Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang Province, China.
Clin Implant Dent Relat Res. 2009 Dec;11(4):279-87. doi: 10.1111/j.1708-8208.2008.00124.x. Epub 2008 Sep 9.
Many clinical observations have shown that immediate loading is indicated when the stabilization of the bone/implant is optimal and when the estimated loads are not excessively high. Nonetheless, more experimental studies are needed to consider the immediate loading protocol as a safe procedure. Mechanical analysis using the finite element (FE) method analysis has been employed by many authors to understand the biomechanical behavior around dental implants.
This study was to evaluate the effect of the diameter and length on the stress and strain distribution of the crestal bone around implants under immediate loading.
By an ad hoc automatic mesh generator, high-quality FE models of complete range mandible was constructed from computer tomography, with three Straumann (Straumann Institute, Waldenburg, Switzerland) implants of various sizes embedded in the anterior zone. The implant diameter ranged from 3.3 to 4.8 mm, and length ranged from 6 to 14 mm, resulting in seven designs. The implant-bone interface was simulated by nonlinear frictional contact algorithm. For each design, vertical and oblique loadings of 150 N were applied, respectively, to each implant, and stresses and strains in the surrounding cortical bone were evaluated.
The biomechanics analysis provided results that the oblique loading would induce significantly higher interfacial stresses and strains than the vertical loading, while the intergroup stress difference significant levels was evaluated using t-tests method and the level of significance (.05) that was accepted for significance. Under both loadings, the maximal values were recorded in the 3.3 (diameter) x 10 (length) mm implant configuration, whose mean and peak values were both higher than that of others with significant statistical differences. The second maximal one is 4.1 x 6 mm configuration, and the minimal stresses were recorded in 4.8 x 10 mm configuration, whose strains were also near to lowest.
Increasing the diameter and length of the implant decreased the stress and strain on the alveolar crest, and the stress and strain values notably increased under buccolingual loading as compared with vertical loading, but diameter had a more significant effect than length to relieve the crestal stress and strain concentration.
许多临床观察表明,当骨/种植体的稳定性最佳且估计负荷不太高时,建议进行即刻负载。尽管如此,仍需要更多的实验研究来考虑即刻负载方案作为一种安全的程序。许多作者使用有限元(FE)方法分析来研究种植体周围的生物力学行为。
本研究旨在评估即刻负载下种植体周围牙槽嵴骨的直径和长度对种植体的应力和应变分布的影响。
通过专门的自动网格生成器,使用计算机断层扫描技术构建了完整范围下颌骨的高质量 FE 模型,在前区嵌入了三个不同尺寸的 Straumann(Straumann Institute,Waldenburg,瑞士)种植体。种植体直径范围为 3.3 至 4.8 毫米,长度范围为 6 至 14 毫米,共设计了七种方案。种植体-骨界面采用非线性摩擦接触算法模拟。对于每种设计,分别向每个种植体施加 150 N 的垂直和倾斜载荷,并评估周围皮质骨中的应力和应变。
生物力学分析结果表明,倾斜载荷会引起界面处的应力和应变显著高于垂直载荷,而使用 t 检验法评估组间应力差异显著水平,并接受显著性水平(.05)。在两种载荷下,记录到 3.3(直径)x 10(长度)mm 种植体构型的最大值,其平均值和峰值均高于其他构型,具有显著统计学差异。第二大值是 4.1 x 6mm 构型,而最小的应力记录在 4.8 x 10mm 构型中,其应变也接近最低。
增加种植体的直径和长度会降低牙槽嵴的应力和应变,与垂直加载相比,颊舌向加载会显著增加应力和应变,但直径对缓解嵴顶的应力和应变集中的影响比长度更显著。