上颌前牙区种植方案中角度设计的三维有限元分析

上海口腔医学 ›› 2015, Vol. 24 ›› Issue (2): 157-163.

上颌前牙区种植方案中角度设计的三维有限元分析

韩丽会^1,2,邱晓霞²,邢旭娜²,蔡留意³

1.郑州大学口腔医学院,河南郑州 450052;
2.河南省南阳市口腔医院,河南南阳 473000;
3.武警河南总队医院,河南郑州 450052

收稿日期:2014-04-22 出版日期:2015-04-20 发布日期:2015-07-24
通讯作者: 邱晓霞,Tel:0371-66993400,E-mail:zzkqqxx85@sina.com
作者简介:韩丽会（1988-）,女,硕士,住院医师,E-mail:308020070@qq.com
基金资助:
河南省教育厅自然科学研究资助计划项目基金(2010A320033)

Finite element analysis of the angulation designment of implant planning in the anterior maxilla

HAN Li-Hui^1,2,QIU Xiao-Xia²,XING Xu-Na²,CAI Liu-Yi³

1.School of Stomatology, Zhengzhou University. Zhengzhou 450052;
2.Stomatological Hospital of Nanyang City. Nanyang 473000;
3. Armed Police Crops Hospital of Henan. Zhengzhou 450052, Henan Province, China

Received:2014-04-22 Online:2015-04-20 Published:2015-07-24
Supported by:
Natural Science Research Funded Projects From Education Department of Henan Province (2010A320033)

摘要/Abstract

摘要： 目的采用有限元法观察分析不同种植体植入角度与不同角度基台联合运用时种植体周骨组织的应力分布及种植体的位移情况,为上颌前牙区种植修复方案的设计提供依据。方法利用锥形束CT（cone beam computed tomography, CBCT）建立包含部分上颌骨、种植体（4.3 mm×11.5 mm）、基台及上部修复体（氧化锆全瓷冠）的三维有限元模型,以种植体植入角度A,即种植体长轴与理想长轴之间的夹角 (0°、5°、10°、15°、20°、25°)和基台角度B,即基台长轴与种植体长轴之间的夹角(0°、5°、10°、15°、20°、25°)建立有限元模型。在模型上与牙冠长轴呈130°、舌侧切端下2 mm,模拟大小为178 N的力加载,采用Ansys13.0软件观察种植体周围皮质骨、松质骨的最大主应力值、分布情况和种植体的位移。结果建立了16个符合实际情况的不同种植修复方案的上颌中切牙种植义齿的三维有限元模型;各种修复方案的种植体—骨界面应力分布特点相同,应力集中在种植体颈部及根部;在相同的植入角度下,基台角度越大,种植体周围皮质骨、松质骨的最大主应力峰值及种植体位移峰值均越大。在相同的基台角度下,种植体的植入角度越大,种植体周围皮质骨、松质骨的最大主应力峰值及种植体位移峰值均越大;植入角度或基台角度大于20°时,种植体周围皮质骨、松质骨的最大主应力峰值及种植体位移峰值增加幅度较大。结论种植体的植入角度和基台角度均与种植体周围皮质骨、松质骨的最大主应力峰值及种植体位移峰值呈正相关关系,应尽量减小种植体的植入角度和基台角度,尤其是需要严格掌握种植体的植入角度。从应力、位移考虑,前牙区种植体植入角度和基台角度在20°以内为佳。大于20°时,应力有明显升高趋势,增加种植成功的风险。

关键词: 种植体, 角度, 基台, 有限元分析, 应力, 位移

Abstract: PURPOSE: To provide theoretical reference for maxillary anterior restoration designment in clinics by observing the masticatory stress distribution of the implant-bone interface and the displacement of implant. METHODS: This study built simplified 3 dimensional finite models with different angles, which included partial implant (4.3 mm×11.5 mm), abutment and all ceramic crown (Zirconia) and combined with angle of implant A between the long axis of ideal implant and factual implant (0°, 5°, 10°, 15°, 20°, 25°), as well as angle of abutment B between the long axis of abutment and implant (0°, 5°,10°,15°,20°,25°). A force load of 178 N was applied 2 mm below the incisal edge on the palatal surface of the crown, with an approximately 130°angle to the long axis of the crown. The displacement of implant maximum principal stress value and distribution of the implant-bone interface were determined by using Ansys 13.0 software. RESULTS: Sixteen 3-dimensional models of different implant restoration plan of implant dentures of maxillary incisor were built. When the angle of abutment was increasing with the same labial inclination of implant, the objective functions were enhanced. When the labial inclination of implant was increasing with the same angle of abutment, the objective functions were also improved. With the change of labial inclination of implant and angled abutment, the labial inclination of implant concentrated more than the angle of abutment on the objective functions. When the angle of abutment was between 0 degree and 20 degree, the amplitude of all the objective functions were gentle, while the labial inclination of implant and amplitude of all the objective functions were increased when the angle of abutment increased to 25 degree. CONCLUSIONS: A positive correlation is found between the value of stress of the bone around the implant, and the displacement of implant and the labial inclination of the implant and the angle of abutment. It is necessary to decrease the labial inclination of the implant and the angle of abutment, especially strictly control the labial inclination of the implant. Taking the stress and displacement into consideration, both of two angles ranging from 0 degree to 20 degree are the best optimal choice for the anterior implants. When both of two angles increase to much greater than 20 degree, the value of stress increase remarkably, which will decrease the chance of successful implant.

