下颌骨缺损肋骨移植术后种植设计及生物力学评价  

The design and biomechanical evaluation of implantation on the mandibular defect reconstructed with rib graft

作　　者：陈淼[1] 方利华[1] 张青[1] 游嘉[2] 

机构地区：[1]浙江省湖州市中心医院口腔科,浙江湖州313000 [2]浙江工业大学机械学院,浙江杭州310014

出　　处：《上海口腔医学》2014年第3期308-311,共4页Shanghai Journal of Stomatology

摘　　要：目的:通过对单侧肋骨移植术后种植体植入的下颌骨进行几何模拟和有限元分析,评价其生物力学情况以指导,此类颌骨的种植修复。方法:基于CT扫描和图像处理技术,建立下颌骨缺损肋骨修复的几何和有限元力学模型。结合修复需要,利用计算机模拟种植部位并进行有限元分析,评价该种植设计方案的可行性和生物力学性能。结果:该患者下颌骨肋骨移植术后可进行种植修复,种植后应力集中于35近中区域,可垂直肋骨植入,后期需进一步制作赝复体,调整咬合关系。结论:可通过术前CT图像处理技术及生物力学分析,设计种植体位置和角度,后期制作赝复体、调,减少应力,提高肋骨移植术后下颌骨种植修复的精确性和成功率。PURPOSE： Applying geometric simulation and finite element analysis to an unilateral mandibular defect reconstructed with rib graft to evaluate the biomechanical properties and guide the implant restoration for this kind of mandibular defect. METHODS： A geometric and finite element analysis mechanic model of mandibular defect reconstructed with rib graft based on CT scan and graphic processing technique was established. Computer-aided simulation of implantation and finite element analysis were carried out to meet the prosthetic requirement. The feasibility and biomechanical properties of this design were also evaluated. RESULTS： Implant restoration on mandibular defect reconstructed with rib graft was feasible. The implant could be inserted perpendicularly to the rib graft and the stress after implantation was concentrated on the mesial aspect of the left mandibular second premolar area. At the later stage, a prosthetic restoration should be applied to adjust the ocelusal relationship. CONCLUSIONS： The accuracy and success rate of an implant restoration on a mandibular defect reconstructed with rib graft can be raised via preoperative design of the location and angulation of implants aided by CT scan, graphic processing technique, biomechanical analysis, as well as stress reduction by prosthetic fabrication and occlusal adjustment at the later stage.

关 键 词：下颌骨缺损 肋骨移植 三维有限元 应力分析 种植修复 

分 类 号：R782.12[医药卫生—口腔医学]