不同种植设计对下颌无牙颌应力影响的有限元分析  

Finite element analysis of the influence of different implant designs on the stress of mandibular edentulous jaw

作　　者：王璨 顾卫平[1,2] 蒋煜彬 朱琳[1,2] 陈岗 Wang Can;Gu Weiping;Jiang Yubin;Zhu Lin;Chen Gang(Jiangsu Key Laboratory of Oral Diseases,Nanjing Medical University,Nanjing 210029,Jiangsu Province,China;Department of Polyclinics,Affiliated Hospital of Stomatology,Nanjing Medical University,Nanjing 210029,Jiangsu Province,China;Department of Stomatology,Jiangyin People’s Hospital,Jiangyin 214400,Jiangsu Province,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,江苏省南京市210029 [2]南京医科大学附属口腔医院综合科,江苏省南京市210029 [3]江阴市人民医院口腔科,江苏省江阴市214400

出　　处：《中国组织工程研究》2022年第4期573-578,共6页Chinese Journal of Tissue Engineering Research

基　　金：江苏高校优势学科建设工程资助项目(2018-87)。

摘　　要：背景:下颌种植固定全口义齿已经成为临床上无牙颌主要的修复方式之一,针对不同种植设计进行力学研究可以帮助临床选择符合生物力学原则的种植设计方案,有利于维护种植义齿的长期稳定。目的:保持远中悬臂长度一致,建立不同种植位点分布的模型,得出最前端植体位点、植体分布的对称性及植体数目对基台、种植体及骨组织应力分布的影响。方法:选取一无牙颌下颌骨锥形束CT数据,利用锥形束CT数据及种植体、基台、冠部修复体数据分别建立不同种植位点与区域、不同种植体数目的有限元模型,在双侧前磨牙及磨牙区分别施加150 N垂直压力,计算出基台、种植体、骨组织的应力值,并进行统计学分析。结果与结论:(1)当最前端种植体越靠前时,模型中基台、种植体及骨组织表面的应力值有逐渐减小的趋势,对于4颗植体,当位于侧切牙及其以前的种植体数目为2颗时骨组织应力值最小,与1,0颗骨组织应力值比较差异有显著性意义(P <0.05);对于5颗种植体,最前端种植体位点位于侧切牙及其以前模型的基台、种植体、骨组织应力值,与最前端种植体位点位于尖牙及其以后模型比较差异有显著性意义(P <0.05),因此当悬臂长度一定时(实验为10 mm),4,5颗种植体最前端种植体应尽量位于侧切牙及其以前的位点,且4颗种植体时位于侧切牙以前的种植体数目2颗为较好的选择;(2)当悬臂长度和AP距(最前端的种植体与最远端2颗种植体之间连线的距离)保持不变时,对称模型与非对称模型的基台、种植体及骨组织周围应力值比较差异均无显著性意义(P> 0.05),因此在悬臂长度与AP距保持不变时种植体并非一定按照对称原则进行排列;(3)种植体数目为4颗模型的基台及种植体表面应力值高于种植体数目为5,6颗模型(P <0.05)。因此,种植固定全口义齿最好是以5颗及其以上数目的种植体进�BACKGROUND: The implant fixed complete denture for mandibular edentulous jaws has become one of the main clinical restoration methods. Mechanical studies on different implant designs can help clinical selection of implant designs in line with biomechanical principles, which is beneficial to maintain the longterm stability of implant dentures.OBJECTIVE: To establish the models for the distribution of different implant sites with the same cantilever length, and to analyze the influence of implant sites, the symmetry of implant distribution and the number of implants on the stress distribution around the abutment, implant, and bone tissue.METHODS: Cone beam CT data of an edentulous mandible were selected. The cone beam CT data, implant, abutment, and crown restoration data were used to create finite element model of different transplantation sites and regions, and different number of implants. The premolars and molars regions were bilaterally subjected to a vertical load of 150 N. The software was used to calculate the stress of the abutment, implant, and bone tissue, and then statistical analysis was performed.RESULTS AND CONCLUSION:(1) When the frontmost implant was closer to the front, the stress on the abutment, implant and bone tissue would gradually decrease. For four implants, when the number of implants located at and before the lateral incisor was 2, the bone tissue stress value was the smallest, and there was a statistical difference in the stress value with 1 and 0 implants(P < 0.05). For five implants, when the frontmost implant site was located at and before the lateral incisor, there was a statistical difference in the stress value with the canine and later(P < 0.05). Therefore, when the length of the cantilever was fixed(10 mm in the experiment), the foremost implant of 4 or 5 implants should be placed in the lateral incisor and the front site. When there were four implants, the number 2 of implants before the lateral incisor was a better choice(2) When the cantilever length and anterior-posterior spr

关 键 词：材料 口腔 种植义齿 下颌无牙颌 种植固定全口义齿 有限元分析 应力 种植体数目 种植体位点 悬臂长度 

分 类 号：R459.9[医药卫生—治疗学] R331[医药卫生—临床医学]