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即刻种植体植入后套筒冠义齿基牙预备后残根结构的应力分布的有限元分析:一项体外研究。

Finite element analysis of stress distribution on residual root structure in socket shield procedure following immediate dental implant placement: an in vitro study.

机构信息

Private Practice, Pune, India.

Department of Prosthodontics, YCMM and RDF's Dental College & Hospital, 166/1, Vadgaon Gupta, Opp MIDC, Ahmednagar, Maharashtra, 414003, India.

出版信息

BMC Oral Health. 2024 Mar 21;24(1):366. doi: 10.1186/s12903-024-04133-9.

Abstract

BACKGROUND

The success of implants in the socket shield technique relies on stress experienced by root fragments within the socket. Although there is no consensus on optimal root fragment thickness, varying thicknesses and dynamic implant placement induce stress in various directions and degrees. This study aimed to assess biomechanical response and stress distribution across different root fragment thicknesses in the socket shield procedure.

METHODS

This in vitro study was conducted to assess and compare the stress distribution on residual root structures of varying thicknesses positioned within the labial aspect of the maxillary incisor socket during immediate implant placement of standard dimensions. The procedure involved applying an insertional torque of 40 Ncm, and the analysis was conducted using finite element analysis software.

RESULTS

Utilizing the Numerical Technique with Abaqus software for explicit dynamics, von Mises stress and principal strain were analyzed on the root structure and bone under nonlinear contact conditions during implant torque application. For Model A, a loading torque of 40 Ncm was applied vertically on the implant, along with a horizontal force of 20 N on the root structure and bone. Results indicated maximum stress of 12.68 MPa on the root structure with a thickness of 0.5 mm and 5.61 MPa on the bone, with principal strains of 6.82E-03 and 4.10E-03, respectively. In Model B, with a root structure thickness of 1.0 mm, the maximum stress increased to 19.70 MPa, while the bone stress rose to 9.51 MPa, with principal strains of 1.03E-02 and 6.09E-03. Model C, with a root structure thickness of 1.5 mm, exhibited a maximum stress of 21.58 MPa on the root and 10.12 MPa on the bone, with principal strains of 1.16E-02 and 6.10E-03. Lastly, in Model D, with a root structure thickness of 2.0 mm, the maximum stress on the root structure and bone escalated to 28.74 MPa and 11.38 MPa, respectively, with principal strains of 1.55E-02 and 8.31E-03.

CONCLUSIONS

As the thickness of the shield increases (ranging from 0.5 to 2 mm) in socket shield procedures with immediate implant placement, both stress on the root fragment and bone and principal micro-strain escalate. However, employing a shield thickness within the range of 0.5 to 2 mm does not lead to any adverse stress generation on the residual root fragment. However, for enhanced safety, it is recommended to restrict the maximum diameter and extension of the root fragment to 1.5 mm when considering implant sizes and socket diameter for the socket shield technique.

摘要

背景

种植体在牙槽窝盾技术中的成功依赖于牙槽窝内根段所承受的应力。尽管根段的最佳厚度尚无共识,但不同的厚度和动态种植体植入会以不同的方向和程度引起应力。本研究旨在评估不同根段厚度的牙槽窝盾术中的生物力学反应和应力分布。

方法

本体外研究旨在评估和比较不同厚度的残留根段在即刻植入标准尺寸种植体时唇侧牙槽内的应力分布。该过程涉及施加 40 Ncm 的插入扭矩,并使用有限元分析软件进行分析。

结果

在非线性接触条件下,使用 Abaqus 软件的数值技术进行显式动力学分析,分析了在施加种植体扭矩时根结构和骨上的 von Mises 应力和主应变。对于模型 A,在种植体上垂直施加 40 Ncm 的加载扭矩,并在根结构和骨上施加 20 N 的水平力。结果表明,厚度为 0.5mm 的根结构最大应力为 12.68MPa,骨最大应力为 5.61MPa,主应变分别为 6.82E-03 和 4.10E-03。在模型 B 中,根结构厚度为 1.0mm 时,最大应力增加到 19.70MPa,而骨的最大应力增加到 9.51MPa,主应变分别为 1.03E-02 和 6.09E-03。模型 C 中,根结构厚度为 1.5mm 时,根上的最大应力为 21.58MPa,骨上的最大应力为 10.12MPa,主应变分别为 1.16E-02 和 6.10E-03。最后,在模型 D 中,根结构厚度为 2.0mm 时,根结构和骨上的最大应力分别增加到 28.74MPa 和 11.38MPa,主应变分别为 1.55E-02 和 8.31E-03。

结论

随着即刻种植体植入的牙槽窝盾术中屏蔽厚度的增加(范围为 0.5 至 2mm),根段和骨上的应力以及主微应变都会增加。然而,在考虑种植体尺寸和牙槽窝直径时,使用 0.5 至 2mm 范围内的屏蔽厚度不会导致残留根段产生任何不良的应力。然而,为了提高安全性,建议将根段的最大直径和延伸限制在 1.5mm 以内,同时考虑使用牙槽窝盾技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5abf/10958881/ed9daa9bd50b/12903_2024_4133_Fig1_HTML.jpg

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