口腔生物医学 ›› 2023, Vol. ›› Issue (3): 175-182.

• 论著 • 上一篇    下一篇

翼上颌种植设计在上颌后牙区牙列缺损种植修复中的应力分析

朱宪昕1,张宇航2,杨益3,李苑3,江飞3   

  1. 1. 南京医科大学口腔医学院
    2. 南京医科大学附属口腔医院数字化中心
    3. 南京医科大学附属口腔医院
  • 收稿日期:2023-05-01 修回日期:2023-06-19 出版日期:2023-09-25 发布日期:2023-09-21
  • 通讯作者: 江飞 E-mail:nykqjf@njmu.edu.cn
  • 基金资助:
    国家自然科学基金面上项目;江苏省口腔转化医学工程研究中心开放课题合作研究项目;江苏省高校优势学科建设工程

Stress analysis of pterygomaxillary implant design in implant restoration of maxillary posterior partial edentulism

  • Received:2023-05-01 Revised:2023-06-19 Online:2023-09-25 Published:2023-09-21

摘要: 目的:应用三维有限元研究翼上颌种植设计在上颌后牙区牙列缺损种植修复中骨组织及种植体应力分布的变化。方法:在6组上颌后牙区牙列缺损的颌骨模型中,第二前磨牙位置植入一枚常规植体,避开上颌窦在翼上颌区域分别以咬合平面45°或以Frankfort平面70°倾斜植入一枚种植体(分别为:45度倾斜种植或70度倾斜种植),制作三单位种植桥修复体。以200N的静态力垂直加载于后牙功能尖上,应用软件分析翼上颌种植体及周围骨组织的应力,应用SPSS21.0软件对数据进行统计学分析。结果:①70度倾斜种植,加载200N垂直力后,颌骨应力大约为43.18 17.15MPa;45度倾斜种植,加载200N垂直力后,67.25 18.44MPa。②70度倾斜种植配合近中种植体形成联冠(固定桥)修复体,其跨度大于“三单位”,在第二磨牙加载垂直向力200N后,颌骨应力大约为32.49 19.01MPa,最大应力位于倾斜植入的种植体穿出位点处;在第一磨牙加载垂直向力200N后,颌骨应力大约为26.89 14.66MPa,最大应力位于近中种植体穿出位点处。③45度倾斜种植配合近中种植体形成联冠(固定桥)修复体,其跨度约为“三单位”,在第二磨牙加载垂直向力200N后,颌骨应力大约为39.88 17.12MPa,最大应力位于倾斜植入的种植体穿出位点处;在第一磨牙加载垂直向力200N后,颌骨应力大约为31.03 15.05MPa,最大应力位于近中种植体穿出位点处。结论:翼上颌种植设计在上颌后牙区牙列缺损种植修复时,70度倾斜种植时,依据基台穿出位点可选择单冠修复或联冠(固定桥)修复;当45度倾斜种植时,需配合近中种植体或天然牙,形成联冠(固定桥)修复,以避免倾斜种植体近中牙槽骨应力超过极限而出现生物性并发症。

Abstract: Objective:To study the stress distribution after pterygomaxillary implantation in posterior maxillary alveolar by using three-dimensional finite element method. Methods:In six models with dentition defects in the posterior maxillary region, tilted implants were placed at 45° to occlusal plane (45° tilted implantation) or at 70° to Frankfort plane (70° tilted implantation) and constructed fixed bridges with normal implants in the premolar maxillary region. The static force of 200N was vertically loaded on the second molar or first molar of the fixed bridges to analyze the stress distribution in the posterior maxillary alveolar bone. Results:①The stress of alveolar bone was 43.18 17.15MPa after 200N vertical force loading to 70° tilted implantation while it was 67.25 18.44MPa in 45° tilted implantation. ② The stress of alveolar bone was about 32.49 19.01MPa when 200N vertical force loading to the second molar of fixed bridges constructed with the 70° tilted implant and normal implant while the stress was about 26.89 14.66MPa when 200N vertical force loading to the first molar of the fixed bridges. ③ The stress of alveolar bone was about 39.88 17.12MPa when 200N vertical force loading to the second molar of fixed bridges constructed with the 70° tilted implant and normal implant while the stress was about 31.03 15.05MPa when 200N vertical force loading to the first molar of the fixed bridges. Conclusion: The pterygomaxillary implantation was applied to repair dentition defects in the maxillary posterior region, 70° tilted implantation with the single crown or fixed bridge could be selected according to the abutment puncture point. The 45° tilted implantation should be combined with mesial implants or natural teeth to form fixed bridge to avoid biological complications caused by the stress exceeding the limit of alveolar bone tissue.