Arı Ilgın, Acar Gülin, Baş İpek Dilara, Tosun Emre
J Oral Implantol. 2025 Jul 15;51(3):295-303. doi: 10.1563/aaid-joi-D-25-00073.
This study evaluated the stress distributions of subperiosteal implants (SPI) made of titanium and polyetheretherketone (PEEK) in 1-piece and 2-piece designs in edentulous and severely atrophic mandibles subjected to trauma forces. This study applied 4 treatment methods to a severely atrophic edentulous mandibular model. Subperiosteal implant designs made of PEEK consisting of 1 piece in model 1 and two in model 2 were used. Subperiosteal implant designs made of titanium composed of 1 piece in model 3 and two in model 4 were used. Each of the subperiosteal implants was fixed on the mandibular model with 14 osteosynthesis screws placed in the tension lines of the mandible. A traumatic force of 2000 N was applied to the mandibular prosthesis in the anteroposterior direction. Maximum principal stress (Pmax), minimum principal stress (Pmin), and Von Mises stress (VMs) values were measured in MPa. In this study, model 3 showed the highest Pmax value in the symphysis region (45.888 MPa), whereas the values in the other models were similar. The mandibular condyle had the highest Pmax in model 2 (941.338 MPa) and the lowest in model 3 (905.756 MPa). All models compared the Pmin values measured in the symphysis, alveolar crest, and condyle region. The VM stress values on the abutments and abutment screws were lower and more stable in PEEK SPI models than titanium SPI models. However, VMs values on titanium SPI metal frameworks were lower than PEEK SPI models. In this finite element analysis, 1-piece PEEK SPI were the most advantageous design regarding mandibular fracture risk when evaluated under traumatic forces. PEEK SPI treatment may provide a less invasive treatment model for patients with severely atrophic mandibles. Additionally, 2-piece subperiosteal implants may provide greater design flexibility in clinical applications and offer advantages in stress distribution, expanding the range of treatment options available to clinicians.
本研究评估了钛和聚醚醚酮（PEEK）制成的一体式和两件式设计的骨膜下植入物（SPI）在无牙和严重萎缩下颌骨承受创伤力时的应力分布。本研究对严重萎缩的无牙下颌模型应用了4种治疗方法。使用了由PEEK制成的骨膜下植入物设计，模型1为一体式，模型2为两件式。使用了由钛制成的骨膜下植入物设计，模型3为一体式，模型4为两件式。每个骨膜下植入物通过在下颌骨张力线上放置14颗骨合成螺钉固定在下颌模型上。在下颌假体的前后方向施加2000 N的创伤力。以兆帕（MPa）为单位测量最大主应力（Pmax）、最小主应力（Pmin）和冯·米塞斯应力（VMs）值。在本研究中，模型3在联合区显示出最高的Pmax值（45.888 MPa），而其他模型的值相似。下颌髁突在模型2中的Pmax最高（941.338 MPa），在模型3中最低（905.756 MPa）。所有模型比较了在联合区、牙槽嵴和髁突区测量的Pmin值。与钛SPI模型相比，PEEK SPI模型中基台和基台螺钉上的VM应力值更低且更稳定。然而，钛SPI金属框架上的VMs值低于PEEK SPI模型。在这项有限元分析中，在创伤力作用下评估时，一体式PEEK SPI在降低下颌骨骨折风险方面是最有利的设计。PEEK SPI治疗可能为严重萎缩下颌骨患者提供一种侵入性较小的治疗模式。此外，两件式骨膜下植入物在临床应用中可能提供更大的设计灵活性，并在应力分布方面具有优势，从而扩大临床医生可用的治疗选择范围。
