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两种标准种植体或 2 枚迷你种植体固位下颌覆盖义齿的生物力学行为:三维有限元分析。

Biomechanical behavior of mandibular overdenture retained by two standard implants or 2 mini implants: A 3-dimensional finite element analysis.

机构信息

Senior Lecturer in Prosthodontics, Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.

Professor, Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.

出版信息

J Prosthet Dent. 2021 Jan;125(1):138.e1-138.e8. doi: 10.1016/j.prosdent.2020.09.015. Epub 2020 Oct 24.

Abstract

STATEMENT OF PROBLEM

Mini implants (<3 mm in diameter) are being used as an alternative to standard implants for implant-retained mandibular overdentures; however, they may exhibit higher stresses at the crestal level.

PURPOSE

The purpose of this finite element analysis study was to evaluate the biomechanical behavior (stress distribution pattern) in the mandibular overdenture, mucosa, bone, and implants when retained with 2 standard implants or 2 mini implants under unilateral or bilateral loading conditions.

MATERIAL AND METHODS

A patient with edentulous mandible and his denture was scanned with cone beam computed tomography (CBCT), and a 3D mandibular model was created in the Mimics software program by using the CBCT digital imaging and communications in medicine (DICOM) images. The model was transferred to the 3Matics software program to form a 2-mm-thick mucosal layer and to assemble the denture DICOM file. A 12-mm-long standard implant (Ø3.5 mm) and a mini dental implant (Ø2.5 mm) along with the LOCATOR male attachments (height 4 mm) were designed by using the SOLIDWORKS software program. Two standard or 2 mini implants in the canine region were embedded separately in the 3D assembled model. The base of the mandible was fixed, and vertical compressive loads of 100 N were applied unilaterally and bilaterally in the first molar region. The material properties for acrylic resin (denture), titanium (implants), mucosa (tissue), and bone (mandible) were allocated. Maximum von Mises stress and strain values were obtained and analyzed.

RESULTS

Maximum stresses of 9.78 MPa (bilaterally) and 11.98 MPa (unilaterally) were observed in 2 mini implants as compared with 3.12 MPa (bilaterally) and 3.81 MPa (unilaterally) in 2 standard implants. The stress values in the mandible were observed to be almost double the mini implants as compared with the standard implants. The stresses in the denture were in the range of 3.21 MPa and 3.83 MPa and in the mucosa of 0.68 MPa and 0.7 MPa for 2 implants under unilateral and bilateral loading conditions. The strain values shown similar trends with both implant types under bilateral and unilateral loading.

CONCLUSIONS

Two mini implants generated an average of 68.15% more stress than standard implants. The 2 standard implant-retained overdenture showed less stress concentration in and around implants than mini implant-retained overdentures.

摘要

问题陈述

微型种植体(直径<3 毫米)正被用作标准种植体的替代品,用于保留下颌义齿;然而,它们在牙槽嵴水平可能表现出更高的应力。

目的

本有限元分析研究的目的是评估单侧或双侧加载条件下,使用 2 个标准种植体或 2 个微型种植体保留时,下颌覆盖义齿、黏膜、骨和种植体的生物力学行为(应力分布模式)。

材料和方法

对一位无下颌牙的患者进行锥形束计算机断层扫描(CBCT)扫描,并使用 CBCT 数字成像和通信在医学(DICOM)图像在 Mimics 软件程序中创建 3D 下颌模型。该模型被转移到 3Matics 软件程序中,以形成 2 毫米厚的黏膜层,并组装义齿 DICOM 文件。使用 SOLIDWORKS 软件程序设计了 12 毫米长的标准种植体(Ø3.5 毫米)和微型牙科种植体(Ø2.5 毫米)以及 LOCATOR 男性附件(高度 4 毫米)。在 3D 组装模型中分别嵌入 2 个标准种植体或 2 个微型种植体。下颌骨的基底被固定,在第一磨牙区域单侧和双侧施加 100 N 的垂直压缩载荷。分配了丙烯酸树脂(义齿)、钛(种植体)、黏膜(组织)和骨(下颌骨)的材料特性。获得并分析了最大 von Mises 应力和应变值。

结果

与 2 个标准种植体的 3.12 MPa(双侧)和 3.81 MPa(单侧)相比,观察到 2 个微型种植体的最大应力为 9.78 MPa(双侧)和 11.98 MPa(单侧)。与标准种植体相比,下颌骨的应力值几乎是微型种植体的两倍。在单侧和双侧加载条件下,义齿的应力值在 3.21 MPa 和 3.83 MPa 范围内,黏膜的应力值在 0.68 MPa 和 0.7 MPa 范围内,两种种植体均为 2 个。在双侧和单侧加载下,应变值表现出相似的趋势。

结论

与标准种植体相比,2 个微型种植体产生的平均应力高 68.15%。与微型种植体保留的覆盖义齿相比,2 个标准种植体保留的覆盖义齿在种植体周围的应力集中较小。

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