本文選題：牙周炎 + CBCT��； 參考：《錦州醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的本實(shí)驗(yàn)擬建立中度牙周炎完整牙列套筒冠牙周夾板的三維有限元分析模型,通過修復(fù)前后牙周膜內(nèi)應(yīng)力的分布變化,為套筒冠牙周夾板的修復(fù)效果提供實(shí)驗(yàn)室依據(jù)。方法本實(shí)驗(yàn)研究方法如下:一、從50名志愿者中篩選出1名實(shí)驗(yàn)對象,進(jìn)行下頜骨CBCT掃描,建立含健康完整牙列下頜骨三維幾何模型(包括完整牙列、牙周膜、牙槽骨),驗(yàn)證模型有效性,分析健康狀態(tài)下牙周膜應(yīng)力分布,提供參考。二、修改健康完整下頜骨模型,建立中度牙周炎完整牙列下頜骨三維幾何模型,分析牙周膜應(yīng)力變化,與健康模型進(jìn)行對比,分析差異。三、修改中度牙周炎下頜骨模型,建立中度牙周炎完整牙列套筒冠夾板修復(fù)后下頜骨三維模型法,分析牙周膜應(yīng)力改變,與未修復(fù)完整牙列下頜骨模型對比,分析差異。結(jié)果實(shí)驗(yàn)結(jié)果如下:一、成功基于CBCT建立含完整牙列及牙周膜的下頜骨模型,解剖形態(tài)逼真。有限元分析顯示牙周膜應(yīng)力規(guī)律符合以往研究。正常完整牙齒咀嚼時(shí),牙周膜的Von Mises應(yīng)力值大致在2.39 MPa~3.96 MPa;二、中度牙周炎和套筒冠修復(fù)后的牙周膜Von Mises應(yīng)力值相對正常情況來說,都有不同程度的增加,應(yīng)力增幅也不一樣。套筒冠修復(fù)后的各牙周膜Von Mises應(yīng)力值均比牙周炎模型的小,對比各牙應(yīng)力增量變化幅度,套筒冠修復(fù)后的牙周膜應(yīng)力增幅相比牙周炎模型降低很多,相對降幅約12.55%~102.66%,可以說明套筒冠修復(fù)在一定程度上有助于改善牙周膜受力情況。三、套筒冠修復(fù)降低了牙周膜應(yīng)力,將大多數(shù)應(yīng)力轉(zhuǎn)移到牙槽骨上。牙周炎模型牙齒的Von Mises應(yīng)力最大值約31.3 MPa,下頜骨的Von Mises應(yīng)力最大值約4.99 MPa;套筒冠修復(fù)后模型,牙齒的Von Mises應(yīng)力最大值約25.6 MPa,而下頜骨的Von Mises應(yīng)力最大值有所增加,約6.51 MPa。套筒冠修復(fù)后的牙齒的Von Mises應(yīng)力相對中度牙周炎模型的應(yīng)力降幅約8.04%,套筒冠修復(fù)后的下頜骨的Von Mises應(yīng)力相對中度牙周炎的應(yīng)力增幅約14.21%。結(jié)論一、基于CBCT建立完整牙列下頜骨模型是可行的,模型可信度好,滿足對此模型進(jìn)行調(diào)整及分析的需要。二、套筒冠牙周夾板可有效減小中度牙周炎各牙不利應(yīng)力,有利于減小咬合創(chuàng)傷對牙周炎的影響,利于牙周炎的長期治療維護(hù)。三、從生物力學(xué)角度判斷,利用有限元方法對中度牙周炎、套筒冠修復(fù)進(jìn)行力學(xué)仿真模擬分析是有很大幫助的,可以為中度或重度牙周炎修復(fù)治療提供較好的臨床理論研究指導(dǎo)作用,為今后牙齒修復(fù)臨床手術(shù)提供了寶貴的科學(xué)依據(jù)。
[Abstract]:Objective to establish a three-dimensional finite element analysis model of periodontal plywood with complete abutment crown for moderate periodontitis, and to provide a laboratory basis for the effect of periodontal plywood restoration through the distribution of stress in periodontal ligament before and after restoration. Methods the methods of this experiment were as follows: 1. One sample was selected from 50 volunteers, and the mandibular CBCT scan was performed to establish a three-dimensional geometric model of mandible with healthy and complete dentition (including complete dentition and periodontal ligament). Alveolar bone to verify the validity of the model, to analyze the periodontal ligament stress distribution under healthy conditions, to provide a reference. Second, the healthy intact mandible model was modified, and the three-dimensional geometric model of the complete dentition mandible was established, and the stress changes of periodontal ligament were analyzed, compared with the healthy model, and the difference was analyzed. Third, the mandibular model of moderate periodontitis was modified, and the mandibular model was established after the restoration of the complete denture with crown splint. The stress changes of periodontal ligament were analyzed, and the difference was analyzed compared with the model of the unrepaired complete dentition mandible. Results the results were as follows: first, the mandibular model with complete dentition and periodontal ligament was successfully established based on CBCT, and the anatomical morphology was lifelike. Finite element analysis shows that the stress law of periodontal ligament accords with previous studies. The Von Mises stress value of periodontal ligament was about 2.39 MPa~3.96 MPA when normal teeth were chewed, and the Von Mises stress value of periodontal ligament after moderate periodontitis and abutment crown repair was increased in different degree and the increase of stress was also different compared with the normal condition. The Von Mises stress value of each periodontal membrane was smaller than that of periodontitis model. Compared with each tooth stress increment, the periodontal ligament stress increase after abutment crown restoration was much lower than that of periodontitis model. The relative decrease was about 12.55 and 102.66, which indicated that the restoration of sleeve crown was helpful to improve the stress of periodontal membrane to some extent. Thirdly, the socket crown reduced the stress of periodontal membrane and transferred most of the stress to the alveolar bone. The maximum value of Von Mises stress in periodontitis model teeth was about 31.3 MPA, the maximum value of Von Mises stress in mandible was about 4.99 MPA, the maximum value of Von Mises stress in teeth was about 25.6 MPA, and the maximum value of Von Mises stress in mandible was increased (about 6.51 MPA). Compared with moderate periodontitis model, the Von Mises stress of the teeth repaired by the sleeve crown decreased by 8.04, and the Von Mises stress of the mandible repaired by the sleeve crown increased about 14.21% compared with that of the moderate periodontitis. Conclusion 1. It is feasible to establish a complete dentition mandibular model based on CBCT, and the model is reliable and meets the needs of adjustment and analysis of the model. Second, the periodontal splint of the abutment crown can effectively reduce the adverse stress of each tooth in moderate periodontitis, which is beneficial to the reduction of the effect of occlusal trauma on periodontitis and to the long-term treatment and maintenance of periodontitis. Third, judging from the biomechanical point of view, it is very helpful to use finite element method to simulate and analyze the mechanics of moderate periodontitis and sleeve crown repair. It can provide good theoretical guidance for the treatment of moderate or severe periodontitis, and provide a valuable scientific basis for the clinical operation of dental repair in the future.
【學(xué)位授予單位】：錦州醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R781.42

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