松质骨和皮质骨厚度对种植体周围应力分布的影响

doi:10.13481/j.1671-587x.20160203

摘要/Abstract

摘要：

目的: 观察不同松质骨和皮质骨厚度下种植体周围应力分布的情况,探讨骨组织厚度比例及总厚度对种植体可靠性的影响。方法: 使用Abaqus软件建立颌骨三维有限元模型并进行计算,研究侧向力和轴向力作用下不同厚度比例的松质骨和皮质骨对种植体周围应力分布的影响,其中松质骨和皮质骨的比值分别为3:1、2:1、1:1、1:2和1:3,两者的总厚度分别取0.5、1.0、2.0、3.0和4.0 mm。结果: 皮质骨、松质骨和种植体表面最大应力随着松质骨和皮质骨总厚度的增大而递减,总厚度在0.5~2.0 mm区间内减小速度较快,在2.0~4.0 mm区间内减小速度较慢。对于不同厚度比例的松质骨和皮质骨,种植体颈部皮质骨内的最大应力在总厚度为2.0 mm时取得最小值。当总厚度小于2.0 mm时,种植体颈部皮质骨内的最大应力值随着总厚度的减小而快速升高;当总厚度大于2.0 mm时,种植体颈部皮质骨内的最大应力值随着总厚度的增大而缓慢升高。结论: 松质骨和皮质骨厚度的比值及总厚度均对种植体周围的应力分布有显著影响;在种植体手术中松质骨和皮质骨的总厚度应大于或等于2.0 mm,最佳值为2.0 mm。

关键词: 皮质骨, 松质骨, 种植体, 有限元分析, 骨质厚度, 厚度比例

Abstract:

Objective: To investigate the stress distribution surrounding an implant under different thickness of cancellous bone and cortical bone, and to analyze the influence of thickness ratio and total thickness of bone tissues on the reliability of an implant.Methods: By using the commercial finite element method software Abaqus, a simplified three-dimensional model of a jawbone consisting of a cancellous bone, a cortical bone, an implant, and a ceramic crown was constructed, and then the computation was performed.Under the condition that the system was loaded by lateral and normal stresses, the influence of thickness ratio and total thickness of cancellous bone and cortical bone in the stress distribution surrounding the implant was studied, where the thickness ratios were 3:1, 2:1, 1:1, 1:2, and 1:3; the total thickness were 0.5, 1.0, 2.0, 3.0 and 4.0 mm, respectively.Results: The maximum stresses on the cortical bone, the cancellous bone as well as the implant were all found to decrease with the increasing of the total thickness of cortical and cancellous bones, with a higher decreasing rate in the range between 0.5-2.0 mm and a lower decreasing rate between 2.0-4.0 mm.More importantly, the maximum value of stress in the cortical bone within the neck region of the implant was observed to increase dramatically via reducing the total thickness below 2 mm, while it was increased insignificantly when the total thickness was above 2.0 mm.Conclusion: The thickness ratio and the total thickness of cancellous bone and cortical bone have strong influence in the stress distribution surrounding the implant. In dental implantation surgery, the total thickness of cancellous bone and cortical bone should be at least 2 mm, and therefore 2 mm is an optimal value.

Key words: cancellous bone, cortical bone, implant, finite element analysis, bone thickness, thickness ratio

中图分类号:

R783

陈庆生, 陈笑风, 单晔杰, 丁熙, 王慧明. 松质骨和皮质骨厚度对种植体周围应力分布的影响[J]. 吉林大学学报(医学版), 2016, 42(02): 204-209.

CHEN Qingsheng, CHEN Xiaofeng, SHAN Yejie, DING Xi, WANG Huiming. Influence of thickness of cancellous bone and cortical bone in stress distribution in vicinity of an implant[J]. Journal of Jilin University Medicine Edition, 2016, 42(02): 204-209.

参考文献

[1] Hasan I,Bourauel C,Mundt T,et al.Biomechanics and load resistance of short dental implants:a review of the literature[J].ISRN Dent,2013,2013:1-5.

