上部结构材料对无牙下颌种植固定修复影响的三维有限元分析  

Three-dimensional finite element analysis of different framework materials in implant-supported fixed mandibular prosthesis

作　　者：于文倩 李晓茜 陈思艺 马晓妮 徐欣 Yu Wenqian;Li Xiaoqian;Chen Siyi;Ma Xiaoni;Xu Xin(Department of Implantology,School and Hospital of Stomatology,Cheeloo College of Medicine,Shandong University&Shandong Key Laboratory of Oral Tissue Regeneration&Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration,Jinan 250012,China;Department of Periodontology,School and Hospital of Stomatology,Cheeloo College of Medicine,Shandong University&Shandong Key Laboratory of Oral Tissue Regeneration&Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医学院口腔医学院·口腔医院种植科山东省口腔组织再生重点实验室,山东省口腔生物材料与组织再生工程实验室,济南250012 [2]山东大学齐鲁医学院口腔医学院•口腔医院牙周科山东省口腔组织再生重点实验室山东省口腔生物材料与组织再生工程实验室,济南250012

出　　处：《中华口腔医学杂志》2021年第2期190-195,共6页Chinese Journal of Stomatology

基　　金：国家重点研发计划(2016YFC1102705);山东省医药卫生科技发展计划(2017WS112);山东省泰山学者建设项目专项基金(ts201511106);山东大学口腔医学院青年科研基金(2018QNJJ01)。

摘　　要：目的通过三维有限元方法探讨上部结构材料对无牙下颌种植固定修复生物力学的影响,为无牙颌修复治疗提供参考。方法构建无牙下颌种植固定修复三维有限元模型,用6种牙科材料(纯钛、钴铬合金、金合金、氧化锆、聚醚醚酮及碳纤维增强聚醚醚酮)分别对种植上部结构进行赋值,得到6种模型,模拟斜向加载,对种植体、周围骨组织及上部结构进行应力分析。结果无论采用何种材料,斜向加载下模型应力均集中于后牙区种植体远中颊侧颈部及周围骨皮质,骨松质受力远小于骨皮质。6种模型种植体及骨皮质的应力由小到大分别为氧化锆、钴铬合金、纯钛、金合金、碳纤维增强聚醚醚酮、聚醚醚酮。聚醚醚酮模型磨牙区种植体及骨皮质von Mises应力最大值分别为44.96和29.13 MPa;氧化锆模型磨牙区种植体及骨皮质的von Mises应力最大值分别为21.29和17.79 MPa。与聚醚醚酮模型相比,氧化锆和金属模型种植体及周围骨皮质的应力值更小,且应力分布更均匀。结论无牙下颌种植固定修复中使用氧化锆和金属等非聚合物材料制作上部结构,更有利于种植体及周围骨组织的应力分散。Objective To evaluate the biomechanical behaviors of different framework materials in implant-supported fixed mandibular prosthesis using three-dimensional finite element analysis.Methods A model of implant-supported fixed mandibular prosthesis was established.The simulations were divided into six groups according to the framework materials:pure titanium,cobalt-chromium alloy,gold alloy,zirconia,polyether ether ketone(PEEK)and carbon fiber-reinforced PEEK.An oblique load of 300 N with a 75°angle to the occlusal plane was applied from the lingual side on the buccal cusps of the two premolars and the first molar teeth.The stresses on implants,surrounding bones and frameworks were analyzed and compared among the framework materials both quantitatively and qualitatively.Results In implant-supported fixed mandibular prosthesis model,the highest stresses were located around the neck of the implants and cortical bone during oblique loading among six designs.In addition,the stresses were concentrated on the buccal and distal cortical bone around the implants of the posterior region.Stress values of implants and cortical bones from low to high were as follows:zirconia,cobalt-chromium alloy,pure titanium,gold alloy,carbon fiber-reinforced PEEK,PEEK.The von Mises stress values of implant and cortical bone in the first molar site of PEEK framework material were 44.96 and 29.13 MPa,while the von Mises stress values of implant and cortical bone in the first molar site of zirconia framework material were 21.29 and 17.79 MPa.The zirconia and medal framework materials were more advantageous in stress distribution around implants than PEEK framework material.Conclusions In implant-supported fixed mandibular prostheses,biomechanical analysis showed that the zirconia and medal framework materials were more advantageous in stress distribution around implants than PEEK framework materials.

关 键 词：有限元分析 颌 无牙 牙种植 牙应力分析 

分 类 号：R783.6[医药卫生—口腔医学]