不同附着体下颌种植覆盖义齿咬合运动与应力分布的有限元研究  

Influence of different attachment on the overdenture occlusal movement and stress distribution of mandibular implant-retained overdentures:A three-dimensional finite element analysis

作　　者：宋鑫磊 辛海涛 李恺 赵艳芳[2] 贾晓瑞 

机构地区：[1]第四军医大学口腔医院,陕西西安710032 [2]兵器工业北京北方医院口腔科,北京100089

出　　处：《临床口腔医学杂志》2014年第10期599-602,共4页Journal of Clinical Stomatology

基　　金：国家自然科学基金(11072261);陕西省科学技术研究发展计划项目(2011K12-68)

摘　　要：目的:采用有限元分析法,研究不同附着体类型对种植覆盖义齿咬合运动方式、载荷分配及牙槽骨内应力分布的影响。方法:采集下颌骨及其所佩戴义齿的CT数据,利用逆向工程技术构建包含下颌骨、附着体(杆卡附着体B;ERA附着体E;球帽附着体R;磁性附着体M)和义齿的完整下颌2植体种植覆盖义齿三维有限元模型,通过对上述不同部件接触关系的定义,模拟正中咬合力作用下,种植覆盖义齿运动方式、载荷分配及颌骨内应力分布情况。结果:正中咬合时,ERA组和球帽组义齿整体均匀沉降,植体所受载荷较小;磁性组和杆卡组垂直向无缓冲,义齿前端无沉降,后端旋转下沉,植体所受载荷增大。植体周围应力分布:杆卡组最高,磁性组其次,ERA组较低,球帽组最低;后方牙槽嵴应力分布:杆卡组最高,球帽组其次,ERA和磁性组最低。结论:不同附着体类型对义齿的运动方式、载荷分配及应力分布有显著影响;附着体缓冲间隙可以延缓植体所受垂直向载荷,降低植体周围颌骨吸收的风险。Objective：The aim of this study was to evaluate the behavior of the overdenture ,the mastication force distribution and the stress distribution in alveolar bone induced by the type of the attachment ,through three-dimension finite element analysis. Method：The CT data of mandible and denture from a patient were collected. Then reverse engineer soft-wares were used to construct a 3D finite element model of the complete two implants-supported overdenture ,which include mandible,different type of attachment（bar clip attachment B;ERA E;ball attachment R;magnetic attachment M） and over-denture. By definition the contact relationship of different parts of the model and simulate centric occlusion ,to investigate the behavior of the overdenture, the mastication force distribution and the stress distribution in alveolar bone. Result：Dur-ing centric occlusion,the front of the overdenture with ERA or ball attachments were sagged,buffer space delayed and re-duced the vertical load of implants;The overdenture with magnetic or bar attachments have no vertical gap ,so the front of the overdentue have no settlement,while the back of the overdenture rotated and sagged,Which increased the load of im-plants. The peak stress in peri-implant alveolar： the bar attachment was the highest,followed by magnetic attachment,ERA was low and the ball attachment was the lowest;The peak stress in posterior alveolar ridge：the bar attachment was the high-est,ball attachment secondly,ERA and magnetic attachments were the lowest. Conclusion：The type of attachment have a significant effect on the behavior of the overdenture,the mastication force distribution and the stress distribution in alveolar bone;The vertical gap of the attachments can delay the vertical load of the implants and reduce the risk of the bone resorp-tion surrounding implants.

关 键 词：下颌种植覆盖义齿 附着体 咬合运动 应力 

分 类 号：R783.6[医药卫生—口腔医学] O242.21[医药卫生—临床医学]