareketleri simüle edilerek retrodiskal dokulardaki stres dağılımı analiz edilmiştir. Von Mises stres değerleri ölçülerek DDwoR tarafı ile sağlıklı taraf karşılaştırılmıştır. Bulgular: Hem normal hem de DDwoR tarafları, sağlıklı kontrole kıyasla değişen stres paternleri göstermiştir. DDwoR tarafı, ağız açma sırasında üst bölgede artmış stres seviyeleri sergileyerek mekanik açıdan daha hassas olduğunu ortaya koymuştur. Normal taraf, DDwoR tarafına kıyasla daha az etkilenmiş olsa da özellikle ağız açma sırasında orta bölgede telafi edici stres artışları göstermiştir. Sonuç: Bu bulgular, DDwoR varlığında özellikle retrodiskal dokuların üst bölgesinin mekanik strese karşı savunmasız olduğunu vurgulamaktadır. Çalışma, ilerleyici eklem hasarını önlemek için retrodiskal doku bütünlüğünün korunmasına yönelik klinik stratejilerin önemini ortaya koymaktadır.

Keywords

• redüksiyonsuz disk deplasmanı
• retrodiskal doku
• sonlu eleman analizi
• stres
• temporomandibular eklem

Project Number

PYO.DIS.1904.20.003

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