两种方案设计下支架材料对无牙上颌种植固定修复影响的有限元分析  

Finite element analysis of the influence of scaffold materials on the fixed restoration of edentulous maxillary implants under two designs

作　　者：陈圆圆 王为[1] 赵璐[1] 安尼卡尔·安尼瓦尔 尼加提·吐尔逊[1] Chen Yuanyuan;Wang Wei;Zhao Lu;Annikaer·Aniwaer;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》2024年第3期411-418,共8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),课题名称:维药买朱尼对种植体周围炎龈沟液中IL-β1以及骨界面改建影响的实验研究,项目负责人:尼加提·吐尔逊。

摘　　要：背景:在上颌无牙颌种植体支持式固定修复治疗中,上部支架结构材料的选择及不同远端种植体植入方式的设计密切影响着全口种植修复体的长期稳定性。目的:采用三维有限元方法,综合研究3种材料的上部支架及2种固定种植设计方案对上颌种植固定修复生物力学的影响。方法:根据1名健康成人正常颌的锥形束CT资料,采用Mimics软件分离上颌骨及上颌牙列三维实体模型,利用Geomagic Studio软件结合具体的模型参数构建无牙上颌全牙弓种植固定义齿的三维有限元模型。依据上颌后牙区远中种植体植入方式设计的不同,建立两种方案模型:方案1,按照临床常规应用的“All-on-4”设计,即2个种植体垂直植入上颌骨的双侧侧切牙区,另2个种植体则倾斜30°植入到双侧第二前磨牙区;方案2,即2个种植体垂直植入上颌骨的侧切牙区,后牙区采用2个短植体垂直植入双侧第二前磨牙区;在两种方案设计中使用3种材料(钛、氧化锆及聚醚醚酮)分别对上部支架结构进行赋值,得到6个模型,随后对比分析在斜向加载力方向下种植体、周围骨组织及上部支架结构的生物力学效果。结果与结论:①无论采用何种材料的上部支架,在两种无牙颌种植固定修复方案设计下,每个模型的最大应力峰值均分布于后侧种植体周围的颈部区域和皮质骨处;②与方案2中采用短种植体垂直植入的替代设计相比,方案1在上颌骨上显示出更为理想的应力分布;③由聚醚醚酮材料构建的支架模型,向上颌骨接近载荷区的种植体和周围骨组织传递了更高的应力,其次是钛、氧化锆;对于支架本身,聚醚醚酮上部支架内部应力峰值均明显小于氧化锆和钛支架;在3种上部支架材料中,选用氧化锆支架更有利于分散种植体及骨组织的应力分布;④结果提示,两种无牙颌种植固定修复设计方案都可以应用于临床实践,但从生物力学�BACKGROUND:In the treatment of edentulous maxillary implants supported fixed repair,the selection of upper scaffold structure materials and the design of different distal implant implantation methods have a close influence on the long-term stability of the whole mouth implant repair.OBJECTIVE:To comprehensively explore the influence of three different materials of upper scaffold and two implant fixation designs on the biomechanics of the fixed maxillary implant repair based on the three-dimensional finite element method.METHODS:Based on the conical beam CT data of a healthy adult with normal jaws,the Mimics software was used to separate the maxillary and maxillary dentin three-dimensional solid models,and the Geomagic Studio software was used to construct the three-dimensional finite element model of denture with denture implant and fixed maxillary arch combined with specific model parameters.According to the different designs of distal implants in the maxillary posterior region,two scheme models were established.Scheme 1(Design 1)was designed in accordance with the“All-on-4”design used in clinical practice.Two implants were vertically implanted in the bilateral incisor region of the maxilla,and the other two implants were implanted in the bilateral second premolar region at a 30°angle.In scheme 2(Design 2),two implants were vertically implanted in the lateral incisor region of the maxilla,and two short implants were vertically implanted in the posterior region of the maxilla in the bilateral second premolar region.Three materials(titanium,zirconia and polyether ether ketone)were used to assign values to the upper scaffold structure in the two designs,and six different models were obtained.The biomechanical effects of the implant,surrounding bone tissue and the upper scaffold structure were compared and analyzed in the oblique loading direction.RESULTS AND CONCLUSION:(1)The maximum stress peaks of all models were distributed in the neck region around the posterior implant and the cortical bone under the two

关 键 词：上颌无牙颌 无牙颌固定种植修复 All-on-4 倾斜种植 短植体 支架材料 静态载荷 三维有限元分析 

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