仿真“骨小梁”牙种植体的生物力学研究

发布时间：2018-01-02 18:29

本文关键词：仿真“骨小梁”牙种植体的生物力学研究　出处：《西南医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过系统评价“骨小梁”(PTTM)牙种植体的临床应用状况,结合三维有限元生物力学分析,评价三维多孔结构和钽的临床有效性,探究PTTM在口腔种植领域的应用价值,为“骨小梁”牙种植体的临床推广应用提供理论基础。方法:1、计算机检索9个电子数据库,结合手工检索有关骨小梁牙种植体的相关临床研究,无时间、地区和语言限制;按照纳入排除标准,筛选文献并提取相关数据,风险评估后纳入合格文献,作出系统评价;2、应用Mimics16.0、CATIA、Hypermesh软件建立近似“骨小梁”牙种植体(PTTM)、常规钛种植体(ITI)、下颌骨、基台的实体模型,将仿真“骨小梁”种植体(实验组)和钛种植体(对照组)分别植入不同骨质(Ⅱ、Ⅲ、Ⅳ)的下颌骨中,并组装基台;模拟种植体在骨块中的约束条件,于颊舌向45°、100 N的力在基台中心集中加载,利用MSC Patran和MSC Nastran软件计算各组种植体在不同骨质内应力应变数据,采集具有代表性的Von Mises来分析各工况应力分布规律,比较两类植体在不同骨质条件下各自的优势和缺点。结果:1、系统评价共检索到1246篇文献,通过浏览题目和摘要后纳入17篇文献,分析全文并进行质量评估后最终纳入7篇文献,涉及到394名患者,487枚PTTM种植体,关注了221名患者,244枚PTTM种植体,选择种植体留存率(survival rate)、平均牙槽骨丧失量(mean marginal bone loss),初期和二期稳定性(primary and secondary stability)及术后并发症(complications)等作为效应量来评估该种植体的临床有效性,做出定性分析和评价;2、建立了PTTM种植体和常规钛种植体在下颌骨第一磨牙区三类不同骨质中(Ⅱ、Ⅲ、Ⅳ)行颊舌向45度,大小100N的力学加载模型,共六组工况;MSC Patran和MSC Nastran软件绘制出各组应力分布云图,计算Von Mises应力平均值和最大值,结果显示不同骨质下PTTM与TI种植体之间均有统计学差异。结论:1、在有限的随访时间和临床对照下,PTTM牙种植体可广泛地应用于牙列缺损和牙列缺失患者,植入或早期负载1年后种植体留存率大于96.26%,平均牙槽骨吸收量小于0.43mm,未发现严重并发症,提示PTTM牙种植体可能具有较好的初期、二期稳定性,但临床初期数据不足以证明PTTM牙种植体与常规钛种植体相比是否具有统计学差异。2、1)两组中Von Mises应力集中于骨皮质-种植体-基台连接区域;骨松质应力较小2)随着骨质疏松程度的增大(Ⅱ-Ⅳ),PTTM、TI种植体周围Von Mises应力平均值均增大,PTTM组周围Von Mises应力平均值、最大值均小于TI组。
[Abstract]:Objective: To study the evaluation system of "bone" (PTTM) the clinical application of dental implants, combined with biomechanical finite element analysis, the effective assessment of the three-dimensional porous structure and the clinical application value of TA, PTTM in the field of oral implantology, provide a theoretical basis for the clinical application of trabecular bone teeth "implant. Methods: 1, searched 9 electronic databases, combined with clinical research, the manual retrieval of trabecular bone implant without time, area and language restrictions; according to the inclusion and exclusion criteria, literature screening and collect the relevant data, after the risk assessment included in this system, make the evaluation; 2. The application of Mimics16.0, CATIA, Hypermesh software to establish the approximate" trabecular bone implant "(PTTM), conventional titanium implant (ITI), mandible, solid model of the base station, the simulation of trabecular bone implant" (experimental group) and titanium implants The body (control group) were implanted with different bone (II, III, IV) of the mandible, and assembly base station; condition simulation of implant in bone block, in buccolingual direction 45 degrees, a force of 100 N in the base station center loading were calculated at different implant bone stress strain Patran and MSC data using MSC Nastran software, collecting representative Von Mises to analyze the condition of stress distribution, comparison of two kinds of implants and their advantages and disadvantages in different bone conditions. Results: 1. The evaluation system of 1246 literatures were retrieved, through reading the title and abstract in 17 the analysis of literature, and to evaluate the quality of the final 7 articles were included, involving 394 patients, 487 PTTM implants, about 221 patients, 244 PTTM implants, choose the implant retention rate (survival rate), the average amount of alveolar bone loss (mean marginal bone loss), early And the two phase stability (primary and secondary stability) and postoperative complications (complications) as a measure to assess the effect of effective implant clinical, make qualitative analysis and evaluation; 2, establish the PTTM implant and conventional titanium implants in mandibular first molars of three different types of bone (II, III, IV) this tongue to 45 degrees, the mechanical loading of the model size 100N, a total of six cases of MSC Patran and MSC group; Nastran software to draw out each stress distribution calculation of Von Mises, the average stress and maximum results showed significant difference between PTTM and TI under different bone implants. Conclusion: 1. In the control of limited time and clinical follow-up, PTTM dental implants can be widely used in dentition defect patients, implantation or early loading of 1 years after the implant retention rate is greater than 96.26%, the average loss of alveolar bone is less than 0.43mm, no The serious complications, suggesting that PTTM dental implants may be effective in the early two period of stability, but early clinical data is not sufficient to prove PTTM dental implants and conventional titanium implants compared with statistical difference.2,1 two) in the group of Von Mises stress concentration on the cortical bone - implant abutment connection loose bone area; matter less stress 2) with the increase of the degree of osteoporosis (II - IV), PTTM, TI Von Mises around the implant average stress increases, the PTTM Von Mises group around the average stress, the maximum value was less than that of TI group.

【学位授予单位】：西南医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R783

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