应力中断式附着体义齿修复下颌双侧游离端缺失的生物力学分析  

Biomechanical Analysis of the Mandibular Bilateral Distal-extension Absence Restored with a Stress-breaking Attachment-retained Removabale Partial Denture

作　　者：崔嘉玺 谭力芯 熊宇[1] 王少君[2] 霍相茹 杜甫 周继祥[1] 

机构地区：[1]第三军医大学西南医院口腔科,重庆400038 [2]四川大学制造科学与工程学院,四川成都610065 [3]金典义齿连锁机构,四川成都610225

出　　处：《中国美容医学》2017年第3期25-28,共4页Chinese Journal of Aesthetic Medicine

基　　金：重庆市基础与前沿研究计划项目(cstc20l3jcyjA10112);第三军医大学西南医院临床创新基金项目(SWH2013LC16)

摘　　要：目的：分析并阐明一种自主设计的应力中断式附着体修复下颌双侧游离端缺失后支持组织的应力分布规律。方法：设计和建立修复下颌双侧磨牙缺失的KenndeyⅠ类应力中断式附着体和常规冠外弹性附着体义齿的三维有限元模型,应用三维有限元法,比较轴向载荷下两种修复方式支持组织的应力分布情况。结果：成功建立了应力中断式附着体和常规冠外弹性附着体义齿修复双侧下颌双侧游离端缺失的三维有限元模型。在轴向载荷下,应力中断式附着体义齿的基牙、牙周膜、牙槽嵴各部分承受的最大Von-Mi ses应力值分别约是常规冠外弹性附着体义齿的71.0%,26.6%和25.0%,且其牙周膜和牙槽嵴黏膜受力分布较常规冠外弹性附着体义齿更加均匀和广泛。结论：应力中断式附着体较常规冠外弹性附着体能明显减轻局部可摘义齿在轴向载荷下基牙和牙周膜的受力,均匀分散力,起到应力中断和保护基牙的作用。Objective To analyze the stress distribution on the supported tissues of the mandibular bilateral distal-extension absence restored with a removable partial denture （RPD） retained by a self-designed stress-breaking attachment. Methods Mandibular Kennedy Class I RPDs retained by a self-designed stress-breaking attachment or an ERA were designed and established. Three-dimensional finite element method was used to analyze the stress distribution of the supporting tissues under the two kinds of restoration modes under axial load. Results The three-dimensional finite element models of the two RPDs were established successfully. Under the axial load, the maximal Von-Mises values of the abutments, periodontal ligament and alveolar ridge under the RPD retained by a self-desinged stress-breaking attachment was about 71.0%, 26.6% and 25.0% of those under the PRD retained by ERA; the stress distributed on the periodontal ligament and alveolar ridge mucosa was more uniform and extensive in the stress-breaking attachment retained RPD. Conclusion The harmful stress loaded on the supported tissues under the RPDs can dramatically diminished by the self-designed stress-breaking attachment. The design of the stress-breaking attachment shows promising clinical perspective.

关 键 词：三维有限元 冠外弹性附着体 应力中断附着体 双侧游离端缺失 应力值 

分 类 号：R783.6[医药卫生—口腔医学]