骨质量对上颌窦提升术后植入种植体稳定性影响的三维有限元分析

中国口腔颌面外科杂志 ›› 2016, Vol. 14 ›› Issue (3): 209-212.

骨质量对上颌窦提升术后植入种植体稳定性影响的三维有限元分析

马猛¹, 沈洪洲¹, 黄圣运², 左书玉², 张世周^{1, 2}, 张东升^{1, 2}

1.山东大学口腔医学院山东省口腔组织再生重点实验室,山东济南 250012;
2.山东大学附属省立医院口腔颌面外科,山东济南 250021

收稿日期:2015-10-18 出版日期:2016-06-20 发布日期:2016-07-04
通讯作者: 张东升，E-mail：ds63zhang@sdu.edu.cn
作者简介:马猛（1988-），男，硕士研究生，E-mail：mzfxh@126.com
基金资助:
山东省科技发展计划项目（2012GGB14022）

The impact of bone quality on implant stability after maxillary sinus augmentation: A 3-D finite element analysis

MA Meng¹, SHEN Hong-zhou¹, HUANG Sheng-yun², ZUO Shu-yu², ZHANG Shi-zhou^{1, 2}, ZHANG Dong-sheng^{1, 2}

1.School of Stomatology of Shandong University, Shandong University, Shandong Provincial Key Laboratory of Oral Tissue Regeneration. Jinan 250012; 2.Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong University. Jinan 250021, Shangdong Province, China)

Received:2015-10-18 Online:2016-06-20 Published:2016-07-04

摘要/Abstract

摘要： 目的探讨骨质量对上颌窦提升术后上颌后牙区种植体稳定性的影响。方法建立简化的上颌后牙区颌骨模型,将颌骨设定为D2、D3、D4 3类骨质,每种类型的颌骨又分为上颌窦提升术后使用植入物组及无处理组。将种植体与颌骨模型装配,并在其顶部中心节点加载大小为150 N的斜向应力,分析周围骨组织内部的应力分布。结果颈周皮质骨是主要的应力集中区域,随着骨质量的下降,骨种植体界面的应力最大值升高,使用植入物可明显减小应力负载。结论骨质量与骨组织内应力水平密切相关,使用植入物可有效改善因较差骨质导致的应力过载。

关键词: 上颌窦提升术, 骨质量, 三维有限元分析

Abstract: PURPOSE: To evaluate the impact of bone quality on implant stability. METHODS: Simplified posterior maxillary segment models were established and classified them into three types of bone quality: D2, D3 and D4. Each type of maxilla was treated with or without bone grafts. The implant was assembled into the maxilla. An oblique force of 150 N was applied to the central node in the top surface of implant. The stress distribution pattern of surrounding bone was analyzed by 3-D finite element method. RESULTS: The stress was mainly concentrated on the cortical bone around the implant neck. The magnitude of stress in surrounding bone increased following the deterioration of bone quality and decreased with the help of grafts. CONCLUSIONS: Bone quality was closely related to the magnitude of stress in bone tissue and bone graft can improve the overload caused by poor bone quality.

Key words: Maxillary sinus augmentation, Bone quality, 3-D finite element analysis

中图分类号:

R783.4

马猛, 沈洪洲, 黄圣运, 左书玉, 张世周, 张东升. 骨质量对上颌窦提升术后植入种植体稳定性影响的三维有限元分析[J]. 中国口腔颌面外科杂志, 2016, 14(3): 209-212.

MA Meng, SHEN Hong-zhou, HUANG Sheng-yun, ZUO Shu-yu, ZHANG Shi-zhou, ZHANG Dong-sheng. The impact of bone quality on implant stability after maxillary sinus augmentation: A 3-D finite element analysis[J]. China J Oral Maxillofac Surg, 2016, 14(3): 209-212.

