上海口腔医学

上海口腔医学 ›› 2024, Vol. 33 ›› Issue (4): 367-372.doi: 10.19439/j.sjos.2024.04.006

• 论著 • 上一篇    下一篇

聚醚醚酮用于上颌牙列缺失种植固定修复桥架的三维有限元分析

韩祥永1, 鞠雅琼1, 张琳琳2, 田芝娟1   

  1. 1.上海市闵行区牙病防治所 口腔种植科,上海 201107;
    2.上海健康医学院 康复学院,上海 201318
  • 收稿日期:2023-07-07 修回日期:2023-09-15 出版日期:2024-08-25 发布日期:2024-09-03
  • 通讯作者: 田芝娟,E-mail: leonardo1110@163.com
  • 作者简介:韩祥永（1982-）,男,硕士研究生,副主任医师,E-mail: xyhan1982@163.com
  • 基金资助:
    闵行区自然科学研究课题(2020MHZ081); 闵行区医教研协同型健康服务体系下高层次专科骨干医师(2021年-2023年)(2020MZYS23)

Analysis of polyetheretherketone framework on the stress distribution of implant-supported fixed maxillary prosthesis: 3-D finite element analysis

HAN Xiang-yong1, JU Ya-qiong1, ZHANG Lin-lin2, TIAN Zhi-juan1   

  1. 1. Dental Implant Clinic, Shanghai Minhang District Dental Center. Shanghai 201107;
    2. Shanghai University of Medicine & Health Sciences. Shanghai 201318, China
  • Received:2023-07-07 Revised:2023-09-15 Online:2024-08-25 Published:2024-09-03

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摘要： 目的：利用三维有限元方法分析聚醚醚酮（polyetheretherketone,PEEK）作为种植固定修复桥架的可行性。方法：建立以PEEK为桥架材料,树脂、全锆、PEEK、烤塑和二硅酸锂为冠修复体的上颌牙列缺失种植固定修复三维有限元模型作为实验组,纯钛桥架全锆冠修复体模型作为对照组。在双侧第一磨牙垂直与斜向加载150 N,比较桥架、冠修复体、种植体、中央螺丝、松质骨、皮质骨压应力与拉应力最大值和von Mises应力值,分析PEEK材料作为桥架的可行性。结果：垂直加载时,实验组冠修复体von Mises应力全锆、二硅酸锂组较大,为361、295 MPa,树脂冠与PEEK冠应力较小,为35、37 MPa。实验组中央螺丝von Mises应力为694~724 MPa,远大于对照组的61 MPa,其中的最大压应力出现在树脂冠、PEEK冠组。斜向加载时,实验组桥架的von Mises应力小于对照组,但最大应力出现在树脂冠、PEEK冠组。实验组冠修复体全锆、二硅酸锂冠von Mises应力较大,树脂冠与PEEK冠应力较小。种植体von Mises应力为对照组的2倍。实验组中央螺丝von Mises应力远大于对照组,应力最大值为对照组的22倍。实验组松质骨、皮质骨应力为对照组的2倍,差异大于垂直加载。结论：PEEK材料作为上颌牙列缺失种植固定修复桥架时,应优先使用弹性模量较低的树脂或PEEK材料作为冠修复体,以降低修复体内部应力,同时减少悬臂及侧向力,避免中央螺丝应力过大。

关键词: PEEK支架, 三维有限元分析, 上颌, 牙列缺失

Abstract: PURPOSE: To analyze the stress distribution of polyetheretherketone framework of implant-supported fixed maxillary prosthesis by three-dimensional finite element method. METHODS: Three dimensional finite element model of implant-supported fixed maxillary prosthesis was established. Polyetheretherketone as framework material, resin, zirconia, PEEK, baked plastic and lithium silicate were used to make crown prosthesis as experimental group, pure titanium and monolithic zirconia prosthesis model was used as control group. The feasibility of PEEK framework was analyzed by loading 150N axially and obliquely on the first molar, and the maximum compressive stress, minimum tensile stress and von Mises principal stress of the framework, crown, screw, implant, cortical and cancellous bone were measured and compared. RESULTS: Under axially loading, the von Mises stress in the monolithic zirconia and lithium silicate crowns were 361 MPa and 295 MPa, while the stress in resin and PEEK crowns were 35 MPa and 37 MPa, respectively. The screw von Mises stress of the experimental group was 694-724 MPa, which was much higher than 61 MPa of the control group.The maximum and minimum stresses of the screw appeared in the resin crown and PEEK crown group. Under oblique loading,von Mises stress of the framework in the experimental group was lower than that in the control group, but the maximum stress appeared in the resin crown and PEEK crown. von Mises stresses of monolic zirconia and lithium disilicate crowns in the experimental group were higher than that of resin and PEEK crowns. von Mises stress of the implant in the experimental group was twice that of the control group. von Mises stress in screw of the experimental group was much higher than that of the control group, and the maximum stress was 22 times that of the control group. The stresses of cancellous bone and cortical bone in the experimental group were twice that of the control group, and the differences were larger than that under vertical loading. CONCLUSIONS: In order to reduce the stress of crowns,resin or PEEK materials are preferred to be used as the crown prosthesis when PEEK was framework of implant-supported fixed maxillary prosthesis. Reducing the cantilever and lateral force may avoid excessive stress in screw.

Key words: PEEK framework, Finite element analysis, Maxilla, Dentition loss

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