Modelagem tridimensional da região da articulação temporomandibular a partir de tomografia computadorizada visando o projeto, estudo e análise de prótese personalizada
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Data
2017-05-02
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Universidade Estadual Paulista (Unesp)
Resumo
O uso de ferramentas computacionais atualmente está auxiliando o aprimoramento dos processos e procedimentos de análise e simulações em inúmeras áreas do conhecimento humano. A tomografia computadorizada (TC) é uma ferramenta de diagnóstico já consolidada na área médica e atualmente começa a ser utilizada como uma ferramenta para algo ainda mais inovador, a geração de modelos tridimensionais de órgãos ou estruturas ósseas do paciente para uso na criação de biomodelos e fabricação de próteses personalizadas. Biomodelos são cópias físicas das estruturas anatômicas de regiões ou orgãos do corpo humano utilizados para diagnóstico e planejamento cirúrgico. O uso de imagens tomográficas para geração de modelos 3D tem despertado um grande interesse na área médica e de bioengenharia. Além da criação do biomodelo é possível, com o uso das imagens, a geração de modelos computacionais representativos, possibilitando com isso, a realização de diversas simulações e análises biomecânicas da região ou órgão de interesse, visando a fabricação de próteses ou órteses personalizadas. Neste trabalho é apresentada uma metodologia para a geração de modelos matemáticos tridimensionais a partir de tomografias computadorizadas com o objetivo de estudar e analisar um implante personalizado da ATM (Articulação Temporomandibular), solicitado mecanicamente e fabricado em liga de titânio (Ti6Al4V) pelo processo de manufatura aditiva rápida do tipo DMLS (Sinterização Direta de Metais a Laser). Através do modelo criado para a região da ATM foram realizadas simulações computacionais de tensões e deformações na mandíbula saudável do paciente (sem aplicação do implante) e na mandíbula implantada, considerando esforços severos da mastigação humana aplicados nos dentes frontais (incisivos) da mandíbula. A máxima tensão encontrada na mandíbula saudável foi de 27,94 MPa e a máxima deformação foi de 0,28 mm. Já na mandíbula implantada a máxima tensão, localizada na prótese, foi de 191,10 MPa e a máxima deformação encontrada na mandíbula foi de 0,28 mm.
The use of computational tools is currently helping to improve the processes and procedures of analysis and simulations in many areas of human knowledge. Computed tomography (CT) is a diagnostic tool already consolidated in the medical field and is now being used as a tool for something even more innovative, the generation of three-dimensional models of organs or bone structures of the patient for use in the creation of biomodels and Manufacture of customized prostheses. Biomodels are physical copies of the anatomical structures of regions or organs of the human body used for diagnosis and surgical planning. The use of tomographic images for generating 3D models has aroused great interest in the medical and bioengineering field. Besides the creation of the biomodel it is possible, through the use of the images, the generation of representative computational models, making possible the accomplishment of several simulations and biomechanical analyzes of the region or organ of interest, aiming at the manufacture of customized prostheses or orthoses. In this work is presented a methodology for the generation of three-dimensional mathematical models from CT scans in order to build, study and analyze a custom implant TMJ (Temporomandibular Joint), requested mechanically and made of titanium alloy (Ti6Al4V) by the prototyping process of type DMLS (Direct Metal Laser Sintering). Through the model created for the TMJ region, computational simulations of stresses and deformations were performed on the patient's healthy mandible (without implant application) and on the mandible implanted, considering the severe efforts of human mastication applied to the front teeth (incisors) of the mandible. The maximum stress found in healthy jaw was 27.94 MPa and the maximum deformation was 0.28 mm. In the jaw implanted the maximum stress, located in the prosthesis, was 191.10 MPa and the maximum deformation found in the jaw was 0.28 mm.
The use of computational tools is currently helping to improve the processes and procedures of analysis and simulations in many areas of human knowledge. Computed tomography (CT) is a diagnostic tool already consolidated in the medical field and is now being used as a tool for something even more innovative, the generation of three-dimensional models of organs or bone structures of the patient for use in the creation of biomodels and Manufacture of customized prostheses. Biomodels are physical copies of the anatomical structures of regions or organs of the human body used for diagnosis and surgical planning. The use of tomographic images for generating 3D models has aroused great interest in the medical and bioengineering field. Besides the creation of the biomodel it is possible, through the use of the images, the generation of representative computational models, making possible the accomplishment of several simulations and biomechanical analyzes of the region or organ of interest, aiming at the manufacture of customized prostheses or orthoses. In this work is presented a methodology for the generation of three-dimensional mathematical models from CT scans in order to build, study and analyze a custom implant TMJ (Temporomandibular Joint), requested mechanically and made of titanium alloy (Ti6Al4V) by the prototyping process of type DMLS (Direct Metal Laser Sintering). Through the model created for the TMJ region, computational simulations of stresses and deformations were performed on the patient's healthy mandible (without implant application) and on the mandible implanted, considering the severe efforts of human mastication applied to the front teeth (incisors) of the mandible. The maximum stress found in healthy jaw was 27.94 MPa and the maximum deformation was 0.28 mm. In the jaw implanted the maximum stress, located in the prosthesis, was 191.10 MPa and the maximum deformation found in the jaw was 0.28 mm.
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Palavras-chave
Modelagem tridimensional, Biomodelos, Elementos finitos, Imagem médica, Próteses personalizadas, Three-dimensional modeling, Biomodels, Finite elements, Medical imaging, Custom prostheses