超短种植体不同修复方式的三维有限元分析  

Three-dimensional finite element analysis of different restorative methods for ultrashort implants

作　　者：热依拉·库尔班 霞黑达·依拉尔江 陈欣[1] 孜拉来·居来提 白布加甫·叶力思 尼加提·吐尔逊[1] Reyila·Kuerban;Xiaheida·Yilaerjiang;Chen Xin;Zilala·Julaiti;Baibujiafu·Yellisi;Nijati·Turson(Department of Stomatology,Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆医科大学第二附属医院口腔科,新疆维吾尔自治区乌鲁木齐市830063

出　　处：《中国组织工程研究》2023年第30期4824-4829,共6页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区自然科学基金项目(2016D01C192),项目负责人:尼加提·吐尔逊。

摘　　要：背景:在超短种植体修复过程中,不同的修复方式与不同方向的咬合受力等因素影响着种植体内部结构及植体-骨界面处应力的分布,其决定着种植体存留时间及周围骨质水平的稳定性。目的:分析超短种植体植入牙槽骨严重吸收(距下颌神经距离不足)的第一、二磨牙区后,不同修复方式对种植体及周围骨组织应力的影响。方法:从新疆医科大学第二附属医院口腔科选取一名患者的锥形束CT影像资料,该患者下颌第一、二磨牙区需行种植修复,并且满足颌骨骨质分类中的Ⅱ类骨质,种植体选用超短种植体2枚(Φ5 mm×5 mm)。依据锥形束CT影像资料,建立下颌骨三维模型,随后构建下第一、二磨牙区种植体联冠修复体模型或2颗单冠修复体模型,在第一、二磨牙区施加垂直于牙体长轴与牙体长轴呈45°斜向的力(作用点分别位于牙合面窝沟与颊侧牙合1/2面上,第一、二磨牙的作用点上各施加150 N)。应用有限元软件分析种植体内部各个结构与骨组织的应力分布。结果与结论:①施加垂直载荷时,采用单冠修复时,牙冠的应力集中均位于冠的内侧壁与基台连接处,各组件应力峰值集中于中央螺丝上;采用联冠修复时,牙冠的应力峰值集中于联冠连接体靠近龈缘处,各部件应力峰值集中于联冠上;单冠修复各部件的应力峰值均高于联冠修复,骨组织应力峰值也明显大于联冠修复;②施加斜向载荷时,采用单冠修复时,牙冠的应力集中区位于冠的内侧壁与基台连接处,各组件应力峰值集中于中央螺丝上;采用联冠修复时,牙冠的应力峰值集中于联冠连接体靠近龈缘处,冠、中央螺丝、基台、超短种植体的应力分布较集中;单冠修复体及各部件应力峰值明显小于联冠修复,行联冠修复时中央螺丝、超短种植体、基台的应力峰值较大;③采用单冠修复时,施加两种载荷后的应力分布大小无明显差异;采BACKGROUND:During the restoration of ultrashort implants,different restorative methods and occlusal forces in different directions affect the internal structure of the implant and the distribution of stresses at the implant-bone interface,which determine the longevity of the implant and the stability of the surrounding bone level.OBJECTIVE:To analyze the effects of different restorative methods on the implant and surrounding bone tissue after implantation of ultrashort implants in the first and second molar areas with severe alveolar bone resorption(insufficient distance from the mandibular nerve).METHODS:Cone beam CT images of a patient with implant restoration in the first and second mandibular molar areas were selected from Department of Stomatology,Second Affiliated Hospital of Xinjiang Medical University.This patient met the Class II bone quality classification of the jaw.TwoΦ5 mm×5 mm ultra-short implants were used.Based on cone beam CT imaging data,a three-dimensional model of the mandible was established.A joint-crown restoration model or two single-crown restoration models for the implants in the lower first and second molar areas were established.A force perpendicular to the long axis of the dentition with the long axis of the dentition was applied in the first and second molar areas at 45°obliquely(the points of action were located on the fossa of the dentition and buccal occlusal half surface,respectively)with a loading force of 150 N on the points of the first and second molars respectively.The stress distribution in the internal structures and bone tissues of the implant was analyzed using finite element software.RESULTS AND CONCLUSION:(1)When the vertical load was applied,using single-crown restoration,the stress of the crown was concentrated at the connection between the inner wall of the crown and the abutment,and the peak stress of each component was concentrated on the central screw.When using the joint-crown restoration,the peak stress of the crown was concentrated near the gingival margin

关 键 词：口腔种植 超短种植体 骨量不足 单冠修复 联冠修复 应力 生物力学 三维有限元 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R783.4