愈合时间对Ⅲ类骨质中微种植体稳定性影响的三维有限元分析
发布时间：2019-07-02 10:07
【摘要】：目的：正畸治疗过程中支抗的控制是影响治疗效果的关键因素。微种植体支抗与腭杆、舌弓、口外弓等传统支抗相比，凭借其操作简便、创伤小、成本低以及疗效可靠等优点，成为近年来正畸领域的研究热点并越来越多的应用于临床。 微种植体为正畸治疗提供强支抗的前提是微种植体自身的稳定性，而其稳定性与颌骨质量密切相关。颌骨质量在人群中有很大的变异，临床应用中常发现有些青少年具有较薄的皮质骨，植入种植体时初期稳定性较差，延长愈合时间及调整载荷力值是否能提高种植体成功率很少有报道。 微种植体的固位形式主要有机械嵌合力和生物结合两种方式。机械嵌合力主要是在种植体植入初期，还未形成骨结合的情况下，由微种植体与骨组织之间的摩擦力提供。生物结合又分为纤维结合（种植体与骨组织间存在一层非矿化的纤维结缔组织）、骨结合（种植体与骨组织直接接触，其间不存在骨以外的组织，达到种植体与骨组织在结构和功能上的直接联系）以及混合性结合。 研究表明，微种植体加载前的愈合时间会对其稳定性产生一定影响，但最佳加载时间仍存在争议。传统观点认为，种植体植入后，应保证一定的骨愈合过程再加载，以提高骨结合率，从而保证其稳定性。而近年来一种新的观点认为，种植体植入早期固位良好者一定限度的微动有利于骨结合，这为微种植体即刻加载提供了依据。 研究种植体支抗的方法很多，近年来证明三维有限元是一种有效的力学分析方法。应用三维有限元进行分析可以更为精确的模拟实物内部的结构和组织学变化。因此三维有限元法现在广泛的应用于正畸领域中。 本实验拟采用三维有限元方法，建立Ⅲ类骨的模型及种植体支抗模型，通过加载前不同愈合时间微种植体-骨接触面的不同，对模型进行应力分析，从而观察及比较Ⅲ类骨不同愈合时间对微种植体稳定性的影响，为指导临床应用提供理论依据，提高种植的成功率。 方法： 1实验设备 计算机：台式，(Intel(R) Xeon(R) CPU E5-1650，3.20GHz:8G内存，win7,64bit位操作系统) 软件包：Catia V5，Hyperworks11.0，Abaqus6.10 2微种植体-颌骨模型的设定 2.1建立颌骨模型 依据一女性志愿者上颌骨左侧第二前磨牙与第一磨牙之间种植体植入部位的颌骨CT纵断面，建立颌骨模型。颌骨表面部分为皮质骨，厚度为0.7mm，内部为松质骨。根据实际的尺寸，将断面简化成等腰梯形，断面尺寸：上表面宽15mm，下表面宽13.5mm，，高7.5mm。然后用面拉伸成长20mm的六面体。 2.2建立微种植体模型 根据临床常用正畸微种植体形态建立微种植体模型，数据如下：总长度12mm，骨内段总长度8mm、直径1.6mm、螺纹高度0.2mm、刃状螺纹顶角60°、螺距0.6mm。 2.3装配微型种植体-上颌骨实体模型 将颌骨及微种植体按照相应位置进行装配得到微种植体-颌骨模型。在种植体颈部分别施加1N及2N的正畸力。设定以龈方为Y轴正向，以远中为X轴正向，以种植体长轴为Z轴。加载方向为平行于X-Y平面（垂直于种植体长轴）与Y轴平行方向相反（牙合方）的正畸力。 2.4实验分组设计： 2.4.1即刻加载组（Immediate Load，IL）： 采用库仑摩擦模型模拟非骨结合状态，摩擦系数μ=0.2。同时采用过盈配合的方法模拟种植体骨界面的初始应力。 即刻加载1组（Immediate Loading1，IL1）：设定过盈量为0.03； 即刻加载2组（Immediate Loading2，IL2）：设定过盈量为0.05； 即刻加载3组（Immediate Loading3，IL3）：设定过盈量为0.1； 2.4.2早期加载组（Early Loading, EL）及延期加载组（Delay Loading，DL）： EL组和DL组分别模拟愈合３周后及愈合７周后加载的情况，以微种植体-骨结合率（bone-implant contact rate，BIC）定义两组的微种植体-骨接触面： EL组：BIC=34% DL组：BIC=44% 通过微种植体-骨界面不同比例的骨结合和非骨结合来模拟不同微种植体-骨结合率。骨结合与非骨结合区域间隔出现，并随机分配。骨结合区域骨组织和种植体界面单元在载荷作用下相对位移为0，为固定接触；非骨结合区域界面单元在外力作用下允许相对滑动，摩擦系数μ=0.2。 3材料 3.1材料属性 假设种植体，皮质骨和松质骨均为连续，均匀，各向同性的线弹性材料，材料变形为弹性小变形。 3.2实体建模 利用电子计算机技术，按照实际尺寸，建立颌骨和微种植体的三维模型，形成装配。 3.3网格划分 利用电子计算机技术，导入三维模型到有限元建模软件Hyperwork11.0的Hypermesh模块中对模型进行网格细化。 3.4部件连接 将有限元网格模型导入到Abaqus6.10中，建立各部分相应的接触面。 ４计算结果 利用Hyperworks11.0的Hyperview模块查看计算结果，并采集各组的Von-Mises应力值及位移值。分析微种植体-骨界面及微种植体的的应力分布、应变规律。 结果: 1建立了不同愈合时间下的微种植体-颌骨模型，其几何相似性及生物力学相似性好，满足力学运算要求。 2微种植体上应力及位移分布：所有工况下微种植体的Von-Mises应力主要分布在其骨内与皮质骨接触的区域；位移主要集中在骨外部分，骨内部分主要集中在与皮质骨接触的区域。 3微种植体-骨界面的应力及位移分布：颌骨内所有工况Von-Mises应力分布主要集中在皮质骨范围内，应力在其范围内迅速衰减，松质骨范围内的应力较小；EL组和DL组，位移在皮质骨范围内较为集中，在松质骨内迅速减小；而在IL组，位移峰值分布在皮质骨区域内，但是位移的变化在整个颌骨内呈现波浪形，波浪的顶点数值出现在每个螺纹的刃状部。 4愈合时间对微种植体-骨界面应力、位移的影响：IL组具有较高的应力和位移峰值，EL组和DL组的应力及位移峰值基本相同。说明在皮质骨较薄的Ⅲ类骨质中，34%的骨结合率即足以提供微种植体所需的稳定性。 5不同过盈量对微种植体-骨界面应力的影响：IL1~IL3组的应力峰值可见过盈量的大小与微种植体-骨界面的应力基本呈正相关，且对同一过盈量而言，不加载、加载1N或2Ｎ的力值，其应力峰值并无变化。这说明在种植体植入初期，微种植体-骨界面的应力基本由微种植体和骨的机械嵌合力提供，1N~2N的正畸加载对骨界面无明显影响。 结论： 1微种植体-骨界面的应力分布主要集中于皮质骨范围内，松质骨范围内的应力较小； 2在种植体植入初期，微种植体-骨界面的应力基本由微种植体和骨的机械嵌合力提供，1N~2N的正畸加载对骨界面无明显影响。提示在Ⅲ类骨质中可以进行适量力值的即刻加载； 334%的骨结合率即可以提供微种植体所需的稳定性； 4在Ⅲ类骨质中减少载荷力值可以降低微种植体-骨界面应力、位移峰值，使微种植体-骨界面应力更加均匀，有利于微种植体的稳定性。
[Abstract]:Objective: The control of the support in the course of orthodontic treatment is the key factor that affects the treatment effect. The microimplant has the advantages of simple operation, small wound, low cost and reliable curative effect, and has become a hot spot in the field of orthodontics in recent years. The premise of providing strong support for orthodontic treatment is the self-stability of the micro-implant, and the stability of the micro-implant is closely related to the quality of the jaw. The quality of the jaw has a large variation in the population. It is often found in the clinical application that some of the adolescents have a thin cortical bone, the initial stability of the implant is poor, the healing time and the adjustment of the load force value can improve