Li Y, Sun C, Jia H, Luo X J
Department of Prosthodontics, The First Affiliated Hospital of Shanxi Medical University, Taiyuan 030001.
Department of Stomatology, Shanxi Medical University, Taiyuan 030001, China(Present address: Department of Stomatology, The Second People's Hospital of Changzhi, Changzhi Shanxi 046011, China).
Zhonghua Kou Qiang Yi Xue Za Zhi. 2017 Nov 9;52(11):672-677. doi: 10.3760/cma.j.issn.1002-0098.2017.11.005.
To evaluate the effect of different placement of mesial implants in edentulous jaws on the stress of the implant and the surrounding bone tissue by three-dimensional (3D)finite element analysis. Cone-beam CT data of mandibular edentulous patients was transferred into Mimics 17.0 and UG NX8.5 software, and three groups of 3D solid model were established: two mesial implants were implanted in the anterior region of the mandible (bilateral central incisor, lateral incisor, canine), and two distal oblique implant with 30° were implanted in the mandibular second premolar area(5 mm near the mental foramen). Set mandible 3D model with 4 implant by using UG NX8.5 software, produced 3 groups (mandible Ⅰ-Ⅲ). We took dynamic loading on models with help of software Abaqus 6.12, working side posterior teeth loading was set to 150 N and the simulation cycle was 0.875 s. The first stage: 0.000 s to 0.130 s, the lower jaw moves outward (moving toward the side of the work), with no contact between the upper and lower teeth; the second stage: 0.130 s to 0.150 s, mandibular upward, the same tooth tip of the working side were relative, the loading position were the posterior buccal tip, tongue tip; the third stage: 0.150 s to 0.260 s, the buccal slopes of buccal tips of mandibular posterior teeth glide along the lingual slopes of buccal tips of maxillary posterior teeth, the loading force was from the buccal side to the lingual side, the long axis of the tooth was 45°, loaded on the buccal slopes of buccal tips of posterior teeth; the fourth stage: 0.260 s to 0.300 s, the lingual slopes of buccal tips of mandibular posterior teeth glide along the buccal slopes of the tongue tips of maxillary posterior teeth, separate from the tip of the tooth at half the length, the loading force was from the lingual side to the buccal side, the long axis of the tooth was 45°, loaded on the lingual slopes of buccal tips of posterior teeth; the fifth stage: 0.300 s to 0.875 s, at the unloading stage, mandibular posterior teeth were separated from the maxillary teeth and returned to the intercuspal position. The loading position varied according to the mastication cycle. The stress distribution of implant and surrounding bone tissue at different stages of each model were observed. From the early stage to chew occlusal contact to the end of the mastication cycle, three groups of models were displayed: the stress of distal implants was greater than that of mesial implants and the neck stress reached the maximum and gradually decreased to the root tip. The stress of distal implant bone was greater than that of mesial implant bone and the stress of distal bone of distal implant was greater than that of mesial bone of distal implant. All the stress peak showed a gradual increase, and the stress reach the maximum at the fourth stage. In the 3 models, the bone stress around the distal implant of model of the anterior implant located in the lateral incisor region was the lowest. The peak stress of cortical bone of the distal position of implant was 58.7 MPa. The bone stress around the distal implant of model of the anterior implant located in the canine region reached the maximum, and the peak stress of cortical bone of the distal position of implant was 135.6 MPa. When mesial implants of edentulous jaws located in the lateral incisor region, it is good for stress dispersion.
通过三维(3D)有限元分析,评估无牙颌中不同位置的近中种植体对种植体及周围骨组织应力的影响。将下颌无牙患者的锥形束CT数据导入Mimics 17.0和UG NX8.5软件,建立三组3D实体模型:在下颌前部区域(双侧中切牙、侧切牙、尖牙)植入两枚近中种植体,在距颏孔5mm的下颌第二前磨牙区域植入两枚呈30°角的远中斜向种植体。利用UG NX8.5软件建立含4枚种植体的下颌3D模型,分为三组(下颌Ⅰ - Ⅲ组)。借助Abaqus 6.12软件对模型进行动态加载,工作侧后牙加载力设定为150N,模拟周期为0.875s。第一阶段:0.000s至0.130s,下颌向外移动(向工作侧移动),上下牙无接触;第二阶段:0.130s至0.150s,下颌向上移动,工作侧同名牙尖相对,加载位置为后牙颊尖、舌尖;第三阶段:0.150s至0.260s,下颌后牙颊尖颊斜面沿上颌后牙颊尖舌斜面滑动,加载力从颊侧向舌侧,牙长轴呈45°,加载于后牙颊尖颊斜面;第四阶段:0.260s至0.300s,下颌后牙颊尖舌斜面沿上颌后牙舌尖颊斜面滑动,在牙长一半处脱离牙尖,加载力从舌侧向颊侧,牙长轴呈45°,加载于后牙颊尖舌斜面;第五阶段:0.300s至0.875s,卸载阶段,下颌后牙与上颌牙分离并回到牙尖交错位。加载位置根据咀嚼周期变化。观察各模型不同阶段种植体及周围骨组织的应力分布。从咀嚼初期咬合接触到咀嚼周期结束,三组模型显示:远中种植体的应力大于近中种植体,颈部应力最大并逐渐向根尖减小。远中种植体周围骨组织的应力大于近中种植体周围骨组织的应力,远中种植体远中侧骨组织的应力大于远中种植体近中侧骨组织的应力。所有应力峰值均呈逐渐增大趋势,在第四阶段应力达到最大值。在3个模型中,位于侧切牙区域的前部种植体模型中远中种植体周围的骨应力最低。种植体远中位置皮质骨的峰值应力为58.7MPa。位于尖牙区域的前部种植体模型中远中种植体周围的骨应力最大,种植体远中位置皮质骨 的峰值应力为135.6MPa。当无牙颌的近中种植体位于侧切牙区域时,有利于应力分散。