本文選題：種植體設計 + 三維有限元分析��； 參考：《華南理工大學》2014年博士論文

【摘要】：牙種植體的生物力學相容性和組織相容性是實現(xiàn)義齒種植成功和長期穩(wěn)定性的基礎。因此，牙種植體的設計過程中不僅要根據(jù)載荷條件選擇材料學性能和加工性能適配的材料，設計種植體及其基臺的形狀、長度、直徑和連接方式等，同時還需要系統(tǒng)研究牙種植體表面仿生結構的構建及其與細胞之間的相互作用機制。本研究通過表面改性技術構建結構合理、力學性能優(yōu)良、具有模擬骨細胞外基質骨架的表面微納米拓撲結構和骨整合性能優(yōu)異的鈣磷涂層鈦基牙種植體。通過體外仿生礦化實驗、蛋白吸附和動物體內植入實驗系統(tǒng)研究經(jīng)不同表面處理的種植體的體內、外成骨性能，在此基礎上對等離子噴涂鈣磷涂層牙種植體進行前瞻性臨床實驗研究，為設計和制備滿足臨床應用需求的長期穩(wěn)定的新型表面改性鈦合金牙種植體提供參考。 根據(jù)機械力學、生物力學原理，結合中國人牙及頜骨的解剖特點，設計出面向臨床應用的牙種植體系統(tǒng)。該牙種植體系統(tǒng)具有圓柱和螺紋兩種形態(tài)，5種直徑和5種長度規(guī)格，基臺和種植體連接采用7莫氏錐度，360度旋轉定位和平臺轉移結構�；_4、5、6、7及8錐度內連接在35N·cm的預載力作用下,基臺與種植體之間存在冷焊現(xiàn)象，表現(xiàn)為脫位力矩大于預載力矩5%-10%，且各錐度之間無明顯差異，而超過40N·cm的力矩，將破壞界面的冷焊結合。三維有限元分析發(fā)現(xiàn)，4-8不同錐度連接的基臺在垂直和水平加載的情況下，應力分布相似，應力集中區(qū)均在種植體和基臺連接的頸部，且隨錐度的增大，應力值呈線性減小。水平向加載的應力及應變位移均明顯高于垂直加載，說明水平向的載荷更易對種植體結構產(chǎn)生破壞作用；0、15和45肩臺斜面設計的種植體連接7錐度的基臺，在垂直加載和水平加載情況下，它們之間應力分布在種植體結構間及與周圍頜骨之間差異不大。特別的是水平加載時皮質骨最大應力值與垂直加載之間無明顯差異，而松質骨內的應力與垂直加載相比雖有約1.5倍的增大，但位置明顯移至種植體的根部，表明平臺轉移可有效地減少種植體頸部周圍骨的應力集中，從而減少種植體周圍骨的吸收，利于種植修復的長期成功。 采用噴砂-酸蝕處理技術對鈦基種植體表面進行處理，系統(tǒng)研究了酸的種類以及酸蝕時間對于表面微納米粗糙度、表面親疏水性、表面成分等的影響規(guī)律。通過控制酸蝕時間和酸的種類實現(xiàn)了表面微納米拓撲結構的調控，其中在HCl/H2SO4混合溶液中酸蝕處理的鈦基種植體樣品表面形成了具有多級尺度的拓撲結構，即由1～2μm的小孔組成的直徑10～20μm的腐蝕坑。這種表面微納米拓撲結構是晶界腐蝕與點蝕共同作用的結果。通過噴砂-酸蝕構建的仿生多級拓撲結構可模擬細胞外基質的物理信號刺激，促進粘附、增殖、分化等細胞行為，有利于加速骨整合過程。 種植體的骨整合性能對其初期穩(wěn)定非常重要，本研究采用等離子噴涂技術在鈦基種植體表面構建鈣磷生物活性涂層。系統(tǒng)研究了包括噴涂功率、粉體粒徑以及噴涂距離對涂層致密度、涂層表面形貌以及涂層中的物相組成的影響規(guī)律。結果表明：在噴涂功率30kW、噴涂距離110mm、HA粉末粒度為20～50μm時所制備的表面涂層致密度高、性能優(yōu)異。從熱力學上系統(tǒng)分析了等離子噴涂過程中可能出現(xiàn)的鈣磷鹽物相轉變過程。將噴砂-酸蝕處理樣品和等離子噴涂鈣磷涂層樣品浸入模擬體液6天后，均可見表面有磷灰石層沉積，利用掃描電鏡、X射線衍射、紅外光譜和能譜對表面沉積物進行分析表明，噴砂-酸蝕鈦種植體樣品表面生成的是非晶態(tài)絨球狀磷酸鈣，而等離子噴涂種植體樣品表面在短時間內沉積出較厚、結晶度較高的磷灰石層。此外，蛋白吸附的定性和定量分析結果表明噴砂-酸蝕以及等離子噴涂鈣磷涂層樣品表面可以顯著促進蛋白的吸附。 對經(jīng)兩種表面處理的鈦基種植體進行了兔腿骨內種植實驗。結果表明，兩種種植體都可以與骨組織發(fā)生緊密的骨性結合，顯著提高種植體與骨組織之間的結合力，促進骨組織的形成。