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影响牙种植体支持的固定局部义齿生物力学行为的基牙数量:有限元分析

Number of dental abutments influencing the biomechanical behavior of tooth‒implant-supported fixed partial dentures: A finite element analysis.

作者信息

de Oliveira Janaina Cordeiro, Sordi Mariane Beatriz, da Cruz Ariadne Cristiane Cabral, Zanetti Raquel Virgínia, Betiol Ederson Aureo Golçalves, Vieira Sérgio Roberto, Zanetti Artêmio Luiz

机构信息

Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.

Postgraduate in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil.

出版信息

J Dent Res Dent Clin Dent Prospects. 2020 Fall;14(4):228-234. doi: 10.34172/joddd.2020.047. Epub 2020 Dec 7.

Abstract

Local or systemic issues might prevent installing a sufficient number of dental implants for fixed prosthetic rehabilitation. Splinting dental implants and natural teeth in fixed dentures could overcome such limitations. Therefore, this study aimed to evaluate the influence of the number of dental abutments in the biomechanics of tooth‒implant-supported fixed partial dentures (FPDs). The null hypothesis was that increasing the number of abutment teeth would not decrease the stress over the abutments and surrounding bone. Left mandibular lateral incisor, canine, premolars, and molars were reconstructed through computed tomography and edited using image processing software to represent a cemented fixed metal‒ceramic partial denture. Three models were set to reduce the number of abutment teeth: 1) lateral incisor, canine, and first premolar; 2) canine and first premolar; 3) the first premolar. The second premolar and first molar were set as pontics, and the second molar was set as an implant abutment in all the models. Finite element analyses were performed under physiologic masticatory forces with axial and oblique loading vectors. After simulation of axial loads, the stress peaks on the bone around the implant, the bone around the first premolar, and prosthetic structures did not exhibit significant changes when the number of abutment teeth decreased. However, under oblique loads, decreasing the number of abutment teeth increased stress peaks on the surrounding bone and denture. Increasing the number of dental abutments in tooth‒implant-supported cemented FPD models decreased stresses on its constituents, favoring the prosthetic biomechanics.

摘要

局部或全身问题可能会妨碍为固定义齿修复植入足够数量的牙种植体。在固定义齿中使用牙种植体与天然牙联冠修复可以克服这些限制。因此,本研究旨在评估牙基台数量对牙-种植体支持的固定局部义齿(FPD)生物力学的影响。原假设是增加基牙数量不会降低基牙及其周围骨组织上的应力。通过计算机断层扫描重建左下颌侧切牙、尖牙、前磨牙和磨牙,并使用图像处理软件进行编辑,以呈现粘结固定金属烤瓷局部义齿。设置了三种模型来减少基牙数量:1)侧切牙、尖牙和第一前磨牙;2)尖牙和第一前磨牙;3)第一前磨牙。在所有模型中,将第二前磨牙和第一磨牙设置为桥体,将第二磨牙设置为种植体基台。在生理咀嚼力作用下,分别沿轴向和斜向加载向量进行有限元分析。在模拟轴向载荷后,当基牙数量减少时,种植体周围骨、第一前磨牙周围骨和修复结构上的应力峰值未表现出显著变化。然而,在斜向载荷下,基牙数量减少会增加周围骨和义齿上的应力峰值。在牙-种植体支持的粘结式FPD模型中增加牙基台数量可降低其组成部分上的应力,有利于修复体的生物力学性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbec/7867679/2c851e6c4b21/joddd-14-228-g001.jpg

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