动态载荷下牙半切与种植体联合修复的三维有限元分析  

Three-dimensional finite element analysis of dental implant combined with residual tooth after hemisection under dynamic loads

作　　者：邹英楠 王屹博[1] 丁超[1] 潘新宇 史久慧[1] Zou Yingnan;Wang Yibo;Ding Chao;Pan Xinyu;Shi Jiuhui(Department of Stomatology,the First Affiliated Hospital of Harbin Medical University,Harbin 150010,Heilongjiang Province,China)

机构地区：[1]哈尔滨医科大学附属第一医院口腔科,黑龙江省哈尔滨市150010

出　　处：《中国组织工程研究》2019年第2期178-183,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:磨牙半切除术后传统的修复方式对基牙健康均存在不利影响,近年来,随着种植技术的发展,牙半切与种植体联合为下颌磨牙修复提供了新的思路。目的:对比动态载荷下牙半切与种植体联合修复、单种植体修复和双种植体修复下颌磨牙的生物力学差异。方法:分别建立牙半切与种植体联合修复、单种植体修复、双种植体修复下颌第一磨牙的三维有限元模型,对修复体施加一个周期0.875 s的动态载荷,分析种植体、天然牙根及其周围骨组织在咀嚼周期不同阶段的应力分布情况。结果与结论:(1)同一材料咀嚼周期不同阶段的应力对比:种植体、皮质骨和松质骨的应力变化,舌颊向加载>颊舌向加载>垂直向加载;天然牙根的应力变化,垂直向加载>颊舌向加载>舌颊向加载;(2)1个咀嚼周期末种植体、皮质骨、松质骨的应力对比:牙半切与种植体联合修复模型>双种植体修复模型>单种植体修复模型;(3)种植体与基台连接处安全系数较低,是发生疲劳破坏的危险区域;牙半切与种植体联合修复模型的种植体使用寿命远大于种植体再口腔内受到的咀嚼压力次数,不会发生疲劳断裂现象;(4)结果表明,牙半切与种植体联合修复遵循仿生学原理,对咬合力的调节有重要作用,从生物力学角度是一种安全可行的下颌磨牙修复方式。BACKGROUND:The traditional treatment options after tooth hemisection are harmful to the abutment tooth.In recent years,with the development of oral implantology technique,combination of dental implant and residual tooth after hemisection provides a new way for mandibular molar restoration.OBJECTIVE:To compare the biomechanical properties of implant-residual tooth supported prosthesis,single implant and double implants in the mandibular molar restoration under dynamic loads.METHODS:Three-dimensional finite element models in which implant-residual tooth supported prosthesis,single implant and double implants were used to restore the mandibular first molar were established.A dynamic load of 0.875 s as a chewing cycle was applied on the restorations.Stress distributions of the implant,natural tooth and its surrounding bone tissues during the chewing cycle were analyzed.RESULTS AND CONCLUSION:(1)At different stages of one chewing cycle,the stresses of the implant,cortical bone and cancellous bone changed as follows:lingual-buccal loading>buccal-lingual loading>vertical loading;the stress of the natural tooth changed as follows:vertical loading>buccal-lingual loading>lingual-buccal loading.(2)At the end of the chewing cycle,the stress distribution of the implant,cortical bone and cancellous bone was ranked as follows:the implant-residual tooth model>double-implant model>single-implant model.(3)The safety factor at the implant-abutment junction was lowest,which was the most dangerous area of fatigue failure.The implant-residual tooth supported prosthesis had a service life enough to bear chewing pressures in the oral cavity,but not developing fatigue fracture.All these results suggest that dental implant combined with residual tooth after hemisection follows the principle of bionics and plays an important role in the regulation of occlusal force,which is an acceptable treatment from a biomechanical perspective.

关 键 词：口腔材料 种植体 有限元分析 动态载荷 牙半切 下颌磨牙 生物材料 牙种植体 牙修复体 有限元分析 磨牙 组织工程 

分 类 号：R459.9[医药卫生—治疗学]