中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (34): 5027-5032.doi: 10.3969/j.issn.2095-4344.2016.34.002

• 组织工程口腔材料 tissue-engineered oral materials • 上一篇    下一篇

种植体联合牙半切剩余牙体共同支持下颌磨牙的三维有限元分析

陈俊良1，2，何 芸1，2，黄 跃2   

  1. 1西南医科大学附属口腔医院口腔颌面外科，四川省泸州市 646000；2西南医科大学口颌面修复重建和再生实验室，四川省泸州市 646000
  • 收稿日期:2016-07-20 出版日期:2016-08-19 发布日期:2016-08-19
  • 通讯作者: 何芸，硕士，副教授，西南医科大学附属口腔医院，四川省泸州市 646000
  • 作者简介:陈俊良，男，1981年生，四川省泸州市人，汉族，硕士，主治医师，主要从事口腔牙槽外科和口腔种植方面的研究。
  • 基金资助:

    国家自然科学基金项目(81300903)；四川省卫生厅项目(130378)；泸州市科技计划项目(2011-I-S44)

Three-dimensional finite element analysis of dental implant combined with residual tooth after hemisection to support a mandibular molar

Chen Jun-liang1, 2, He Yun1, 2, Huang Yue2   

  1. 1Department of Oral and Maxillofacial Surgery, the Hospital of Stomatology, Southwest University, Luzhou 646000, Sichuan Province, China; 2Orofacial Reconstruction and Regeneration Laboratory, Southwest University, Luzhou 646000, Sichuan Province, China
  • Received:2016-07-20 Online:2016-08-19 Published:2016-08-19
  • Contact: He Yun, Master, Associate professor, Department of Oral and Maxillofacial Surgery, the Hospital of Stomatology Southwest University, Luzhou 646000, Sichuan Province, China; Orofacial Reconstruction and Regeneration Laboratory, Southwest University, Luzhou 646000, Sichuan Province, China
  • About author:Chen Jun-liang, Master, Attending physician, Department of Oral and Maxillofacial Surgery, the Hospital of Stomatology, Southwest University, Luzhou 646000, Sichuan Province, China; Orofacial Reconstruction and Regeneration Laboratory, Southwest University, Luzhou 646000, Sichuan Province, China
  • Supported by:

     the National Natural Science Foundation of China, No. 81300903; a grant from the Health and Family Planning Commission of Sichuan Province, No. 130378; Office of Science & Technology and Intellectual Property of Luzhou, No. 2011-I-S44

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摘要：

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文题释义：
种植修复：是通过置入骨内的钛基种植体获得固位支持后，然后在其上部进行上部结构修复恢复牙根牙冠的修复方式。它最大限度地模拟了天然牙，同时具有传统固定修复的美观、舒适、方便等优点，目前已成为广泛使用的修复方式。但种植修复也有其局限性，它不能恢复患牙牙周膜和咀嚼时的本体感觉，甚至可能因为缺乏牙周膜反馈而导致过大咬合力，引起种植修复失败。
种植联合牙半切修复：采用种植体与半牙联合支持的单冠修复设计方式，可有限模拟天然多根牙的颌力传递与应力分布方式；同时还避免了按传统方法制作固定桥时，对正常天然牙的切磨，消除了患者对正常牙齿破坏的担心，充分体现了种植义齿的特点和优越性。


背景：牙半切术后部分牙根和牙周膜的保留可防止牙槽骨吸收，但牙半切术后最常见的固定桥修复方式影响基牙的健康。种植体的引入，为其修复提供了新的思路。
目的：联合种植和牙半切的优势，利用三维有限元方法分析种植联合牙半切剩余牙体共同支持下颌磨牙的可行性。
方法：将1名志愿者颌骨影像学资料导入软件，建立3种不同方式修复下颌半切磨牙的三维有限元模型，分别为种植联合牙半切修复模型、种植体修复模型及固定桥修复模型，均分别定义2种骨松质密度，对修复体施加垂直向100 N的载荷，分析不同模型的生物力学性能。
结果与结论：①种植体和牙齿位移：随着骨松质密度降低，种植联合牙半切修复模型中种植体和牙齿的位移增大。种植联合牙半切修复模型的种植体位移大于种植体修复模型中种植体的位移。在种植体联合牙半切模型中，种植体的位移小于剩余牙齿的位移；②骨皮质应力：各模型低密度骨松质下的皮质骨应力高于对应模型高密度骨松质下的皮质骨应力，高密度骨松质下：种植体修复模型>种植联合牙半切修复模型>固定桥修复模型；低密度骨松质下：种植联合牙半切修复模型>种植体修复模型>固定桥修复模型；③骨松质应变：各模型低密度骨松质下的骨松质应变高于对应模型高密度骨松质下的骨松质应变，高密度骨松质下：固定桥修复模型>种植联合牙半切修复模型>种植体修复模型；低密度骨松质下：种植联合牙半切修复模型>固定桥修复模型>种植体修复模型；④结果表明：从生物力学角度来看，种植联合牙半切修复下颌磨牙在高密度骨松质条件下是一种可接受的修复方式。

关键词: 生物材料, 口腔生物材料, 牙半切, 牙周膜, 种植体, 应力, 应变, 位移, 三维有限元, 国家自然科学基金

Abstract:

BACKGROUND: Tooth hemisection contributes to preserving partial tooth structure and periodontal ligament that are able to reduce the resorption of alveolar bone. However, the traditional fixed partial denture (FPD) for dental restoration after hemisection jeopardizes the health of abutment tooth. Given this, the use of dental implant offers a new option for tooth restoration.
OBJECTIVE: To analyze the feasibility of preserving a mandibular molar after hemisection by combining an inserted dental implant with the residual tooth by means of finite element analysis.
METHODS: Based on the image data of a volunteer, three models with different ways of restorations were created: the model of combining implant and residual tooth after hemisection to support a molar crown (combined model), the model of implant to support a molar crown (implant model) and the model of FPD. Densities of two kinds of spongy bones were assigned respectively. Vertical load of 100 N was applied on the prosthesis. Biomechanical properties of different models were analyzed.
RESULTS AND CONCLUSION: (1) Displacement of the tooth and implant: As the decrease of the density of spongy bone, displacements of the tooth and implant increased in the combined model. The implant displacement was higher in the combined model as compared with the implant model. For the combined model, the implant displacement was lower than that of the residual tooth. (2) Stress in the cortical bone: Stress in the cortical bone in models with low-density spongy bone was higher than that in the corresponding models with high-density spongy bone. Under the condition of high-density spongy bone, the highest values were obtained in the implant model, followed by the combined model and FPD model. Under the condition of low-density spongy bone, the highest values were obtained in the combined model, followed by the implant model and FPD model. (3) Strain in the spongy bone: Strain in the spongy bone in models with low-density spongy bone was higher than that in the corresponding models with high-density spongy bone. Under the condition of high-density spongy bone, the highest values were obtained in the FPD model, followed by the combined model and implant model. Under the condition of low-density spongy bone, the highest values were obtained in the combined model, followed by the FPD model and implant model. From the biomechanical point of view, it can be concluded that the combined use of an implant and residual molar after tooth hemisection is an acceptable treatment option under the condition of high-density spongy bone.

Key words: Dental Implants, Dental Stress Analysis, Finite Element Analysis, Tissue Engineering

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