the success rate of the implant. The retention form of the micro-implant is mainly composed of a mechanical block force and a biological combination. In the first stage of the implant implantation, the mechanical engagement force is mainly the friction between the micro-implant and the bone tissue without the formation of a bone union in the initial implantation stage of the implant. The force is provided. The biological combination is also divided into fiber-binding (there is a layer of non-mineralized fibrous connective tissue between the implant and the bone tissue), the bone union (the implant is in direct contact with the bone tissue, there is no bone other than the bone), Tissue to achieve direct contact between the implant and bone tissue in structure and function) and mixing The study shows that the healing time before microimplant loading can have a certain effect on its stability, but the optimal loading time There is still a dispute. The traditional view is that after the implant is implanted, a certain bone healing process should be guaranteed to be re-loaded in order to increase the bone-binding rate, thereby protecting the bone. In recent years, a new point of view is that a limited amount of micromotion of the implant in the early retention of the implant is beneficial to the bone union, which provides immediate loading of the microimplant. There are many methods to study the anchorage of the implant. In recent years, it is proved that the three-dimensional finite element is an effective method. The mechanical analysis method based on the three-dimensional finite element method can more accurately simulate the inside of the object. The three-dimensional finite element method is now widely used. in that field of orthodontics, a three-dimensional finite element method is used to establish a model of type III bone and an implant support model, The stress analysis of the model was carried out to observe and compare the effect of different healing time on the stability of the micro-implant and provide the theoretical basis for guiding the clinical application. and improve the success of planting Rate. Method:1 experimental device computer: desktop, (Intel (R) Xeon (R) CPU E5-1650, 3.20 GHz: 8G memory, win7, 64bit operating system) software package: Catia V5,Hyperwo rks11.0, Abaqu s6.10 2 micro The setting of the implant-jaw model: 2.1 The jaw model is established according to a female volunteer's second premolar on the left side of the maxilla and the first molar The maxilla CT profile of the implant site of the interdental implant and the model of the maxilla. The maxilla table The face is divided into cortical bone with a thickness of 0.7 mm and the inside is cancellous bone. According to the actual size, the section is simplified into the isosceles trapezoid, the section size: the upper surface 15 mm wide and 13.5 mm wide, 7.5 mm high. Then face The micro-implant model was established according to the clinical common orthodontic microimplant morphology. The data were as follows: total length of 12 mm, total length of intraosseous segment 8 mm, diameter of 1.6 mm, Thread height of 0.2 mm, edge-like thread top angle 60 deg., pitch 0.6 mm. 2.3 Assembly of micro-implant-maxillary solid model The jaw and the micro-implant are assembled in accordance with the corresponding position A micro-implant-jaw model was obtained.1 N and 2 N orthodontics were applied to the neck of the implant, respectively. Force. Set to the Gingival to the Y-axis positive, in the distal direction to the X-axis, and the long axis of the implant as the Z-axis. The loading direction is parallel to the X-axis. Y-plane (perpendicular to the implant The orthodontic force in