本文選題：上頜竇　切入點：短種植體　出處：《山東大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的：運用三維有限元分析法(three-dimensional finite element method,FEM)分析,當短種植體聯(lián)合上頜竇內(nèi)提升(maxillary sinus lift)運用于上頜后牙區(qū)垂直骨量高度不足的情況時,不同種植體冠根比(crown to implant ratio,C/IR)以及不同松質(zhì)骨密度,是否會影響種植體以及相應的骨質(zhì)區(qū)域所受應力情況,從而對種植修復設計起到臨床指導作用。材料及方法：(1)以BICON6x5.7mm種植體為樣本,運用UG NX8.5軟件,繪制含有短種植體的高度吸收的上頜竇區(qū)骨塊模型。上頜竇區(qū)分為三個區(qū)域分別為皮質(zhì)骨區(qū),松質(zhì)骨區(qū)及骨替代品區(qū),種植體底端離上頜竇底為1mm, C/IR分別為1：1、1.5：1、2：1、2.5：1、3：1,相應松質(zhì)骨密度分別為二類、三類、四類的5組模型。(2)分別對5組模型施加垂直向和45度斜向的力量,大小分別為150N和50N.(3)運用三維有限元分析法,通過ANSYS WORKBENCH 16.1軟件對五組模型進行分析,得到上頜竇三個區(qū)域及種植體的應力分布情況。結(jié)果：(1)在垂直向力加載的情況下,各組模型的應力分布情況大致相同,種植體的應力分布主要位于種植體頸部與基臺的連接處,上頜竇區(qū)骨塊的應力分布主要位于與種植體相接觸的頸部及上頜竇底的皮質(zhì)骨。隨著C/IR的增大及骨質(zhì)密度的降低,種植體及皮質(zhì)骨,松質(zhì)骨,骨替代品的應力峰值沒有明顯的改變。(2)在斜向力加載的情況下,各組模型的應力分布情況大致相同,種植體的應力分布位于受力側(cè)種植體頸部與基臺的連接之處,上頜竇區(qū)骨塊的應力分布主要位于受力側(cè)與種植體鰭狀螺紋相接觸的區(qū)域。隨著C/IR的增大種植體的最大應力峰值明顯升高,皮質(zhì)骨的應力峰值也有增高。隨著松質(zhì)骨骨密度的降低,皮質(zhì)骨承擔更大的應力。結(jié)論：將短種植體聯(lián)合上頜竇內(nèi)提升運用于上頜后牙區(qū)垂直骨量高度不足的情況是可行的。(1)C/IR的大小在種植體受到斜向力時對種植體及相應骨質(zhì)區(qū)域是有一定的影響的。特別是對種植體基臺連接處的應力峰值增大比較明顯。(2)當松質(zhì)骨的密度降低時,對種植體的影響不大,但其松質(zhì)骨的應力峰值下降,而皮質(zhì)骨的應力峰值升高,增加了種植體頸部皮質(zhì)骨吸收的可能性。所以在臨床種植修復中,可以將C/IR設計在合理范圍內(nèi),并對上頜后牙區(qū)骨質(zhì)不佳的患者做到降低牙尖斜度,減小牙冠頰舌徑等措施來減少側(cè)向力的影響。但是由于三維有限元分析法的局限性,我們還需進行相應的臨床觀察及研究。
[Abstract]:Objective: to use three-dimensional finite element method to analyze short implants combined with maxillary sinus liftof maxillary in maxillary sinus. Whether crown to implant ratio of different implants and different cancellous bone mineral density affect the stress of implants and corresponding bone regions, The material and method: 1. Take BICON6x5.7mm implant as the sample, use UG NX8.5 software, A bone mass model of the maxillary sinus region with short implants was developed. The maxillary sinus was divided into three regions: cortical bone region, cancellous bone region and bone substitute area, and the maxillary sinus was divided into three regions: cortical bone region, cancellous bone region and bone substitute area. The bottom end of the implant is 1mm from the bottom of the maxillary sinus, and the C/IR is 1: 1: 1.5: 1: 1: 1: 1: 1: 1: 1: 1: 1. The corresponding cancellous bone mineral density (BMD) is class 2, 3, and 4 groups of 5 models respectively) exerting vertical force and 45 degree oblique force on the 5 groups, respectively. Using ANSYS WORKBENCH 16.1 software to analyze the five groups of models, the stress distribution in three regions of maxillary sinus and implants was obtained. The results showed that the stress distribution of the three regions and implants of maxillary sinus was obtained by using the three-dimensional finite element analysis method. The results showed that the stress distribution of the three regions and implants of the maxillary sinus was obtained by using the software ANSYS WORKBENCH 16.1. The stress distribution of each group of models was approximately the same, and the stress distribution of implant was mainly located at the junction between the implant neck and the abutment. The stress distribution of the bone mass in the maxillary sinus region was mainly located in the cortical bone of the neck and the floor of the maxillary sinus in contact with the implant. With the increase of C/IR and the decrease of the bone density, the implant and cortical bone, cancellous bone, and cancellous bone, There was no significant change in the peak stress of bone substitute. 2) under oblique force loading, the stress distribution of each model was approximately the same, and the stress distribution of implant was located at the connection between the neck of the implant and the abutment. The stress distribution of the bone mass in the maxillary sinus region was mainly located in the area where the stress side was in contact with the fin thread of the implant. The maximum stress peak value of the implant increased with the increase of C/IR. The peak stress of cortical bone also increased. With the decrease of bone mineral density of cancellous bone, Conclusion: it is feasible to apply short implants combined with lifting in maxillary sinus to lower vertical bone mass in maxillary posterior teeth. In particular, the peak stress at the junction of the implant abutment is significantly increased. 2) when the density of cancellous bone decreases, the density of the cancellous bone decreases, and the density of the cancellous bone decreases when the density of the cancellous bone decreases. But the peak stress of cancellous bone decreases, but the peak stress of cortical bone increases, which increases the possibility of cortical bone resorption in implant neck. So in clinical implant repair, C/IR can be designed within a reasonable range. In order to reduce the influence of lateral force on the patients with poor bone in the maxillary posterior region, we should reduce the cusp inclination and the diameter of the crown, buccal tongue, etc. However, due to the limitation of 3D finite element analysis, we need to make corresponding clinical observation and study.
【學位授予單位】：山東大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R783.6

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