基底冠材料和形态设计对种植固定义齿被动适合性影响的研究

发布时间：2018-03-26 19:06

本文选题：种植固定义齿　切入点：被动适合性　出处：《山东大学》2017年硕士论文

【摘要】：目的1.研究氧化锆全瓷和纯钛烤瓷两种修复材料对计算机辅助设计及制作的种植体支持粘结固位义齿被动适合性的影响。2.研究360°颈环设计对计算机辅助设计及制作的种植固定义齿被动适合性的影响。3.探究饰瓷烧结前后不同基底冠的修复体被动适合性的变化情况。4.通过检测种植体周围树脂的应变,探究种植固定义齿周围应力分布的情况。方法调配环氧树脂使之弹性模量与牙槽骨相近,制作成32个大小相同的树脂块并在每块植入两枚种植体,模拟左下颌第二前磨牙至第二磨牙缺失后的种植修复。在每个种植体颈部颊侧、舌侧、近中、远中四个方向上分别粘结应力感应器。采用计算机辅助设计及制作4组不同材料及形态设计的三单位固定义齿内冠,每组8个(n=8)。A组为常规氧化锆全瓷冠组,B组为360°氧化锆颈环基底全瓷冠组,C组为常规纯钛烤瓷冠组,D组为360°纯钛金属颈环基底烤瓷冠组。利用应力感应装置分别测量内冠和经烧结饰瓷的最终修复体粘结于种植体后,各组种植体周围应变。用SPSS分析软件进行数据处理。结果1.A、B、C、D四组各部位应力感应器均感应到应力。2.饰瓷烧结前,不同的内冠材料对应变有影响,氧化锆组应变较小(P0.01);不同内冠形态对应变有影响,有颈环组应变较小(P0.01);材料与形态存在交互作用(P0.01)。3.饰瓷烧结后,不同的内冠材料对最终修复体所产生的应变有影响,氧化锆组应变较小(P0.01);不同内冠形态对最终修复体所产生的应变有影响,有颈环组应变较小(P0.01);材料与形态存在交互作用,氧化锆有颈环组应变最小(P0.01)。4.经饰瓷烧结,各组应变均增加。不同材料内冠对烤瓷前后应变差异无影响(P0.05);不同内冠形态对烤瓷前后应变差异有影响,有360°颈环组差异较小(P0.01)。5.A、B、C、D四组经饰瓷烧结后,近远中方向上的应变大于其颊舌方向上的应变,近负荷点处应变最大,有统计学意义(P0.05)。结论1.CAD/CAM制作的种植体支持的固定义齿无法达到绝佳的被动适合性。2.氧化锆全瓷比纯钛金属烤瓷修复体具有更好的被动适合性。3.360°颈环有利于提高种植固定义齿被动适合性。4.氧化锆全瓷固定义齿及纯钛金属烤瓷固定义齿经饰瓷烧结后,其被动适合性均降低;360°颈环有利于减轻由烧结饰瓷带来的不良影响,而材料对烤瓷导致的适合性变化无影响。5.临床上应采取措施减小种植固定义齿颈部周围近远中方向,尤其是两种植体近桥体侧位置的应力。
[Abstract]:Objective 1. To study the effect of zirconia all-ceramic and pure titanium porcelain on the passive suitability of implant supported adhesive retention denture. 2. To study the influence of 360 掳neck ring design on computer aided design and fabrication. Study on the change of passive fitness of restoration with different base crowns before and after sintering. 4. By detecting the strain of resin around the implant, To investigate the stress distribution around the implant fixed denture. Methods Epoxy resin was blended to make the elastic modulus close to the alveolar bone, and 32 resin blocks of the same size were made and two implants were implanted in each implant. Imitating implant restoration after left mandibular second premolar to second molar missing. In each implant neck, buccal side, tongue side, proximal center, The four directions in the far distance are respectively bonded to the stress sensors. Four groups of three unit fixed denture crowns with different materials and shapes are designed and fabricated by means of computer aided design. Each group consisted of 8 Zirconia ceramic crowns, group B, 360 掳zirconia neck ring, all-ceramic crowns, group C, conventional pure titanium fused porcelain crowns, group D, 360 掳pure titanium metal neck ring, porcelain crowns, respectively, were measured by stress sensing apparatus. The internal crown and the final restoration of sintered porcelain are bonded to the implant, The data were processed by SPSS software. Results 1. The stress sensors in each of the four groups were sensitive to stress. 2. Before sintering, different crown materials affected the strain. The strain of zirconia group is smaller than that of zirconia group, the strain of different inner crown has influence on the strain, and the strain of neck ring group is smaller than that of P0.01.The interaction between material and morphology is P0.010.3.After sintered porcelain, different inner crown materials have an effect on the strain produced by the final restoration. The strain of Zirconia group is smaller than that of Zirconia group, the shape of different inner crown has influence on the strain produced by the final prosthesis, and the strain is smaller in the group of neck ring. There is interaction between the material and the form, and the minimum strain of Zirconia with cervical ring group is P0.01U. 4. Sintered by ceramic ornament, The strain of each group increased. The internal crown of different materials had no effect on the strain difference before and after the porcelain, and the different shape of the inner crown had an effect on the strain difference before and after the porcelain, there was a little difference in 360 掳neck ring group (P 0.01). 5. After sintering, the four groups were sintered with porcelain. The strain up near the far side is larger than the strain in the direction of the cheek and tongue, and the strain at the near load point is the largest. Conclusion the 1.CAD/CAM implant-supported fixed denture can not achieve excellent passive fitness. 2.Zirconia all-ceramic has better passive fitness than pure titanium metal ceramic prosthesis. 3.360 掳neck ring is good for improving the species. Zirconia all porcelain fixed denture and pure titanium metal porcelain fixed denture after sintered with porcelain, All the passive adaptations were reduced by 360 掳neck ring, and the adverse effects caused by sintered porcelain were alleviated, while the material had no effect on the change of fitness caused by porcelain. 5. In clinic, measures should be taken to reduce the near and far side direction around the neck of implant fixed denture. Especially, the stress of the two implants near the side of the bridge.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.6

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