Tokar Emre, Uludag Bulent, Karacaer Ozgul
Int J Oral Maxillofac Implants. 2017 Mar/Apr;32(2):363-371. doi: 10.11607/jomi.5291.
Implant-retained overdentures are the first choice of rehabilitation for edentulous mandibles. Bone morphology and anatomical landmarks may be influenced by the location and angulation of implants and distances between the implants. The purpose of this study was to investigate stress distribution characteristics and to compare stress levels of three different attachment designs of three-implant-retained mandibular overdentures with three different interimplant distances.
Three photoelastic mandibular models with three implants were fabricated using an edentulous mandible cast with moderate residual ridge resorption. The center implants were embedded parallel to the midline, and the distal implants were aligned at a 20-degree angulation corresponding to the center implants. Distances between the center and distal implants were set at 11, 18, and 25 mm at the photoelastic models. Bar, bar-ball, and Locator attachment-retained overdentures were prepared for the models. Vertical loads were applied to the overdentures, and stress levels and distribution were evaluated by a circular polariscope.
The greatest observed stress level was moderate for the tested overdenture designs. The Locator attachment system showed the lowest stress level for the 11-mm and 25-mm photoelastic models. The bar attachment design transmitted less stress compared with the other tested designs for the 18-mm photoelastic model.
Stresses were observed on the loaded side of the photoelastic models. The lowest stress was found with the Locator and bar attachments for the 11-mm photoelastic model, which transmitted little or no discernible stress around the implants.
种植体支持的覆盖义齿是无牙下颌骨修复的首选。种植体的位置、角度以及种植体之间的距离可能会影响骨形态和解剖标志。本研究的目的是调查三种不同种植体间距的三种植体支持的下颌覆盖义齿的三种不同附着设计的应力分布特征,并比较其应力水平。
使用具有中度剩余牙槽嵴吸收的无牙下颌骨模型制作三个带有三颗种植体的光弹性下颌模型。中间种植体与中线平行植入,远端种植体与中间种植体呈20度角对齐。在光弹性模型上,中间种植体与远端种植体之间的距离设置为11、18和25毫米。为模型制作杆式、杆球式和Locator附着式覆盖义齿。对覆盖义齿施加垂直载荷,并通过圆偏振光镜评估应力水平和分布。
对于测试的覆盖义齿设计,观察到的最大应力水平为中度。Locator附着系统在11毫米和25毫米光弹性模型中显示出最低的应力水平。对于18毫米光弹性模型,杆式附着设计与其他测试设计相比传递的应力较小。
在光弹性模型的加载侧观察到应力。在11毫米光弹性模型中,Locator和杆式附着的应力最低,在种植体周围传递的应力很小或几乎没有可察觉的应力。