Mourya Akanksha, Nahar Rajvi, Mishra Sunil Kumar, Chowdhary Ramesh
Department of Prosthodontics, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India.
Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India.
J Oral Biol Craniofac Res. 2021 Apr-Jun;11(2):313-320. doi: 10.1016/j.jobcr.2021.03.005. Epub 2021 Mar 16.
AIM & OBJECTIVES: Clinical trials had concluded a significant relationship between implant failure and bruxism. A three-dimensional (3D) finite element analysis (FEA) was done to evaluate the stress distribution in straight and angled abutments around titanium and carbon fiber-reinforced polyetheretherketone (CFR-PEEK) implant with 2 different prosthetic crowns under parafunctional loading.
Twelve 3D models of bone block were created representing the maxillary right premolar area with osseointegrated implants. The models were divided in two group; CFR-PEEK implant (n = 6) and group titanium implant (n = 6).Each group was subdivided based on implants with three different abutments (straight, 15°, 25° angled abutments) and having two different prosthetic crowns: porcelain fused to metal (PFM) and polyetheretherketone (PEEK). A vertical load of 1000 N was applied to the central fossa and an oblique load of 500 N (30°) was applied to the buccal incline of the palatal cusp. The von Mises stresses and principal stresses were analyzed using ANSYS software.
CFR-PEEK and titanium implants produced similar stress in bone under vertical and oblique loading. Straight abutment showed better results than 15° and 25° angled abutments in all the groups. PEEK crown produced lesser stress than PFM crown under vertical and oblique loading.
The study concluded that straight abutment along with PEEK crown could be given in patients with bruxism to reduce the stress concentration in bone, thus preventing possible implant failure. Titanium and CFR-PEEK implants with straight abutments if given, then it should be provided with an occlusal splint.
临床试验已得出种植体失败与磨牙症之间存在显著关联。进行了三维(3D)有限元分析(FEA),以评估在异常功能负荷下,带有两种不同修复冠的钛和碳纤维增强聚醚醚酮(CFR-PEEK)种植体周围直型和角度基台的应力分布。
创建了12个代表上颌右前磨牙区域带骨结合种植体的骨块三维模型。这些模型分为两组;CFR-PEEK种植体组(n = 6)和钛种植体组(n = 6)。每组根据种植体分为三种不同的基台(直型、15°、25°角度基台),并带有两种不同的修复冠:金属烤瓷(PFM)和聚醚醚酮(PEEK)。在中央窝施加1000 N的垂直载荷,在腭尖的颊斜面施加500 N(30°)的斜向载荷。使用ANSYS软件分析von Mises应力和主应力。
在垂直和斜向加载下,CFR-PEEK和钛种植体在骨中产生的应力相似。在所有组中,直型基台的效果优于15°和25°角度基台。在垂直和斜向加载下,PEEK冠产生的应力小于PFM冠。
该研究得出结论,对于磨牙症患者,可采用直型基台搭配PEEK冠,以降低骨中的应力集中,从而预防可能的种植体失败。如果使用带有直型基台的钛和CFR-PEEK种植体,则应配备咬合板。