参考文献

[1] Ashman RB, Van Buskirk WC. The elastic properties of a human mandible [J]. Adv Dent Res, 1987, 1(1): 64-67.
[2] Lekholm U, Zarb GA. Patient selection and preparation. Tissue integrated prostheses: osseointegration in clinical dentistry [M]. Chicago: Quintessence Publishing Company, 1985: 199-209.
[3] Tepper G, Haas R, Zechner W, et al. Three-dimensional finite element analysis of implant stability in the atrophic posterior maxilla: a mathematical study of the sinus floor augmentation [J]. Clin Oral Implants Res, 2002, 13(6): 657-665.
[4] Chang SH, Lin CL, Hsue SS, et al. Biomechanical analysis of the effects of implant diameter and bone quality in short implants placed in the atrophic posterior maxilla [J]. Med Eng Phys, 2012, 34(2): 153-60.
[5] Li T, Yang X, Zhang D, et al. Analysis of the biomechanical feasibility of a wide implant in moderately atrophic maxillary sinus region with finite element method[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2012, 114(2): e1-8.
[6] 杨德圣, 刘洪臣, 董军, 等. 骨质量和种植体螺纹对种植稳定性影响的三维有限元分析[J].口腔颌面修复学杂志, 2005, 6(2): 118-120.
[7] Lee JS, Cho IH, Kim YS, et al. Bone-implant interface with simulated insertion stress around an immediately loaded dental implant in the anterior maxilla: a three-dimensional finite Element analysis [J]. Int J Oral Maxillofac Implants, 2012, 27(2): 295-302.
[8] Lee JS, Lim YJ. Three-dimensional numerical simulation of stress induced by different lengths of osseointegrated implants in the anterior maxilla [J]. Comput Methods Biomech Biomed Engin, 2013, 16(11): 1143-1149.
[9] 何毅, 姜培林, 耿建平, 等. 高度吸收的上颌窦区种植体生物力学分析 [J].中国组织工程研究, 2013, 17(20): 3679-3686.
[10] Koca OL, Eskitascioglu G, Usumez A. Three-dimensional finite-element analysis of functional stresses in different bone locations produced by implants placed in the maxillary posterior region of the sinus floor [J]. J Prosthet Dent, 2005, 93(1): 38-44.
[11] Inglam S, Suebnukarn S, Tharanon W, et al. Influence of graft quality and marginal bone loss on implants placed in maxillary grafted sinus: a finite element study[J]. Med Biol Eng Comput, 2010, 48(7): 681-689.
[12] Demenko V, Linetsky I, Nesvit V, et al. FE study of bone quality effect on load-carrying ability of dental implants[J]. Comput Methods Biomech Biomed Engin, 2014, 17(16): 1751-1761.
[13] Su YY, Wilmes B, Hönscheid R, et al. Application of a wireless resonance frequency transducer to assess primary stability of orthodontic mini-implants: an in vitro study in pig ilia[J]. Int J Oral Maxillofac Implants, 2009, 24(4): 647-654.
[14] Rozé J, Babu S, Saffarzadeh A, et al. Correlating implant stability to bone structure[J]. Clin Oral Implants Res, 2009, 20(10): 1140-1145.
[15] Tada S, Stegaroiu R, Kitamura E, et al. Influence of implant design and bone quality on stress/strain distribution in bone around implants: a 3-dimensional finite element analysis[J]. Int J Oral Maxillofac Implants, 2003, 18(3): 357-368.
[16] Yoon HG, Heo SJ, Koak JY, et al. Effect of bone quality and implant surgical technique on implant stability quotient (ISQ) value[J]. J Adv Prosthodont, 2011, 3(1): 10-15.
[17] Sevimay M, Turhan F, Kilicarslan MA, et al. Three-dimensional finite element analysis of the effect of different bone quality on stress distribution in an implant-supported crown[J]. J Prosthet Dent, 2005, 93(3): 227-234.
[18] Chou HY, Müftü S, Bozkaya D. Combined effects of implant insertion depth and alveolar bone quality on periimplant bone strain induced by a wide-diameter, short implant and a narrow-diameter, long implant [J]. J Prosthet Dent, 2010, 104(5): 293-300.
[19] Huang HL, Fuh LJ, Hsu JT, et al. Effects of implant surface roughness and stiffness of grafted bone on an immediately loaded maxillary implant: a 3D numerical analysis[J]. J Oral Rehabil, 2008, 35(4): 283-290.