北京大学学报（医学版）
北京大學學報（醫學版）
북경대학학보（의학판）
JOURNAL OF BEIJING MEDICAL UNIVERSITY(HEALTH SCIENCES)
2015年
1期
72-77
,共6页
杨雪%荣起国%杨亚东
楊雪%榮起國%楊亞東
양설%영기국%양아동
义齿,局部,可摘%义齿,植入物支持%义齿精密附着体%有限元分析
義齒,跼部,可摘%義齒,植入物支持%義齒精密附著體%有限元分析
의치,국부,가적%의치,식입물지지%의치정밀부착체%유한원분석
Denture,partial,removable%Dental prosthesis,implant-supported%Denture precision at-tachment%Finite element analysis
目的：研究种植支持可摘局部义齿修复下颌远中游离端缺失的应力分布，探讨附着体类型对于种植体、各支持组织、义齿以及附着体的应力影响。方法：建立可摘局部义齿修复下颌双侧前磨牙和磨牙缺失的KennedyⅠ类牙列缺损的三维有限元模型，分别为采用传统可摘局部义齿（无种植体）、种植体＋Locator附着体＋可摘局部义齿、种植体＋Magfit磁性附着体＋可摘局部义齿进行修复。分析对比各主要成分的应力分布，得到最大von Mises应力值和位移值。结果：建立含有牙体组织、牙周组织以及种植体、附着体、可摘局部义齿的三维有限元模型。有种植体的模型义齿基托下黏骨膜的最大位移量（Locator模型垂直向载荷9．38μm、斜向载荷45．48μm，Magfit模型垂直向载荷9．54μm、斜向载荷39．45μm）小于没有种植体的RPD（removable partial dentures）模型（模型垂直向载荷95．27μm，斜向155．70μm）。 Locator和Magfit两种类型的附着体相比较，Locator模型中种植体颈部周围皮质骨的最大应力值大于Magfit模型（Locator模型垂直向载荷10．850 MPa、斜向载荷43．760 MPa，Magfit模型垂直向载荷7．100 MPa、斜向载荷19．260 MPa）。 Magfit 模型中末端基牙的牙周膜受力更小（ Locator 模型垂直向载荷0．520 MPa，Magfit模型垂直向载荷0．420 MPa）。结论：在修复下颌KennedyⅠ类牙列缺损时，种植支持可摘局部义齿可减少对末端基牙的扭力，提高义齿稳定性；Locator和Magfit磁性附着体两者对比，Locator附着体水平约束作用更大。
目的：研究種植支持可摘跼部義齒脩複下頜遠中遊離耑缺失的應力分佈，探討附著體類型對于種植體、各支持組織、義齒以及附著體的應力影響。方法：建立可摘跼部義齒脩複下頜雙側前磨牙和磨牙缺失的KennedyⅠ類牙列缺損的三維有限元模型，分彆為採用傳統可摘跼部義齒（無種植體）、種植體＋Locator附著體＋可摘跼部義齒、種植體＋Magfit磁性附著體＋可摘跼部義齒進行脩複。分析對比各主要成分的應力分佈，得到最大von Mises應力值和位移值。結果：建立含有牙體組織、牙週組織以及種植體、附著體、可摘跼部義齒的三維有限元模型。有種植體的模型義齒基託下黏骨膜的最大位移量（Locator模型垂直嚮載荷9．38μm、斜嚮載荷45．48μm，Magfit模型垂直嚮載荷9．54μm、斜嚮載荷39．45μm）小于沒有種植體的RPD（removable partial dentures）模型（模型垂直嚮載荷95．27μm，斜嚮155．70μm）。 Locator和Magfit兩種類型的附著體相比較，Locator模型中種植體頸部週圍皮質骨的最大應力值大于Magfit模型（Locator模型垂直嚮載荷10．850 MPa、斜嚮載荷43．760 MPa，Magfit模型垂直嚮載荷7．100 MPa、斜嚮載荷19．260 MPa）。 Magfit 模型中末耑基牙的牙週膜受力更小（ Locator 模型垂直嚮載荷0．520 MPa，Magfit模型垂直嚮載荷0．420 MPa）。結論：在脩複下頜KennedyⅠ類牙列缺損時，種植支持可摘跼部義齒可減少對末耑基牙的扭力，提高義齒穩定性；Locator和Magfit磁性附著體兩者對比，Locator附著體水平約束作用更大。
목적：연구충식지지가적국부의치수복하합원중유리단결실적응력분포，탐토부착체류형대우충식체、각지지조직、의치이급부착체적응력영향。방법：건립가적국부의치수복하합쌍측전마아화마아결실적KennedyⅠ류아렬결손적삼유유한원모형，분별위채용전통가적국부의치（무충식체）、충식체＋Locator부착체＋가적국부의치、충식체＋Magfit자성부착체＋가적국부의치진행수복。분석대비각주요성분적응력분포，득도최대von Mises응력치화위이치。결과：건립함유아체조직、아주조직이급충식체、부착체、가적국부의치적삼유유한원모형。유충식체적모형의치기탁하점골막적최대위이량（Locator모형수직향재하9．38μm、사향재하45．48μm，Magfit모형수직향재하9．54μm、사향재하39．45μm）소우몰유충식체적RPD（removable partial dentures）모형（모형수직향재하95．27μm，사향155．70μm）。 Locator화Magfit량충류형적부착체상비교，Locator모형중충식체경부주위피질골적최대응력치대우Magfit모형（Locator모형수직향재하10．850 MPa、사향재하43．760 MPa，Magfit모형수직향재하7．100 MPa、사향재하19．260 MPa）。 Magfit 모형중말단기아적아주막수력경소（ Locator 모형수직향재하0．520 MPa，Magfit모형수직향재하0．420 MPa）。결론：재수복하합KennedyⅠ류아렬결손시，충식지지가적국부의치가감소대말단기아적뉴력，제고의치은정성；Locator화Magfit자성부착체량자대비，Locator부착체수평약속작용경대。
Objective: To compare influences of different retention attachments on stress among supporting structures .Methods: By 3-dimensional laser scanner and reverse engineering computer aided design ( CAD) software , a basic partially edentulous digital model with mandibular premolar and molar missing was established .Implant attachment and removable partial dentures ( RPD) were added into the basic model to build three kinds of models: RPD only, RPD +implant +Locator attachment , and RPD +implant +Magfit attachment .Vertical and inclined loads were put on artificial teeth unilaterally . By means of 3-dimensional finite element analysis , the stress distribution and displacement of the main supportive structures were compared . Results: A complete 3-dimensional finite element model was established , which contained tooth structure , and periodontal structures .The displacement of the denture was smaller in Locator (9.38μm vertically, 45.48μm obliquely) and Magfit models (9.54μm vertically, 39.45 μm obliquely) compared with non-implant RPD model (95.27 μm vertically, 155.70 μm oblique-ly) .Compared with the two different attachments , cortical bone stress value was higher in Locator model ( Locator model 10.850 MPa vertically , 43.760 MPa obliquely;Magfit model 7.100 MPa vertically , 19.260 MPa obliquely).The stress value of abutment periodontal ligamentin Magfit model (0.420 MPa vertically) was lower than that in Locator model (0.520 MPa vertically).Conclusion:The existence of implant could reduce maximum von Mises value of each supportive structure when Kennedy Ⅰpartially edentulous mandible was restored .Comparing the structure of Magfit and Locator attachment , the contact of Magfit attachment was rigid , while Locator was resilient .Locator attachment could improve stability of the denture dramatical -ly.Locator had stronger effect on defending horizontal movement of the denture .
