愈合时间对Ⅲ类骨质中微种植体稳定性影响的三维有限元分析  

Effect of healing time on the stability of mini-implant in type Ⅳ bone using the three-dimension finite element analysis

作　　者：李晨曦[1] 刘一冰 郄会[1] 周冠军[1] 芦琳[1] 单丽华[1] LI Chenxi;LIU Yibing;QIE Hui;ZHOU Guanjun;LU Lin;SHAN Lihua(Department of Stomatology,the Second Hospital of Hebei Medical University,Shijiazhuang 05000)

机构地区：[1]河北医科大学第二医院口腔正畸科,石家庄050000 [2]河北医科大学第三医院

出　　处：《现代口腔医学杂志》2018年第4期193-197,共5页Journal of Modern Stomatology

基　　金：河北省卫生厅青年科技课题(20130516)

摘　　要：目的比较Ⅲ类骨质中不同愈合时间对微种植体稳定性的影响,为临床上最佳加力时机的选择提供理论依据。方法建立Ⅲ类骨质的即刻加载(IL组,IL1~IL3组过盈量分别为0.03mm、0.05mm、0.1mm)、早期加载(EL组,骨结合率34%,愈合3周)及延期加载(DL组,骨结合率44%,愈合7周)的颌骨-微型种植体三维有限元模型。测量各组在1N和2N正畸力的作用下和IL组未加力状态下颌骨的应力分布,分析愈合时间及不同加载力值对颌骨应力分布的影响。结果Ⅲ类骨质患者种植体-骨界面的应力主要集中在皮质骨区。IL组具有很高的应力峰值,且随着过盈量的增加应力峰值明显增加,IL1~IL3组分别为316MPa、519 MPa、902 MPa,对同一过盈量而言,不加载、加载1N或2N的力,其应力峰值并无变化。2N载荷EL组和DL组应力峰值明显高于1N载荷,1N载荷时EL组3.75MPa、DL组3.91MPa,2N载荷时EL组7.68MPa、DL组7.84MPa。结论针对Ⅲ类骨质患者,应在微型种植体愈合一段时间达到一定的骨结合后再轻力加载,以增强种植体稳定性,不可即刻加载。Objective The purposes of this study wereto evaluate the effect ofhealing time onstability of miniimplants in type Ⅲ bone, and to provide theoretical evidence for clinical application. Methods Created the maxillary segment finite element model of type Ⅲ bone with mini-implant; embrace Immediate Loading group（EL） Early Loading group（EL, after 3 weeks） and Delay Loading group（DL, after 7 weeks）. Analysis the stress through the difference implant-bone interface of different healing time before loading with 1 N and 2 N loading. Results The periimplant bone stressis mainly concentrated in the contact area of the mini-implant neck and the cortical bone. IL group shows a high stress; IL1 ~IL3 group were 316 MPa、519 MPa and 902 MPa, and IL1 ~IL3 group show that the peak value shows no difference between no loading, 1 N and 2 N force loading. In the EL and DL group,the stress distribution are basically the same, 3.75 MPa in ELgroup and 3.91 MPa in DLgroup with 1 N loading, 7.68 MPa in ELgroup and 7.84 MPa in DLgroup with2 N loading. Conclusion In type Ⅲ bone, Von-Mises stress is mainly distributed in the area contacted with cortical bone. The BIC of 34% and 44% can provide sufficient stability for mini-implant.Immediate loading was avoided.

关 键 词：微型种植体 愈合时间 Ⅲ类骨质 有限元分析 应力分布 

分 类 号：R783.5[医药卫生—口腔医学]