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使用不同长度和直径的牙种植体固定局部义齿中连接体设计对位移和微动的影响:一项三维有限元研究

Influence of Connector Design on Displacement and Micromotion in Tooth-Implant Fixed Partial Dentures Using Different Lengths and Diameters: A Three-Dimensional Finite Element Study.

作者信息

Mously Hisham A, Naguib Ghada H, Hashem Abou Bakr Hossam, Abougazia Ahmed O, Binmahfooz Abdulelah M, Hamed Mohamed T

机构信息

Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

出版信息

Materials (Basel). 2024 Sep 7;17(17):4416. doi: 10.3390/ma17174416.

Abstract

The literature presents insufficient data evaluating the displacement and micromotion effects resulting from the combined use of tooth-implant connections in fixed partial dentures. Analyzing the biomechanical behavior of tooth-implant fixed partial denture (FPD) prothesis is vital for achieving an optimum design and successful clinical implementation. The objective of this study was to determine the relative significance of connector design on the displacement and micromotion of tooth-implant-supported fixed dental prostheses under occlusal vertical loading. A unilateral Kennedy class I mandibular model was created using a 3D reconstruction from CT scan data. Eight simulated designs of tooth-implant fixed partial dentures (FPDs) were split into two groups: Group A with rigid connectors and Group B with non-rigid connectors. The models were subjected to a uniform vertical load of 100 N. Displacement, strain, and stress were computed using finite element analysis. The materials were defined as isotropic, homogeneous, and exhibiting linear elastic properties. This study focused on assessing the maximum displacement in various components, including the bridge, mandible, dentin, cementum, periodontal ligament (PDL), and implant. Displacement values were predominantly higher in Group B (non-rigid) compared to Group A (rigid) in all measured components of the tooth-implant FPDs. Accordingly, a statistically significant difference was observed between the two groups at the FPD bridge ( value = 0.021 *), mandible ( value = 0.021 *), dentin ( value = 0.043 *), cementum ( value = 0.043 *), and PDL ( value = 0.043 *). Meanwhile, there was an insignificant increase in displacement values recorded in the distal implant ( value = 0.083). This study highlighted the importance of connector design in the overall stability and performance of the prosthesis. Notably, the 4.7 mm × 10 mm implant in Group B showed a displacement nearly 92 times higher than its rigid counterpart in Group A. Overall, the 5.7 mm × 10 mm combination of implant length and diameter showcased the best performance in both groups. The findings demonstrate that wider implants with a proportional length offer greater resistance to displacement forces. In addition, the use of rigid connection design provides superior biomechanical performance in tooth-implant fixed partial dentures and reduces the risk of micromotion with its associated complications such as ligament overstretching and implant overload, achieving predictable prognosis and enhancing the stability of the protheses.

摘要

文献中提供的数据不足以评估固定局部义齿中牙-种植体连接联合使用所产生的位移和微动效应。分析牙-种植体固定局部义齿(FPD)修复体的生物力学行为对于实现最佳设计和成功的临床应用至关重要。本研究的目的是确定在咬合垂直加载下,连接体设计对牙-种植体支持的固定义齿位移和微动的相对重要性。使用CT扫描数据进行三维重建,创建了一个单侧Kennedy I类下颌模型。牙-种植体固定局部义齿(FPD)的八种模拟设计分为两组:A组为刚性连接体,B组为非刚性连接体。对模型施加100 N的均匀垂直载荷。使用有限元分析计算位移、应变和应力。材料被定义为各向同性、均匀且具有线弹性特性。本研究重点评估了包括桥体、下颌骨、牙本质、牙骨质、牙周韧带(PDL)和种植体在内的各个部件中的最大位移。在牙-种植体FPD的所有测量部件中,B组(非刚性)的位移值主要高于A组(刚性)。因此,在FPD桥体(P值=0.021*)、下颌骨(P值=0.021*)、牙本质(P值=0.043*)、牙骨质(P值=0.043*)和PDL(P值=0.043*)处,两组之间观察到统计学上的显著差异。同时,远端种植体记录的位移值增加不显著(P值=0.083)。本研究强调了连接体设计在修复体整体稳定性和性能中的重要性。值得注意的是,B组中4.7 mm×10 mm的种植体显示出的位移几乎是A组中刚性对应种植体的92倍。总体而言,5.7 mm×10 mm的种植体长径组合在两组中表现出最佳性能。研究结果表明,具有适当长度的较宽种植体对位移力具有更大抵抗力。此外,刚性连接设计的使用在牙-种植体固定局部义齿中提供了卓越的生物力学性能,并降低了微动及其相关并发症(如韧带过度拉伸和种植体过载)的风险,实现了可预测的预后并增强了修复体的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73ac/11395790/8d7f1512d5f3/materials-17-04416-g001.jpg

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