微种植体压低基牙后双端固定桥修复基牙及支持组织的动力学研究  

Dynamic analysis of the rigid fixed bridge and related tissue after intrusion of abutment with micro screw implant

作　　者：朱霖 徐培成 鲁刘磊[2] 

机构地区：[1]上海徐汇区牙病防治所,上海200032 [2]暨南大学理工学院力学与土木工程系,广东广州510632

出　　处：《上海口腔医学》2013年第4期384-388,共5页Shanghai Journal of Stomatology

基　　金：上海市卫生局科研计划课题资助项目(2009258)

摘　　要：目的:探讨动态加载时微种植体压低基牙后固定桥力学行为的改变,为临床压低基牙后再进行牙体预备提供理论依据。方法:采用螺旋CT扫描健康人上颌骨、牙及牙周支持组织的二维图像,通过Mimics10.01、Ansys13.0等图像合成、有限元分析软件建立基牙牙槽骨水平吸收10%,上颌后牙分别压低0、0.5、1.0、1.5、2.0 mm后双端固定桥修复的三维有限元分析模型,模拟在1个咀嚼周期0.875 s内连续性施加垂直向、斜向(颊向与舌向)载荷作用,比较压低基牙前、后修复体、牙、牙周膜及硬骨板的应力随时间的变化情况。结果:随着压低量增加,修复体、牙体应力发生一定改变,这一改变与修复体结构、牙体结构有很大关系。牙周膜及硬骨板面积增大,整体应力有所降低。在一个动态载荷周期内,随着时间的积累,牙、修复体、牙周膜、硬骨板的应力均逐渐增大,在斜向载荷作用下,应力达到峰值,卸载终期仍有少量的应力残余。结论:采用微种植体压低基牙后,降低了修复体、牙、牙周膜、硬骨板的应力。在1个咀嚼周期中,基牙及支持组织的应力具有时间依赖性,侧向力对其影响大于垂直向力,且1个咀嚼周期结束时,基牙及支持组织有应力残余。随着基牙压低量的增加,残余应力减少。PURPOSE： To study the variety of mechanical behavior of fixed bridge after abutments being intruded by micro screw implant and to provide theoretical principles for clinical practice of teeth preparation after intrusion of abutments under dynamic loads.METHODS： Two-dimensional images of maxilla,teeth and supporting tissues of healthy people were scanned by spiral CT and were synthesized by Mimics10.01,Ansys13.0,etc.The three-dimensional finite element mathematical model of rigid fixed bridge repairing on double end of maxillary molar was developed.Under the condition of 10% simulative abutment alveolar absorption,vertical and oblique dynamic forces were applied in a circle of mastication（0.875 s） to build mathematical model after the abutment had been intruded for 0.5,1.0,1.5 and 2.0 mm.Stress variety of prosthesis,teeth,periodontal ligaments and supporting tissues were compared before and after intrusion of abutments.RESULTS： Stress variety of the prosthesis occurred,which had close relationship with the structure of prosthesis and teeth,the areas of periodontal ligaments increased,stress on the whole decreased along with the increase of the length of intrusion.With time accumulating,the stress value in prosthesis,teeth,periodontal ligaments and supporting tissues increased gradually and loads in oblique direction induced peak value stress in a masticatory cycle.Some residual stress left after unloading.CONCLUSIONS： By preparing the fixed bridge after abutment intrusion by micro screw implant,the service life of abutment and fixed bridge prosthesis can be reduced.The abutment and its related tissue havetime-dependent mechanical behaviors during one mastication.The influence of oblique force on stress was greater than vertical force.There is some residual stress left after one mastication period.With the increase of the intrusion on abutment,residual stress reduced.Supported by Research Fund of Science and Technology Plan Project from Bureau of Health,Shanghai Municipality（2009258）.

关 键 词：基牙 牙周膜 固定桥 动力分析 

分 类 号：R783.5[医药卫生—口腔医学]