[2] Chun HJ,Cheong SY,Han JH,et al.Evaluation of design parameters of osseo integrated dental implants using finite element analysis[J].J Oral Rehabil,2002,29(6):565-574.

[3] 王煜婷,张少锋,董岩,等.All-on-4种植体参数对周围骨应力影响的三维有限元分析[J].实用口腔医学杂志,2014,30(2):193-197.

[4] Alberius P,Gordh M,Lindberg L,et al.Influence of surrounding soft tissues on onlay bone graft incorporation[J].Oral SurgOral MedOral PatholOral RadiolEndod,1996,82(1):22-33.

[5] Hansson S.A conical implant-abutment interface at the level of the marginal bone improves the distribution of stresses in the supporting bone.An axisymmetric finite element analysis[J].Clin Oral Implants Res,2003,14(3):286-293.

[6] Kitamura E,Stegaroiu R,Nomura S,et al.Biomechanical aspects of marginal bone resorption around osseointegrated implants:considerations based on a three-dimensional finite element analysis[J].Clin Oral Implants Res,2004,15(4):401-412.

[7] 姜琴,邓锋,王超,等.微种植体舌侧内收上前牙力系三维有限元非线性模型的建立[J].第三军医大学学报,2015,37(16):1652-1656.

[8] 李英,鲍萍萍,孙雯,等.下颌第一磨牙种植冠减径后的三维有限元分析[J].现代口腔医学杂志,2015,29(4):205-208.

[9] 赵刚,魏佳佳,张晓平,等.两种颌间牵引对下颌骨微种植体及周围影响的三维有限元分析[J].中国组织工程研究,2013,17(24):4444-4450.

[10] Hasan I,Heinemann F,Reimann S,et al.Finite element investigation of implant-supported fixed partial prosthesis in the premaxilla in immediately loaded and osseointegrated states[J].Comput Methods Biomech Biomed Engin,2011,14(11):979-985.

[11] 马莉莎,唐亮,潘燕环.双端种植固定桥修复前后种植体-骨界面的动力学研究[J].中华口腔医学杂志,2012,47(7):435-438.

[12] 蔡留意,林久祥,张月兰,等.个体化舌侧矫治器微种植体支抗滑动法内收上前牙的三维有限元模型的构建[J].中华口腔正畸学杂志,2014,21(1):14-18.

[13] Huang HL,Hsu JT,Fuh LJ,et al.Biomechanical simulation of various surface roughnesses and geometric designs on an immediately loaded dental implant[J].Comput Biol Med,2010,40(5):525-532.

[14] Bashutski JD,D'Silva NJ,Wang HL.Implant compression necrosis:current understanding and case report[J].J Periodontol,2009,80(4):700-704.

[15] Schuller-Götzburg P,Entacher K,Petutschnigg A,et al.Sinus elevation with a cortical bone graft block:a patient-specific three-dimensional finite element study[J].Int J Oral Maxillofac Implants,2011,27(2):359-368.

[16] Qian L,Todo M,Matsushita Y,et al.Effects of implant diameter,insertion depth,and loading angle on stress/strain fields in implant/jawbone systems:finite element analysis[J].Int J Oral Maxillofac Implants,2008,24(5):877-886.

[17] Clelland NL,Lee JK,Bimbenet OC,et al.A three-dimensional finite element stress analysis of angled abutments for an implant placed in the anterior maxilla[J].J Prosthodont,1995,4(2):95-100.

[18] Bougherara H,Rahim E,Shah S,et al.A preliminary biomechanical assessment of a polymer composite hip implant using an infrared thermography technique validated by strain gage measurements[J].J Biomech Eng,2011,133(7):689-698.

[19] Motoyoshi M,Inaba M,Ono A,et al.The effect of cortical bone thickness on the stability of orthodontic mini-implants and on the stress distribution in surrounding bone[J].Int J Oral Maxillofac Surg,2009,38(1):13-18.