背景:为了防止前牙唇骨板的吸收和塌陷,即刻植入和承窝屏蔽技术已越来越多地应用于前牙美学种植修复。
目的:为上颌前牙种植修复提供生物力学基础,采用有限元分析方法研究了天然牙齿不同解剖部位的应力峰值和分布,传统的立即植入和插座屏蔽技术。
方法:建立三个上颌有限元模型,包括作为天然牙齿的上颌切牙,传统的立即植入和插座屏蔽技术。施加100N的机械载荷来模拟和分析根部的生物力学行为,牙周膜(PDL),植入物和周围的骨界面。
结果:天然牙齿在载荷下的应力分布相对均匀。根的最大vonMises应力,牙周膜,皮质骨和松质骨20.14MPa,2.473MPa,19.48MPa和5.068MPa,分别。当常规的即刻植入被加载时,应力主要集中在种植体颈部。种植体表面最大应力为102MPa,皮质骨16.13MPa,松质骨为18.29MPa。当使用插座屏蔽技术进行植入时,植入物的应力分布与即刻植入相似。种植体表面最大应力为100.5MPa,皮质骨23.11MPa,松质骨为21.66MPa,剩余的牙齿碎片为29.42MPa,牙齿碎片的牙周膜为1.131MPa。
结论:1.在静态载荷下,托槽屏蔽技术和常规即刻植入技术均可在生物力学上支持前牙的美学修复。2.根据短期随访,即刻植入和承窝屏蔽技术均取得了满意的临床效果,包括骨愈合和患者满意度。3.应力分布主要位于植入物的颊骨表面上,并且与在插座屏蔽技术和常规立即植入中进行植入物置换后颊骨板的吸收有关。4.保留的根部碎片的存在对骨移植物间隙有影响。在立即植入时,峰值应力位于植入物位置附近的皮质骨,而在插座屏蔽技术,峰值应力位于皮质骨的颈部,对应于保留的根部碎片。
BACKGROUND: To prevent the absorption and collapse of the labial bone plate of the anterior teeth, immediate implantation and socket shield technique have been increasingly applied to anterior dental aesthetic implant restoration.
OBJECTIVE: To provide a biomechanical basis for implant restoration of maxillary anterior teeth, finite element analysis was used to investigate the stress peak and distribution in different anatomical sites of natural teeth, conventional immediate implantation and socket shield technique.
METHODS: Three maxillary finite element models were established, including a maxillary incisor as a natural tooth, a conventional immediate implantation and a socket shield technique. A mechanical load of 100 N was applied to simulate and analyze the biomechanical behavior of the root, periodontal ligament (PDL), implant and surrounding bone interface.
RESULTS: The stress distribution of the natural tooth was relatively uniform under load. The maximum von Mises stress of the root, periodontal ligament, cortical bone and cancellous bone were 20.14 MPa, 2.473 MPa, 19.48 MPa and 5.068 MPa, respectively. When the conventional immediate implantation was loaded, the stress was mainly concentrated around the neck of implant. Maximum stress on the surface of the implant was 102 MPa, the cortical bone was 16.13 MPa, and the cancellous bone was 18.29 MPa. When the implantation with socket shield technique was loaded, the stress distribution of the implant was similar to that of immediate implantation. Maximum stress on the surface of the implant was 100.5 MPa, the cortical bone was 23.11 MPa, the cancellous bone was 21.66 MPa, the remaining tooth fragment was 29.42 MPa and the periodontal ligament of the tooth fragment was 1.131 MPa.
CONCLUSIONS: 1. Under static loading, both socket shield technology and conventional immediate implantation can support the esthetic restoration of anterior teeth biomechanically. 2.Under short-term follow-up, both immediate implant and socket shield technology achieved satisfactory clinical results, including bone healing and patient satisfaction. 3.The stress distribution is mainly located on the buccal bone surface of the implant and is associated with resorption of the buccal bone plate after implant replacement in both socket shield technology and conventional immediate implantation. 4.The presence of retained root fragment had an impact on the bone graft gap. In immediate implantation, the peak stress was located in the cortical bone near the implant position, while in socket shield technology, the peak stress was at the neck of the cortical bone corresponding to the retained root fragment.