下颌后牙区不同骨质内种植体即刻负载的三维有限元分析  

Influence of bone quality on the stress distribution for three-posterior immediately loaded implants： a three-dimensional finite element analysis

作　　者：陈霞云[1] 陈松龄[2] 张美超[3] 

机构地区：[1]中山大学附属第三医院口腔科,广州510630 [2]中山大学附属第一医院口腔科,广州510080 [3]南方医科大学解剖教研室生物力学实验室

出　　处：《中华口腔医学杂志》2011年第4期233-236,共4页Chinese Journal of Stomatology

基　　金：广东省科技计划（2008B080703019、2009B050700025）

摘　　要：目的 采用三维有限元分析探讨种植体在下颌后牙区不同骨质条件下即刻负载的应力分布,以期为即刻负载的应用选择提供参考.方法 建立下颌后牙区654-｜种植体及上部牙冠和牙槽骨的即刻负载模型,根据骨皮质和骨松质比例构成不同分为B1（颌骨完全由均质的骨皮质构成）、B2（3 mm厚骨皮质包绕致密骨松质）、B3（1.5 mm厚骨皮质包绕致密骨松质）、B4（1.5 mm厚骨皮质包绕疏松骨松质）4种骨质条件,模拟颊舌向45°、100 N的力在修复体中心集中加载,分析各种植体在不同骨质内的von Mises应力分布.结果 颊舌向加载后von Mises应力主要集中于种植体颈部舌侧骨皮质,由B1至B4种植体4-｜颈周骨内应力平均值[分别为（13.17±9.32）、（12.95±9.14）、（15.00±9.44）、（16.81±10.74）N]和种植体5-｜颈周骨内应力平均值[分别为（15.51±10.32）、（14.73±8.96）、（16.79±8.40）、（18.34±8.45）N]的改变趋势一致,B3应力明显高于B1、B2,B4应力明显高于B3（P＜0.05）.从B1～B4种植体6-｜颈周骨内应力平均值[分别为（42.45±25.71）、（41.66±25.29）、（42.70±23.24）、（42.06±23.66）N]随骨质改变不大,但均显著高于相应骨质内4-｜、5-｜颈周骨内应力（P＜0.05）.结论 在本项实验条件下进行即刻负载,种植体周围应力分布不仅受颌骨骨质的影响,种植体的植入位置以及建立合理的咬合同样非常重要.Objective To assess and compare the peri-implant stress distribution of three posterior implants under immediate loading with 4 different bone qualities using three dimensional （3D） finite element （FE） analysis. Methods A 3D finite element model representing three implants in a portion of mandible at the 654-｜ region was developed, and three implants received a crown each. Four types of bone qualities （B1,B2, B3 and B4） were designed for the model. Load of 100 N was applied on the occlusal surfaces of the crowns at a 45° angle to the vertical axis of the implants. Results Von Mises stresses in the peri-implant bone of4-｜ in bone quality from B1 to B4 were （ 13. 17 ± 9. 32）, （ 12. 95 ± 9. 14）, （ 15. 00 ± 9. 44 ）, and（16.81 ±10.74） MPa, and those of 5-｜ were （15.51 ± 10.32）, （14.73 ±8.96）, （16.79 ±8.40）, and（18. 34 ±8.45） MPa. Stress in bone quality B4 showed the highest value, followed by B3 bone, the loweststress were found in B1 and B2 bone. It was significantly different （P ＜0. 05）. However, von Mises stresses in different quality of bone around 6-｜ [（42.45 ±25.71）, （41.66 ±25.29）, （42.70 ±23.24）, （42.06 ±23.66） MPa] were close to each other, and were as twice or three times as those of 4-｜ and 5-｜ , irrespective of different bone qualities. Conclusions The stress distribution around implant under immediate loading was not only affected by different bone qualities, but also by the direction of loading, and the latter may have a greater impact when a severe load delivered.

关 键 词：牙种植体 单牙 牙骨质 有限元分析 

分 类 号：R783.6[医药卫生—口腔医学]