the opposite direction to the Y-axis. Group Design: 2.4.1 Immediate Loading Group (Immediate Load, IL): simulating nonunion with coulomb friction model State, friction coefficient. mu. = 0.2. At the same time, the initial stress of the implant bone interface is simulated by an interference fit method. Load 1 (Immediate Loading1, IL1): set the interference amount to 0.03; Load 2 immediately (Immediate Loading2, IL2): set interference to 0.0 5; Load 3 immediately (Immediate Loading3, IL3): set the interference amount to 0.1;2 4.2.2 Early Loading (EL) and Delay Loading (DL): In the case of three weeks of healing and 7 weeks after healing, the micro-implant- bone-binding ratio (bone-i) mpla nt conta ct rate, BIC) defines two sets of micro-implant-bone contact surfaces: EL group: BIC = 34 % DL group: BIC = 44% by micro-planting Bone-binding and non-bone-binding in different proportions of the body-to-bone interface to simulate different microimplant-bone-binding ratios. The bone-binding and non-bone-binding regional intervals occur and are randomly assigned. The bone-binding region bone tissue and the implant interface the unit is the opposite of the load The displacement is 0, which is fixed contact; the interface unit of the non-bone joint area allows relative sliding under the action of external force, and the coefficient of friction is mu = 0.2. .3 Materials 3.1 Material properties assume that both the implant, the cortical bone, and the cancellous bone are continuous, uniform, isotropic the elastic material, the material, The deformation is an elastic small deformation. 3.2 The solid modeling uses the computer technology to establish a three-dimensional model of the jaw and the micro-implant according to the actual size to form the assembly. .3 Mesh division Using the computer technology, the three-dimensional model is introduced to the finite element modeling software Hyperwor1 1.0 H Mesh refinement of the model in the yermesh module. 3.4 Component connections import the finite element mesh model into the Abaqus6.10 and set up each part of the corresponding contact surface. The results of the calculation take advantage of the Hypershade rks 11.0 The Hyperview module looks at the calculation results and collects the Von-Mises stress values and the displacement values for each group. The stress distribution and the strain law of the micro-implant-bone interface and the micro-implant were established. Results:1 The micro-implant-jaw model with different healing time was established, the geometric similarity and the biomechanical similarity were good, and the mechanical operation requirement was satisfied. The stress and displacement distribution of the implant: The Von-Mises stress of the micro-implant in all working conditions is mainly distributed in the area in which the bone is in contact with the cortical bone; the displacement is mainly concentrated in the outer part of the bone, and the intra-osseous part is mainly concentrated in the area in contact with the cortical bone. The stress of the micro-implant-bone interface and displacement distribution: the stress distribution of the Von-Mises stress in all working conditions in the jaw is mainly concentrated in the cortical bone, the stress is rapidly attenuated in the range of the cortical bone, and the stress in the range of the cancellous bone is small; and the EL group and the DL In the group, the displacement is more concentrated in the cortical bone, and is rapidly reduced in the cancellous bone; in the IL group, the displacement peak is distributed in the cortical bone area, but the change of the displacement is within the whole jaw the wave is presented with the apex value of the wave occurring