穿颧骨种植上颌窦区种植体定位方案的三维有限元分析  

Three-dimensional finite element analysis of implant positioning protocols in the maxillary sinus region for zygomatic bone implantation

作　　者：李静[1] 李晨曦[2,3] 裴培 陈程 龚忠诚[2] LI Jing;LI Chenxi;PEI Pei;CHEN Cheng;GONG Zhongcheng(Department of Oral Surgery,the First Affiliated Hospital/Affiliated Stomatology Hospital of Xinjiang Medical University,Urumqi 830054;Department of Oral and Maxillofacial Oncology&Surgery,the First Affiliated Hospital/Affiliated Stomatology Hospital of Xinjiang Medical University,Stomatological Research Institute of Xinjiang Uygur Autonomous Region,Urumqi 830054;Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration,School of Stomatology,Tongji Medical College,Union Hospital,Huazhong University of Science and Technology,Wuhan 430022;Department of Prosthodontics and Dental Implantology,the First Affiliated Hospital/Affiliated Stomatology Hospital of Xinjiang Medical University,Urumqi 830054;College of Software Engineering,Xinjiang University,Urumqi 830046,China)

机构地区：[1]新疆医科大学第一附属医院(附属口腔医院)口腔外科门诊,乌鲁木齐830054 [2]新疆医科大学第一附属医院(附属口腔医院)口腔颌面肿瘤外科,新疆维吾尔自治区口腔医学研究所,乌鲁木齐830054 [3]华中科技大学同济医学院附属协和医院口腔医学中心,口腔颌面发育与再生湖北省重点实验室,武汉430022 [4]新疆医科大学第一附属医院(附属口腔医院)口腔修复种植科,乌鲁木齐830054 [5]新疆大学软件工程学院,乌鲁木齐830046

出　　处：《口腔颌面外科杂志》2024年第5期371-378,共8页Journal of Oral and Maxillofacial Surgery

基　　金：国家自然科学基金(82360481、82160189);口腔颌面发育与再生湖北省重点实验室开放课题基金(2022-kqhm008);新疆维吾尔自治区研究生科研创新项目(XJ2023G174)。

摘　　要：目的:探究上颌窦沟槽(sinus slot,SS)技术和经上颌窦外(extra sinus,ES)技术结合常规种植体行穿颧种植修复后的生物力学分布特点,为功能性修复上颌骨重度萎缩提供理论基础。方法:通过患者的高分辨计算机断层扫描(computed tomography,CT)资料建立有限元分析(finite element analysis,FEA)模型,虚拟化穿颧种植体(zygomatic implant,ZI)分别置于SS和ES模型,并结合使用2枚或4枚常规种植体。分析种植体von Mises应力值及牙槽骨中的主应力值。结果:配置2枚常规种植体+2枚ES ZI的von Mises应力值最大(292 MPa);而4枚常规种植体+2枚SS ZI的最小(184 MPa)。配置2枚常规种植体+2枚SS ZI的最高主应力值最大(31 MPa);而4枚常规种植体+2枚ES ZI的最小(12 MPa)。配置4枚常规种植体+2枚SS ZI的最低主应力值最小(|-58|MPa);而2枚常规种植体+2枚ES ZI的最大(|-81|MPa)。结论:使用2枚SS ZI和4枚常规种植体联合修复重度萎缩的上颌骨,在生物力学方面安全性更高。Objective:To compare the distribution characteristics of biochemical stress on two techniques of zygomatic implant(ZI),sinus slot(SS)and extra sinus(ES),in combination with conventional implants respectively,and to provide theoretical basis for functional restoration of severe atrophic maxilla.Methods:Finite element analysis(FEA)models were constituted based on high-resolution computed tomography(CT)scanning data of a patient.ZIs were virtually placed into models with SS or ES techniques combined with two or four conventional implants.The von Mises stress values in implants and the principal stress values in alveolar bone were analyzed.Results:The highest von Mises stress was in the configuration of 2 conventional implants and 2 ZIs with ES technique(292 MPa).The lowest von Mises stress level in ZIs was in the configuration of 4 conventional implants and 2 ZIs with the SS technique(184 MPa).The highest maximum principal stress was in the configuration of 2 conventional implants and 2 ZIs with SS technique(31 MPa).The lowest maximum principal stress was in the configuration of 4 conventional implants and 2 ZIs with ES technique(12 MPa).The lowest minimum principal stress was in the configuration of 4 conventional implants and 2 ZIs with the SS technique(|-58|MPa).The highest minimum principal stress value in bone was in the configuration of 2 conventional implants and 2 ZIs with ES technique(|-81|MPa).Conclusion:Two ZIs with the SS technique and four conventional implants may be biomechanically safer for the rehabilitation of severe atrophic maxilla.

关 键 词：上颌骨重度萎缩 穿颧种植体 三维有限元分析 应力分布 

分 类 号：R782[医药卫生—口腔医学]