在此基礎上臨床實驗研究表明，72個病例均無肝腎功能改變及并發(fā)癥的發(fā)生，共計植入117顆種植體3年臨床實驗期間種植體生存率達99.2%，一期術后及二期手術檢查種植體周垂直骨喪失平均為0.07mm，，修復后1-3年全景X光片測量骨吸收平均值為0.14mm，種植體周圍指數(shù)及牙齦指數(shù)無明顯變化，表明種植體周圍軟組織健康穩(wěn)定。臨床研究表明生物功能牙種植體能與牙槽骨形成良好的骨整合，種植系統(tǒng)的結構設計和表面構建有利于減少種植體周骨組織的吸收，并保持種植體周軟組織的健康和軟組織的量。 本論文闡述了牙種植體發(fā)展應用現(xiàn)狀，對種植體的臨床應用和長期成功的關鍵因素種植體表面生物功能構建和結構形態(tài)設計進行了系統(tǒng)研究，經(jīng)多年研發(fā)、動物實驗和臨床試驗證明生物功能牙種植體的安全性和有效性。
[Abstract]:The biomechanical compatibility and histocompatibility of dental implants are the basis for the success and long-term stability of denture implant. Therefore, the design process of dental implants is not only to choose material of material properties and processing properties according to the load conditions, but also to design the shape, length, diameter and connection mode of the implant and its base. The construction of biomimetic structure on the surface of dental implants and the interaction mechanism between the dental implants and the cells are also needed to be studied systematically. The surface modification technology is used to construct a reasonable structure with excellent mechanical properties. The surface micro and nano topology with the skeleton of the bone extracellular matrix and the implantation of calcium and phosphorus coated titanium abutments with excellent bone integration properties are cultivated. Through in vitro biomimetic mineralization experiments, protein adsorption and animal body implantation experimental system to study the internal and external osteogenesis of different surface treated implants, the plasma sprayed calcium phosphorus coated dental implant was prospectively studied in order to design and prepare a long-term stable new clinical application. The reference is provided for the dental implants of type surface modified titanium alloy.