at the edge of each thread. The healing time is for the micro-implant-bone The effect of interface stress and displacement is that the stress and displacement peaks of the IL group have higher stress and displacement peak value, and the stress and displacement peaks of the EL group and the DL group are the same. The effect of the implant-bone interface stress: the stress peak of the IL1-IL3 group was positively correlated with the stress of the micro-implant-bone interface and the same amount of interference No, no, no, no. Loading, loading of 1N or 2N force values, and no change in the stress peak. This indicates that at the initial stage of implant implantation, the microspecies The stress of the bone-bone interface is basically provided by the mechanical block force of the micro-implant and the bone, and the orthodontic loading on the bone-bone interface is applied to the bone. There was no obvious effect on the interface. Conclusion:1 micro-implant -The stress distribution of the bone interface is mainly concentrated in the cortical bone. the stress in the implant range is small; at the initial stage of the implant implantation, the microspecies The stress of the bone-bone interface is basically provided by the mechanical block force of the micro-implant and the bone, and the stress of the bone-bone interface is 1-2N Orthodontic loading has no significant effect on the bone interface.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6
[Abstract]:Objective: The control of the support in the course of orthodontic treatment is the key factor that affects the treatment effect. The microimplant has the advantages of simple operation, small wound, low cost and reliable curative effect, and has become a hot spot in the field of orthodontics in recent years. The premise of providing strong support for orthodontic treatment is the self-stability of the micro-implant, and the stability of the micro-implant is closely related to the quality of the jaw. The quality of the jaw has a large variation in the population. It is often found in the clinical application that some of the adolescents have a thin cortical bone, the initial stability of the implant is poor, the healing time and the adjustment of the load force value can improve the success rate of the implant. The retention form of the micro-implant is mainly composed of a mechanical block force and a biological combination. In the first stage of the implant implantation, the mechanical engagement force is mainly the friction between the micro-implant and the bone tissue without the formation of a bone union in the initial implantation stage of the implant. The force is provided. The biological combination is also divided into fiber-binding (there is a layer of non-mineralized fibrous connective tissue between the implant and the bone tissue), the bone union (the implant is in direct contact with the bone tissue, there is no bone other than the bone), Tissue to achieve direct contact between the implant and bone tissue in structure and function) and mixing The study shows that the healing time before microimplant loading can have a certain effect on its stability, but the optimal loading time There is still a dispute. The traditional view is that after the implant is implanted, a certain bone healing process should be guaranteed to be re-loaded in order to increase the bone-binding rate, thereby protecting the bone. In recent years, a new point of view is that a limited amount of micromotion of the implant in the early retention of the implant is beneficial to the bone union, which provides immediate loading of the microimplant. There are many methods to study the anchorage of the implant. In recent years, it