紧咬型磨牙对后牙游离端种植体周围骨组织应力分布的有限元研究  

The effect of clenched bruxism on the stress distribution of peri-implant bone with distal free-end edentulism: A three-dimensional finite element study

作　　者：蒋煜彬 顾卫平[1] 陈岗[1] 童丽 JIANG Yubin;GU Weiping;CHEN Gang;TONG Li(Jiangsu Key Laboratory of Oral Diseases,Nanjing Medical University,Department of General Dentistry,Affiliated Hospital of Stomatology,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室南京医科大学附属口腔医院综合科,江苏南京210029

出　　处：《口腔医学》2019年第5期409-413,共5页Stomatology

基　　金：江苏高校优势学科建设工程资助项目(2018-87)

摘　　要：目的采用三维有限元分析法,分析紧咬型磨牙对种植体及周围骨组织应力分布的影响。方法采用锥体束CT扫描一成年磨牙症志愿者,通过轮廓提取、三维重建、布尔运算建立带咬合关系的游离端缺失模型。采用参数化建模,建立Ankylos C/X 4.5 mm×11 mm种植体模型。完成模型装配后,模拟紧咬型磨牙载荷与正常咀嚼载荷对模型进行加载,分析种植体与周围骨组织的von Mises应力分布情况。结果两种载荷下种植体、基台中应力主要集中在其颊舌侧颈部周围,种植体周围骨组织应力主要集中于与种植体颈部接触的颊舌侧骨皮质。紧咬型磨牙载荷下种植体及骨组织的von Mises峰值与高应力分布区均大于正常咀嚼载荷。紧咬型磨牙载荷与正常咀嚼载荷下第一磨牙区种植体周围骨组织von Mises峰值分别为163.27 MPa与24.02 MPa,第二磨牙区分别为135.52 MPa与16.94 MPa。结论与正常的咀嚼负荷相比,紧咬型磨牙可能导致种植体与其周围骨组织的应力过度集中。Objective To analyze the effect of clenched bruxism on implants and peri-implant bone by three dimensional finite element analysis. Methods A distal free-end edentulous model with occlusion relationship was established by CBCT scanning of an adult bruxism volunteer through contour extraction, 3 D remodeling and Boolean calculation. Two Ankylos C/X 4.5 mm ×11 mm implants were designed by parametric modeling technology. After the model was assembled, the von Mises stress distribution on the implant and peri-implant bone was analyzed by simulating the clenched bruxism load and the normal masticatory load respectively. Results The stress in the implant and abutment was mainly concentrated on the buccal and lingual sides of the implant, and the stress in the peri-implant bone was mainly concentrated on the buccal and lingual cortical bone in contact with the implant under two loads. The maximum von Misese and high stress distribution area of the implants and peri-implants bone under clenched load were greater than those of under normal masticatory load. In the first molar area, the maximum von Mises in the per-implant bone was 163.27 MPa under clenched load and 24.02 MPa under masticatory load. In the second molar area, it reached to 135.52 MPa and 16.94 MPa respectively. Conclusions Compared with normal masticatory load, clenched bruxism may lead to excessive stress concentration in the implant and the surrounding cortical bone.

关 键 词：磨牙症 种植体 有限元分析 等效应力 种植体周围骨组织 

分 类 号：R783.4[医药卫生—口腔医学]