According to the mechanical mechanics and biomechanics principle, combined with the anatomical characteristics of the Chinese tooth and jaw, the dental implant system is designed to be applied to the clinic. The dental implant system has two forms of cylinder and thread, 5 diameters and 5 length specifications, 7 moth taper, 360 degree rotation positioning and platform transfer structure connecting the base and the implant. There is a cold welding phenomenon between the base platform and the implant under the preloading force of the base platform 4,5,6,7 and the 8 taper under the preloading force of 35N cm. It shows that the dislocation moment is greater than the preload torque 5%-10%, and there is no obvious difference between the taper degrees, and the cold welding of the interface is combined with the moment of 40N. Cm. The three dimensional finite element analysis found that the base of 4-8 different taper connection bases is found. In the case of vertical and horizontal loading, the stress distribution is similar, the stress concentration area is both in the neck of the implant and the base platform, and with the increase of the taper, the stress value decreases linearly. The stress and strain displacement of horizontal loading are obviously higher than that of the vertical loading, which indicates that the horizontal load is more vulnerable to the damage of the implant structure; 0, The 15 and 45 shoulder slope surfaces were designed to connect the base of the 7 taper. Under vertical loading and horizontal loading, the stress distribution between the implant structures and the surrounding jaws was not significant. Although the vertical loading is about 1.5 times larger, the position is obviously moved to the root of the implant. It shows that the platform transfer can effectively reduce the stress concentration around the bone around the neck of the implant, thus reducing the absorption of the bone around the implant, and is beneficial to the long-term success of the implant.
The surface of titanium based implant was treated with sand blasting and acid etching treatment. The effects of acid species and etching time on surface micro and nano roughness, surface hydrophobicity and surface composition were studied. The surface micro and nano topology was controlled by controlling the etching time and the type of acid, in which HCl/H2SO4 The surface of the titanium base implants treated with acid etching in the mixed solution formed a multi-scale topology, that is, a corrosion pit with a diameter of 10~20 micron, consisting of a small hole of 1~2 mu m. This surface micro and nano topology is the result of the interaction of grain boundary corrosion and pitting. The physical signal stimulation of extracellular matrix promotes cell adhesion, proliferation, differentiation and other cell behaviors, and accelerates the osseointegration process.
The bone integration performance of the implant is very important for its initial stability. In this study, the plasma spraying technology was used to construct calcium and phosphorus bioactive coating on the surface of titanium implants. The effects of spraying power, particle size and spray distance on the density of the coating, the surface appearance of the coating and the composition of the phase in the coating were systematically studied. The results show that the surface coating produced by spraying power 30kW, spraying distance 110mm and HA powder size of 20~50 u m has high density and excellent performance. The phase transition process of calcium phosphorus salts may appear in the process of plasma spraying. After 6 days of simulated body fluid, apatite layer was deposited on the surface, and the surface sediments were analyzed by scanning electron microscope (SEM), X ray diffraction, infrared spectrum and energy spectrum. The results showed that the surface of the sample surface of the sanding and acid etching titanium implant was amorphous calcium phosphate, and the surface of the plasma sprayed implant sample deposited in a short time. In addition, the qualitative and quantitative analysis results of protein adsorption show that the surface of sand and acid erosion and the surface of plasma sprayed calcium and phosphorus coating can significantly promote the adsorption of protein.
Two kinds of surface treated titanium implants were planted in the rabbit's leg bone planting experiment. The results showed that the two implants could combine bone tissue closely with bone tissue, significantly increase the binding force between the implant and bone tissue, and promote the formation of bone tissue. On this basis, the experimental study showed that both of the 72 cases had no liver and kidney function. The survival rate of the implant was 99.2% during the 3 year clinical trial of 117 implants. The average of the periimplant bone loss was 0.07mm after the first stage and two stage operation. The average bone absorption of the panoramic X ray after 1-3 year restoration was 0.14mm, the periimplant index and gingival index were not changed obviously. The soft tissue around the implants is healthy and stable. The clinical study shows that the biofunctional dental implant can form a good bone integration with the alveolar bone. The structural design and surface construction of the implant system are beneficial to reduce the absorption of the periimplant bone tissue and maintain the healthy and soft tissue of the soft tissue of the implant.
This paper describes the development and application status of dental implants. The clinical application of implant and the key factors for long-term success are studied systematically. After years of research and development, animal experiments and clinical trials have proved the safety and effectiveness of biological functional dental implant.
【學位授予單位】：華南理工大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R783.6

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