Key words: Implant, Angle, Abutment, Finite element analysis, Stress, Displacement

中图分类号:

R782.11

韩丽会,邱晓霞,邢旭娜,蔡留意. 上颌前牙区种植方案中角度设计的三维有限元分析[J]. 上海口腔医学, 2015, 24(2): 157-163.

HAN Li-Hui,QIU Xiao-Xia,XING Xu-Na,CAI Liu-Yi. Finite element analysis of the angulation designment of implant planning in the anterior maxilla[J]. Shanghai Journal of Stomatology, 2015, 24(2): 157-163.

参考文献

[1] Krekmanov L, Kahn M, Rangert B, et al. Tilting of posterior mandibular and maxillary implants for improved prosthesis support [J]. Int J Oral Maxillary Implants, 2000, 15(3): 405-414.
[2] Sakaguchi RL, Borhersen SE. Nonlinear contact analysis of preload in dental implant screws[J]. Int J Oral Maxillofac Implants, 1995, 10(3): 295-302.
[3] Colling EW. The physical metallurgy of titanium alloys [M]. American Society for Mentals, Ohio: Metals Park, 1984: 53-78.
[4] Menicucci G, Mossolov A, Mozzati M, et al. Tooth-implant connection: some biomechanical aspects based on finite element analyses [J]. Clin Oral Implants Res, 2002, 13(3): 334-341.
[5] Saab XE, Griggs JA, Powers JM, et al. Effect of abutment angulation on the strain on the bone around an implant in the anterior maxilla: a finite element study[J]. J Prosthet Dent, 2007, 97(2): 85-92.
[6] Sadrimanesh R, Siadat H, Sadr-Eshkevari P, et al. Alveolar bone stress around implants with different abutment angulation: an FE-analysis of anterior maxilla [J]. Implant Dent, 2012, 21(3): 196-201.
[7] 陈祖贤, 王超, 樊瑜波, 等. 上颌前牙区非埋入式种植体不同角度基台的三维有限元分析[J]. 中国组织工程研究与临床康复, 2010, 14(30): 5591-5595.
[8] Ridell A, Gröndahl K, Sennerby L. Placement of Brånemark implants in the maxillary tuber region: anatomical considerations, surgical technique and long-term results [J]. Clin Oral Implants Res, 2009, 20(1): 94-98.
[9] Bonnet AS, Postaireb M, Lipinskia P. Biomechanical study of mandible bone supporting a four-implant retained bridge Finite element analysis of the influence of bone anisotropy and foodstuff position [J]. Med Eng Phys, 2009, 31(7): 806-815.
[10] Cavaliaro J Jr, Greenstein G. Angled implant abutments: a practical application of available knowledge [J]. J Am Dent Assoc, 2011, 142(2): 150-158.
[11] Schrotenboer J, Tsao YP, Kinariwala V, et al. Effect of platform switching on implant crest bone stress: a finite element analysis[J]. Implant Dent, 2009, 18(3): 260-269.
[12] Gend JP, Tan KB, Liu GR. Application of finite element analysis in implant dentistry: a review of the literature[J]. J Prosthet Dent, 2001, 85(6): 585-598.
[13] Bayraktar HH, Morgana EF, Nieburb GL, et al. Comparison of the elastic and yield properties of human femoral trabecular and cortical bone tissue [J]. J Biomech, 2004, 37(1): 27-35.
[14] Brunski JB. Avoid pitfalls of overloading and micromotion of intraosseous implants [J]. Dent Implantol Update, 1993, 4(10): 77-81.
[15] Kao HC, Gung YW, Chung TF, et al. The influence of abutment augulation on micromotion level for immediately loaded dental implant:a 3-D finite element analysis[J]. Int J Oral Maxillofac Implants, 2008, 23(4): 623-630.