Himmlová Lucie, Dostálová Tat'jana, Kácovský Alois, Konvicková Svatava
Institute of Dental Research and Czech Technical University, Prague, Czech Republic.
J Prosthet Dent. 2004 Jan;91(1):20-5. doi: 10.1016/j.prosdent.2003.08.008.
Masticatory forces acting on dental implants can result in undesirable stress in adjacent bone, which in turn can cause bone defects and the eventual failure of implants.
A mathematical simulation of stress distribution around implants was used to determine which length and diameter of implants would be best to dissipate stress.
Computations of stress arising in the implant bed were made with finite element analysis, using 3-dimensional computer models. The models simulated implants placed in vertical positions in the molar region of the mandible. A model simulating an implant with a diameter of 3.6 mm and lengths of 8 mm, 10 mm, 12 mm, 14 mm, 16 mm, 17 mm, and 18 mm was developed to investigate the influence of the length factor. The influence of different diameters was modeled using implants with a length of 12 mm and diameters of 2.9 mm, 3.6 mm, 4.2 mm, 5.0 mm, 5.5 mm, 6.0 mm, and 6.5 mm. The masticatory load was simulated using an average masticatory force in a natural direction, oblique to the occlusal plane. Values of von Mises equivalent stress at the implant-bone interface were computed using the finite element analysis for all variations. Values for the 3 most stressed elements of each variation were averaged and expressed in percent of values computed for reference (100%), which was the stress magnitude for the implant with a length of 12 mm and diameter of 3.6 mm.
Maximum stress areas were located around the implant neck. The decrease in stress was the greatest (31.5%) for implants with a diameter ranging from of 3.6 mm to 4.2 mm. Further stress reduction for the 5.0-mm implant was only 16.4%. An increase in the implant length also led to a decrease in the maximum von Mises equivalent stress values; the influence of implant length, however, was not as pronounced as that of implant diameter.
Within the limitations of this study, an increase in the implant diameter decreased the maximum von Mises equivalent stress around the implant neck more than an increase in the implant length, as a result of a more favorable distribution of the simulated masticatory forces applied in this study.
作用于牙种植体的咀嚼力会在相邻骨组织中产生不良应力,进而可能导致骨缺损以及种植体最终失效。
利用种植体周围应力分布的数学模拟来确定何种长度和直径的种植体最有利于分散应力。
采用三维计算机模型,通过有限元分析对种植体植入床中产生的应力进行计算。这些模型模拟了垂直植入下颌磨牙区的种植体。开发了一个模拟直径为3.6毫米、长度分别为8毫米、10毫米、12毫米、14毫米、16毫米、17毫米和18毫米的种植体的模型,以研究长度因素的影响。使用长度为12毫米、直径分别为2.9毫米、3.6毫米、4.2毫米、5.0毫米、5.5毫米、6.0毫米和6.5毫米的种植体对不同直径的影响进行建模。咀嚼负荷通过在自然方向上、与咬合平面呈斜角的平均咀嚼力进行模拟。针对所有变量,使用有限元分析计算种植体 - 骨界面处的冯·米塞斯等效应力值。对每个变量中应力最大的3个单元的值进行平均,并以相对于参考值(100%)计算值的百分比表示,参考值是长度为12毫米、直径为3.6毫米的种植体的应力大小。
最大应力区域位于种植体颈部周围。直径从3.6毫米增加到4.2毫米的种植体应力降低幅度最大(31.5%)。5.0毫米种植体的进一步应力降低仅为16.4%。种植体长度增加也会导致冯·米塞斯等效应力最大值降低;然而,种植体长度的影响不如种植体直径明显。
在本研究的局限性范围内,由于本研究中模拟的咀嚼力分布更有利,种植体直径增加比种植体长度增加更能降低种植体颈部周围的冯·米塞斯等效应力最大值。