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采用有限元法分析两段式牙种植体中短种植体及下牙槽神经的侧方移位情况。

Analysis of short implants and lateralization of the inferior alveolar nerve with 2-stage dental implants by finite element method.

作者信息

Vasco Marco Antonio Amorim, Hecke Mildred Ballin, Bezzon Osvaldo Luiz

机构信息

Prosthodontics and Dental Materials Department, School of Dentistryof Ribeirão Preto–University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

出版信息

J Craniofac Surg. 2011 Nov;22(6):2064-71. doi: 10.1097/SCS.0b013e318231993d.

Abstract

There are difficulties for dental implant use in posterior mandible when there is little bone height for implant placement. Among the treatment alternatives available, there is no direct comparison between short implants and conventional implants placed with lateralization of the inferior alveolar nerve. The present study aimed to comparatively evaluate the risk of peri-implant bone loss of the above treatments. With this aim, computed tomography scans of mandibles were processed, and implants and prosthetic components were reverse engineered for reconstruction of three-dimensional models to simulate the biomechanical behavior of 3-element fixed partial dentures supported by 2 osseointegrated implants, using simulations with the finite element method. The models of implants were based on MK III implants (Nobel Biocare) of 5- and 4-mm diameter by 7-mm length, representing short implants, and 4- and 3.75-mm diameter by 15-mm length, representing implants used in lateralization of the inferior alveolar nerve. All models were simulated with prestress concerning the stresses generated by the torque of the screw. Axial and oblique occlusal loads at 45% were simulated, resulting in 8 different simulations. The results showed that the risk for bone loss in osseointegrated implants is greater for treatments with short implants.

摘要

当用于下颌后部的牙种植体植入时骨高度不足时,会存在困难。在现有的治疗方案中,短种植体与在下牙槽神经侧方定位植入的传统种植体之间没有直接比较。本研究旨在比较评估上述治疗的种植体周围骨丢失风险。为此,对下颌骨的计算机断层扫描进行处理,并对种植体和修复部件进行逆向工程,以重建三维模型,使用有限元方法模拟由2个骨整合种植体支持的三单位固定局部义齿的生物力学行为。种植体模型基于直径5毫米和4毫米、长度7毫米的MK III种植体(诺贝尔生物公司),代表短种植体,以及直径4毫米和3.75毫米、长度15毫米的种植体,代表在下牙槽神经侧方定位中使用的种植体。所有模型均针对由螺钉扭矩产生的应力进行了预应力模拟。模拟了45°的轴向和斜向咬合负荷,产生了8种不同的模拟。结果表明,对于短种植体治疗,骨整合种植体的骨丢失风险更大。

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