在不对称无牙下颌骨中进行种植固定修复的三维有限元分析  

Finite-element Analysis of All-on-4 Prostheses in Asymmetric Edentulous Mandibular

作　　者：冯海楠 廖立凡[1,2] 常晓峰 杜良智 赵宁波[1,2] 贺龙龙 FENG Hai-nan;LIAO Li-fan;CHANG Xiao-feng;DU Liang-zhi;ZHAO Ning-bo;HE Long-long(Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China;Department of Implant Dentistry,College of Stomatology,Xi'an Jiaotong University,Xi'an 710004,Shaanxi,China)

机构地区：[1]陕西省颅颌面精准医学研究重点实验室,陕西西安710004 [2]西安交通大学口腔医院口腔种植科,陕西西安710004

出　　处：《中国美容医学》2019年第10期121-124,共4页Chinese Journal of Aesthetic Medicine

基　　金：陕西省重点研发计划(编号:2018SF-003)

摘　　要：目的:在下颌骨两侧骨高度严重不对称时进行全口种植固定修复,使用三维有限元技术对修复体支架及种植体的受力进行分析。方法:虚拟下颌骨模型资料来源于临床患者的CBCT资料,计划通过All-on-4种植技术修复无牙颌。实验组为一侧牙槽突切除后进行种植修复;对照A组为双侧牙槽突切除后种植修复;对照B组为牙槽突无明显缺损时进行种植固定修复。在指定区域单侧加载150N、双侧各加载150N垂直力量模拟单侧和双侧咬合力,观察修复体、种植体周围以及牙槽骨周围的Von Mises应力集中情况。结果:在牙槽骨切除区域的种植体周围会产生更多的Von Mises应力集中;种植体周围骨质和修复桥架的Von Mises应力要远小于种植体周围的应力。结论:种植固定修复后,种植体承受了主要的咬合应力,因牙槽骨高度缺损的增加会造成种植体及周围骨组织的Von Mises应力增加,所以应当尽可能保留牙槽骨的高度。Objective The purpose of this study was to evaluate the load transmission to the peri-implant bone under a framework supported by 4 implants placed in an edentulous mandible and to compare the stress distribution in an asymmetric mandibular alveolar bone model and controlled symmetric mandibular alveolar bone models via a 3-dimensional finite element analysis.Methods Computerized models of the mandible with a 4-implant-supported bridge following the All-on-4 concept were developed based on patient’s CBCT.The study mandible model was designed with an asymmetric alveolar bone to simulate partial mandibulectomy,and the control mandible models A and B were designed with a flat alveolar bone with different bone resorption.A 150N load was applied to each side of the prostheses,and the von Mises stress was analyzed along the implants,framework and bone.Results More stress concertation would happen in models that implant’s surrounding bone was resorbed or resected,whether in asymmetric alveolar bone or fully resorbed alveolar bone;implant with better bone height would suffer more stress concertation in asymmetric alveolar bone model compared in symmetric alveolar bone model with better bone height.However,the stress on the bone surrounding the implant was lower in all mandible models,and the stress concentrated on the superstructure was low either.Conclusion Based on this research,the All-on-4 plan is feasible for asymmetrical mandibles.Dentist should maintain bone height and width when possible.

关 键 词：无牙颌 种植修复 有限元分析 下颌骨 截骨 

分 类 号：R782.12[医药卫生—口腔医学]