不同材料牙周夹板对牙周炎下前牙牙周组织应力分布影响的三维有限元分析  

Effect of loading angle and fabrication materials on stress distribution with periodontal splint in compromised periodontal tissues:a finite element study

作　　者：方明 刘昱晨 钟声 李冬梅 杨彤 白石柱 Fang Ming;Liu Yuchen;Zhong Sheng;Li Dongmei;Yang Tong;Bai Shizhu(Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University,State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Xi'an 710032,China;Digital Dental Center,School of Stomatology,The Fourth Military Medical University,State Key Laboratory of Oral&Maxillofacial Reconstruction and Regeneration,National Clinical Research Center for Oral Diseases,Shaanxi Key Laboratory of Stomatology,Xi'an 710032,China)

机构地区：[1]第四军医大学口腔医院口腔修复科、口颌系统重建与再生全国重点实验室、国家口腔疾病临床医学研究中心、陕西省口腔医学重点实验室,西安710032 [2]第四军医大学口腔医院数字化口腔医学中心、口颌系统重建与再生全国重点实验室、国家口腔疾病临床医学研究中心、陕西省口腔医学重点实验室,西安710032

出　　处：《中华口腔医学杂志》2024年第11期1120-1125,共6页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81970987);陕西省创新能力支撑计划(2023-CX-PT-27)。

摘　　要：目的分析静态载荷下聚醚醚酮(PEEK)夹板与其他材料制作的牙周夹板对牙周组织、粘接剂层以及夹板本身应力分布的影响, 以期为PEEK夹板的临床应用提供参考。方法选取1例下颌牙列完整且牙周健康的25岁男性志愿者(2021年10月因上颌磨牙牙隐裂于第四军医大学口腔医院口腔修复科就诊)的锥形束CT影像数据, 建立有限元模型, 构建下前牙无骨吸收牙槽骨模型(无骨吸收组)、骨吸收模型(骨吸收对照组)和3种材料制作的牙周夹板模型:PEEK夹板(厚度0.7 mm, 弹性模量4.1 MPa)、纤维带树脂夹板(厚度1.0 mm, 弹性模量37.0 MPa)和钛夹板(厚度1.2 mm, 弹性模量110.0 MPa), 以不同牙周夹板修复的骨吸收模型为牙周夹板组(PEEK组、纤维带组及钛板组)。于41切端中点处静态加载100 N载荷, 方向分别设定为平行于牙体长轴且向下的0°, 从颊侧向舌侧并向下与牙体长轴分别呈30°、60°, 垂直于牙体长轴且向舌侧的90°。利用有限元分析软件分析不同角度加载下各组下颌前牙牙周组织、粘接剂层和牙周夹板的应力分布特征。结果不同角度加载下, 骨吸收对照组牙周膜和牙槽骨最大von Mises应力值分别为15.7~50.2 MPa和38.8~130.3 MPa, 无骨吸收组牙周膜和牙槽骨最大von Mises应力值分别为3.6~6.4 MPa和16.5~42.7 MPa;PEEK组41牙周膜最大von Mises应力值为4.6~6.2 MPa, 与相同角度加载下无骨吸收组相似, 但大于相同角度加载下纤维带组和钛板组。各组牙周膜和牙槽骨最大von Mises应力主要分布于41颈部牙周膜和牙槽骨。牙周夹板弹性模量越大, 夹板最大von Mises应力值越大, 传递至粘接剂层的第一主应力越小。PEEK组、钛板组粘接剂层和牙周夹板应力主要分布于邻近41的夹板连接体处。结论 3种材料制作的牙周夹板均能有效分散基牙牙周组织应力。相比其他牙周夹板组, PEEK夹板自身应力值较小, 传递至粘接剂层的应力�Objective To evaluate the effect of polyetheretherketone(PEEK)periodontal splints and splints made from other materials under static loading on stress distributions in periodontal tissues,cement layer,and splints themselves.Methods A finite element model based on cone-beam CT imaging data of a 25-year-old male patient(treated at the Department of Prosthodontics,School of Stomatology,The Fourth Military Medical University in October 2021 for a cracked maxillary molar)with a healthy and intact mandibular dentition and periodontal health was constructed.The finite element model included anterior mandible dentition,mandibular bone model without bone resorption(WBR group),a periodontally compromised mandible model(control group),and three types of periodontal splints:a PEEK periodontal splint(0.7 mm thick,Young′s modulus:4.1 MPa),a fiber-reinforced resin(FRC)splint(1.0 mm thick,Young′s modulus:37.0 MPa),and a titanium splint(1.2 mm thick,Young′s modulus:110.0 MPa).The bone resorption models fixed with different periodontal splints constituted the experimental groups(PEEK group,FRC group and titanium group).Loading of 100 N was applied on the midpoint of the incisal edge of tooth 41.The direction was set at 0°,which was parallel to the long axis of the tooth and downward.The buccal to lingual and downward angles were 30°and 60°,respectively,perpendicular to the long axis of the tooth and 90°to the lingual side.The finite element analysis software was utilized to analyze the stress distribution characteristics of the periodontal tissues,adhesive layer,and the splint itself in the anterior mandibular teeth among the different group.Results Under the different loading simulation,in the control group,the maximal von Mises stresses of periodontal ligament and bone were 15.7-50.2 MPa and 38.8-130.3 MPa,respectively,and in the WBR group,the maximal von Mises stresses of periodontal ligament and bone were 3.6-6.4 MPa and 16.5-42.7 MPa,respectively.Under the same loading conditions,the magnitude of maximal von Mises s

关 键 词：有限元分析 牙周夹 牙周炎 聚醚醚酮 数字化口腔医学 

分 类 号：R781.42[医药卫生—口腔医学]