紧咬型磨牙对后牙游离端种植体周围骨组织应力分布的有限元研究
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摘要
目的采用三维有限元分析法,分析紧咬型磨牙对种植体及周围骨组织应力分布的影响。方法采用锥体束CT扫描一成年磨牙症志愿者,通过轮廓提取、三维重建、布尔运算建立带咬合关系的游离端缺失模型。采用参数化建模,建立Ankylos C/X 4.5 mm×11 mm种植体模型。完成模型装配后,模拟紧咬型磨牙载荷与正常咀嚼载荷对模型进行加载,分析种植体与周围骨组织的von Mises应力分布情况。结果两种载荷下种植体、基台中应力主要集中在其颊舌侧颈部周围,种植体周围骨组织应力主要集中于与种植体颈部接触的颊舌侧骨皮质。紧咬型磨牙载荷下种植体及骨组织的von Mises峰值与高应力分布区均大于正常咀嚼载荷。紧咬型磨牙载荷与正常咀嚼载荷下第一磨牙区种植体周围骨组织von Mises峰值分别为163.27 MPa与24.02 MPa,第二磨牙区分别为135.52 MPa与16.94 MPa。结论与正常的咀嚼负荷相比,紧咬型磨牙可能导致种植体与其周围骨组织的应力过度集中。
Objective To analyze the effect of clenched bruxism on implants and peri-implant bone by three dimensional finite element analysis. Methods A distal free-end edentulous model with occlusion relationship was established by CBCT scanning of an adult bruxism volunteer through contour extraction, 3 D remodeling and Boolean calculation. Two Ankylos C/X 4.5 mm ×11 mm implants were designed by parametric modeling technology. After the model was assembled, the von Mises stress distribution on the implant and peri-implant bone was analyzed by simulating the clenched bruxism load and the normal masticatory load respectively. Results The stress in the implant and abutment was mainly concentrated on the buccal and lingual sides of the implant, and the stress in the peri-implant bone was mainly concentrated on the buccal and lingual cortical bone in contact with the implant under two loads. The maximum von Misese and high stress distribution area of the implants and peri-implants bone under clenched load were greater than those of under normal masticatory load. In the first molar area, the maximum von Mises in the per-implant bone was 163.27 MPa under clenched load and 24.02 MPa under masticatory load. In the second molar area, it reached to 135.52 MPa and 16.94 MPa respectively. Conclusions Compared with normal masticatory load, clenched bruxism may lead to excessive stress concentration in the implant and the surrounding cortical bone.
Objective To analyze the effect of clenched bruxism on implants and peri-implant bone by three dimensional finite element analysis. Methods A distal free-end edentulous model with occlusion relationship was established by CBCT scanning of an adult bruxism volunteer through contour extraction, 3 D remodeling and Boolean calculation. Two Ankylos C/X 4.5 mm ×11 mm implants were designed by parametric modeling technology. After the model was assembled, the von Mises stress distribution on the implant and peri-implant bone was analyzed by simulating the clenched bruxism load and the normal masticatory load respectively. Results The stress in the implant and abutment was mainly concentrated on the buccal and lingual sides of the implant, and the stress in the peri-implant bone was mainly concentrated on the buccal and lingual cortical bone in contact with the implant under two loads. The maximum von Misese and high stress distribution area of the implants and peri-implants bone under clenched load were greater than those of under normal masticatory load. In the first molar area, the maximum von Mises in the per-implant bone was 163.27 MPa under clenched load and 24.02 MPa under masticatory load. In the second molar area, it reached to 135.52 MPa and 16.94 MPa respectively. Conclusions Compared with normal masticatory load, clenched bruxism may lead to excessive stress concentration in the implant and the surrounding cortical bone.
引文
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[2] 易新竹,王美青.牙合学[M].2版.北京:人民卫生出版社,2007:112.
[3] Brandt J,Brenner M,Lauer HC,et al.Risk factor bruxism in implant-prosthetic restorations[J].Implantologie,2015,23(1):51-65.
[4] Zhou Y,Gao J,Luo L,et al.Doesmbruxism contribute to dental implant failure?a systematic review and eeta-analysis[J].Clin Implant Dent R,2016,18(2):410-420.
[5] 高金霞,周毅,罗乐,等.磨牙症会导致种植失败吗?—系统回顾及Meta分析[A].中华口腔医学会口腔修复学专业委员会.第八次全国口腔修复学学术年会论文汇编[C].中华口腔医学会口腔修复学专业委员会:2014:1.
[6] Chrcanovic BR,Albrektsson T,Wennerberg A.Bisphosphonates and dental implants:a meta-analysis[J].Quintessnce Int,2016,24(5):505-516.
[7] Manfredini D,Poggio CE,Lobbezoo F.Is bruxism a risk factor fordental implants?a systematic review of the literature[J].Clin Implant Dent R,2014,16(3):460-469.
[8] G?re E,Evlio.Assessment of the effect of two occlusal concepts for implant-supported fixed prostheses by Finite Element Analysis in patients with bruxism[J].J Oral Implantol,2014,40(1):68-75.
[9] Cho SY,Huh YH,Park CJ,et al.Three-dimensional finite element analysis on stress distribution of internal implant-abutment engagement features[J].Int J Oral Maxillofac Implants,2018,33(2):319-327.
[10] Borba M,Duan Y,Griggs JA,et al.Effect of ceramic infrastructure on the failure behavior and stress distribution of fixed partial dentures[J].Dent Mater,2015,31(4):413-422.
[11] 宋少云,尹芳.有限元网格划分中的圣维南原理及其应用[J].机械设计与制造,2012(8):63-65.
[12] Gu W,Yang J,Zhang F,et al.Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint:a pilot study[J].J Biomed Sci,2015,29(2):160-168.
[13] Nishigawa K,Bando E,Nakano M.Quantitative study of bite force during sleep associated bruxism[J].J Oral Rehabil,2001,28(5):485-491.
[14] Amemori Y,Yamashita S,Ai M,et al.Influence of nocturnal bruxism on the stomatognathic system.Part I:a new device for measuring mandibular movements during sleep[J].J Oral Rehabil,2010,28(10):943-949.
[15] 皮昕.口腔解剖生理学[M].7版.北京:人民卫生出版社,2012:321.
[16] Hsu YT,Lin GH,Wang HL.Effects of platform-switching on peri-implant soft and hard tissue outcomes:a systematic review and meta-analysis[J].Int J Oral Maxillofac Implants,2017,32 (1):e9-e24.
[17] Chrcanovic BR,Kisch J,Albrektsson T.Bruxism and dental implant treatment complications:a retrospective comparative study of 98 bruxer patients and a matched group[J].Clin Oral Implan Resh,2016,28(7):e1-e9.
[18] Lobbezoo F,Brouwers JE,Cune MS,et al.Dental implants in patients with bruxing habits[J].J Oral Rehabil,2006,33:152-159.
[19] Chrcanovic BR,Kisch J,Albrektsson T,et al.Bruxism and dental implant failures:a multilevel mixed effects parametric survival analysis approach[J].J Oral Rehabil,2016,43(11):813-823.
[20] Komiyama O,Lobbezoo F,Laat AD,et al.Clinical management of implant prostheses in patients with bruxism[J].Int J Biomater,2012:369036.
[21] 陈志飞,顾卫平,刘斌,等.水平内移距离对种植体及其周围骨组织应力分布影响的有限元研究[J].口腔医学,2016,36(11):984-988.