侧方[牙合]时线性[牙合]种植覆盖全口义齿下颌种植体周围骨组织的应力分布  

Stress distribution in alveolar bone around implants under implant supported overdenture with linear occlusion at lateral occlusion

作　　者：吕亚林[1] 荣起国[2] 楼航迪[2] 董坚[1] 徐军[3] 

机构地区：[1]首都医科大学附属北京安贞医院口腔医疗中心,100029 [2]北京大学工学院生物医学工程系 [3]北京大学口腔医学院·口腔医院修复科

出　　处：《中华口腔医学杂志》2008年第12期744-747,共4页Chinese Journal of Stomatology

基　　金：北京市自然科学基金（3073018）

摘　　要：目的通过比较侧方袷时线性[牙合]和解剖[牙合]种植覆盖全口义齿下颌种植体周围骨组织的应力分布，为线性袷种植覆盖全口义齿的临床应用提供依据。方法选择牙槽嵴重度吸收的无牙颌志愿者1名。采用薄层CT及ANSYS7．0软件建立志愿者颌骨、黏膜、两枚位于下颌尖牙区由杆卡附着体连接的种植体、线性[牙合]和解剖[牙合]种植覆盖全口义齿的三维有限元模型，模拟咀嚼肌肌力加载下侧方[牙合]时两种模型下颌种植体周围骨组织的应力分布。结果侧方[牙合]时解剖[牙合]模型下颌种植体周围骨组织的应力主要集中于工作侧种植体的舌侧偏远中；线性[牙合]模型下颌种植体周围骨组织的应力分布于工作侧与非工作侧种植体偏远中，且两侧均有较广泛的应力分布。两种模型种植体周围骨组织的应力峰值均出现于工作侧，垂直方向上应力（σ2）显示，解剖[牙合]和线性[牙合]模型的压应力分别为-6．47MPa、-4．86MPa，拉应力分别为6．81MPa、3．04MPa，最大主应力（σ1）显示，解剖[牙合]和线性[牙合]模型的压应力分别为-4．20MPa、-3．48MPa，拉应力分别为7．20MPa、5．33MPa。结论对于两枚种植体支持的、杆卡附着体固位的下颌种植覆盖全口义齿，在[牙合]力相同的情况下，侧方[牙合]时线性[牙合]种植覆盖全口义齿下颌两侧种植体负载的[牙合]力比解剖[牙合]更均匀，且种植体所受负荷小。Objective To analyze stress distribution in alveolar bone around implants of implant supported overdentures （ISO） with linear occlusion and with anatomic ocelusion at lateral mandibular position, and to justify the possibility of deereased injurious force around implants in ISO with linear occlusion. Methods Computerized tomography scan and finite element analysis （FEA） were used to set up two 3-D FEA models of maxillae and mandible with severe residual ridge resorption. The mueosa, linear and anatomic oeelusal ISO with bar attachments, and two implants inserted between mandibular foramina were also established in the models. With the condition of imitating the loading of masseter muscles, these models were loaded to simulate the stress distributions in alveolar bone around implants under ISO at lateral occlusion position. Results At lateral occlusion, the stress distributions in alveolar bone around implants under ISO with anatomic occlusion were mainly on the lingual and distal sides of the working side implants. However, stress distributions under ISO with linear occlusion were on the distal sides of bilateral implants, Both the stress peaks of ISOs with linear occlusion and with the anatomic one appeared in the working side. In anatomic occlusion model, （σ2 ： - 6.47 MPa and 6. 81 MPa, σ1 ： - 4. 20 MPa and 7.20 MPa （ negative value ： compressive stress, positive value ： tensile stress） ; in linear occlusion model, σ ： - 4. 86 MPa and 3.04 MPa,σ1： - 3.48 MPa and 5.33 MPa. Conclusions At lateral occlusion, when comparing the ISO with two different occlusion schemes, stress peak in alveolar bone around implants in the linear occlusion model was lower than that in the anatomic oeelusion model at equal loading situation. Stress in the alveolar bone under ISO with linear occlusion distributed more evenly than that under ISO with anatomic oeelusion.

关 键 词：牙种植 义齿 全口 有限元分析 线性[牙合] 

分 类 号：R686[医药卫生—骨科学]