CAJ | 학술논문

目的：采用有限元分析法，研究不同附着体类型对种植覆盖义齿咬合运动方式、载荷分配及牙槽骨内应力分布的影响。方法：采集下颌骨及其所佩戴义齿的CT数据，利用逆向工程技术构建包含下颌骨、附着体（杆卡附着体B；ERA附着体E；球帽附着体R；磁性附着体M）和义齿的完整下颌2植体种植覆盖义齿三维有限元模型，通过对上述不同部件接触关系的定义，模拟正中咬合力作用下，种植覆盖义齿运动方式、载荷分配及颌骨内应力分布情况。结果：正中咬合时，ERA组和球帽组义齿整体均匀沉降，植体所受载荷较小；磁性组和杆卡组垂直向无缓冲，义齿前端无沉降，后端旋转下沉，植体所受载荷增大。植体周围应力分布：杆卡组最高，磁性组其次，ERA组较低，球帽组最低；后方牙槽嵴应力分布：杆卡组最高，球帽组其次，ERA和磁性组最低。结论：不同附着体类型对义齿的运动方式、载荷分配及应力分布有显著影响；附着体缓冲间隙可以延缓植体所受垂直向载荷，降低植体周围颌骨吸收的风险。
목적：채용유한원분석법，연구불동부착체류형대충식복개의치교합운동방식、재하분배급아조골내응력분포적영향。방법：채집하합골급기소패대의치적CT수거，이용역향공정기술구건포함하합골、부착체（간잡부착체B；ERA부착체E；구모부착체R；자성부착체M）화의치적완정하합2식체충식복개의치삼유유한원모형，통과대상술불동부건접촉관계적정의，모의정중교합력작용하，충식복개의치운동방식、재하분배급합골내응력분포정황。결과：정중교합시，ERA조화구모조의치정체균균침강，식체소수재하교소；자성조화간잡조수직향무완충，의치전단무침강，후단선전하침，식체소수재하증대。식체주위응력분포：간잡조최고，자성조기차，ERA조교저，구모조최저；후방아조척응력분포：간잡조최고，구모조기차，ERA화자성조최저。결론：불동부착체류형대의치적운동방식、재하분배급응력분포유현저영향；부착체완충간극가이연완식체소수수직향재하，강저식체주위합골흡수적풍험。
Objective:The aim of this study was to evaluate the behavior of the overdenture ,the mastication force distribution and the stress distribution in alveolar bone induced by the type of the attachment ,through three-dimension finite element analysis. Method:The CT data of mandible and denture from a patient were collected. Then reverse engineer soft-wares were used to construct a 3D finite element model of the complete two implants-supported overdenture ,which include mandible,different type of attachment(bar clip attachment B;ERA E;ball attachment R;magnetic attachment M) and over-denture. By definition the contact relationship of different parts of the model and simulate centric occlusion ,to investigate the behavior of the overdenture, the mastication force distribution and the stress distribution in alveolar bone. Result:Dur-ing centric occlusion,the front of the overdenture with ERA or ball attachments were sagged,buffer space delayed and re-duced the vertical load of implants;The overdenture with magnetic or bar attachments have no vertical gap ,so the front of the overdentue have no settlement,while the back of the overdenture rotated and sagged,Which increased the load of im-plants. The peak stress in peri-implant alveolar: the bar attachment was the highest,followed by magnetic attachment,ERA was low and the ball attachment was the lowest;The peak stress in posterior alveolar ridge:the bar attachment was the high-est,ball attachment secondly,ERA and magnetic attachments were the lowest. Conclusion:The type of attachment have a significant effect on the behavior of the overdenture,the mastication force distribution and the stress distribution in alveolar bone;The vertical gap of the attachments can delay the vertical load of the implants and reduce the risk of the bone resorp-tion surrounding implants.