Abrishamkar Sarah, Fathi Amirhossein, Ghorbani Mahsa, Mosharraf Ramin
Dental Students' Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Prosthodontics, Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Prosthodont. 2024 Sep 19. doi: 10.1111/jopr.13954.
This study aimed to comparatively analyze full-arch mandibular reconstruction using dental implants. It focused on two distinct prosthesis configurations: completely splinted and segmentally splinted. These configurations were evaluated under two different occlusal schemes-group function and canine guidance-utilizing finite element analysis (FEA).
The methodology involved developing three-dimensional finite element models from computed tomography data acquired from an edentulous patient. Six dental implants were utilized to complete the mandibular reconstruction. Prosthetic reconstruction was conducted with completely and segmentally splinted prostheses, each employing group function and canine guidance occlusal schemes. Consequently, four distinct models were analyzed. Following meshing, a 200 N load was applied at a 30-degree angle. Subsequent evaluation encompassed stress, strain distribution, and the overall deformation of the implants, crowns, and underlying bone structure assessment.
The group function occlusal scheme generally exhibited lower stress values than the canine guidance occlusal scheme, with three-piece prostheses demonstrating even lower stress levels than one-piece prostheses. Conversely, the canine guidance occlusal scheme exhibited higher stress values overall.
The findings of this study may assist clinicians in selecting the most effective occlusal scheme and prosthetic configuration for implant-supported mandibular restorations, potentially enhancing treatment outcomes and reducing the risk of mechanical complications. In summary, results indicated that group function loading, irrespective of prosthesis type, offers more uniform load distribution and lower stress values, making it a preferable choice over canine guidance. Within the group function occlusal scheme, three-piece prostheses demonstrated lower stress values than one-piece prostheses, but the clinical significance of this difference appears to be minimal.
本研究旨在对使用牙种植体进行全牙弓下颌骨重建进行比较分析。研究重点关注两种不同的修复体构型:完全夹板式和分段夹板式。利用有限元分析(FEA)在两种不同的咬合方案——组功能和尖牙引导下对这些构型进行评估。
该方法包括根据从一名无牙患者获取的计算机断层扫描数据建立三维有限元模型。使用6颗牙种植体完成下颌骨重建。用完全夹板式和分段夹板式修复体进行修复重建,每种修复体都采用组功能和尖牙引导咬合方案。因此,分析了4种不同的模型。网格划分后,以30度角施加200 N的载荷。随后的评估包括应力、应变分布以及种植体、牙冠和下方骨结构的整体变形评估。
组功能咬合方案的应力值通常低于尖牙引导咬合方案,三件式修复体的应力水平甚至低于一体式修复体。相反,尖牙引导咬合方案的整体应力值较高。
本研究结果可能有助于临床医生为种植体支持的下颌修复选择最有效的咬合方案和修复体构型,有可能提高治疗效果并降低机械并发症的风险。总之,结果表明,无论修复体类型如何,组功能加载提供更均匀的载荷分布和更低的应力值,使其比尖牙引导更可取。在组功能咬合方案中,三件式修复体的应力值低于一体式修复体,但这种差异的临床意义似乎很小。