is proved that the three-dimensional finite element is an effective method. The mechanical analysis method based on the three-dimensional finite element method can more accurately simulate the inside of the object. The three-dimensional finite element method is now widely used. in that field of orthodontics, a three-dimensional finite element method is used to establish a model of type III bone and an implant support model, The stress analysis of the model was carried out to observe and compare the effect of different healing time on the stability of the micro-implant and provide the theoretical basis for guiding the clinical application. and improve the success of planting Rate. Method:1 experimental device computer: desktop, (Intel (R) Xeon (R) CPU E5-1650, 3.20 GHz: 8G memory, win7, 64bit operating system) software package: Catia V5,Hyperwo rks11.0, Abaqu s6.10 2 micro The setting of the implant-jaw model: 2.1 The jaw model is established according to a female volunteer's second premolar on the left side of the maxilla and the first molar The maxilla CT profile of the implant site of the interdental implant and the model of the maxilla. The maxilla table The face is divided into cortical bone with a thickness of 0.7 mm and the inside is cancellous bone. According to the actual size, the section is simplified into the isosceles trapezoid, the section size: the upper surface 15 mm wide and 13.5 mm wide, 7.5 mm high. Then face The micro-implant model was established according to the clinical common orthodontic microimplant morphology. The data were as follows: total length of 12 mm, total length of intraosseous segment 8 mm, diameter of 1.6 mm, Thread height of 0.2 mm, edge-like thread top angle 60 deg., pitch 0.6 mm. 2.3 Assembly of micro-implant-maxillary solid model The jaw and the micro-implant are assembled in accordance with the corresponding position A micro-implant-jaw model was obtained.1 N and 2 N orthodontics were applied to the neck of the implant, respectively. Force. Set to the Gingival to the Y-axis positive, in the distal direction to the X-axis, and the long axis of the implant as the Z-axis. The loading direction is parallel to the X-axis. Y-plane (perpendicular to the implant The orthodontic force in the opposite direction to the Y-axis. Group Design: 2.4.1 Immediate Loading Group (Immediate Load, IL): simulating nonunion with coulomb friction model State, friction coefficient. mu. = 0.2. At the same time, the initial stress of the implant bone interface is simulated by an interference fit method. Load 1 (Immediate Loading1, IL1): set the interference amount to 0.03; Load 2 immediately (Immediate Loading2, IL2): set interference to 0.0 5; Load 3 immediately (Immediate Loading3, IL3): set the interference amount to 0.1;2 4.2.2 Early Loading (EL) and Delay Loading (DL): In the case of three weeks of healing and 7 weeks after healing, the micro-implant- bone-binding ratio (bone-i) mpla nt conta ct rate, BIC) defines two sets of micro-implant-bone contact surfaces: EL group: BIC = 34 % DL group: BIC = 44% by micro-planting Bone-binding and non-bone-binding in different proportions of the body-to-bone interface to simulate different microimplant-bone-binding ratios. The bone-binding and non-bone-binding regional intervals occur and are randomly assigned. The bone-binding region bone tissue and the implant interface the unit is the opposite of the load The displacement is 0, which is fixed contact; the interface unit of the non-bone joint area allows relative sliding under the action of external force, and the coefficient of friction is mu = 0.2. .3 Materials 3.1 Material properties assume that both the implant, the cortical bone, and the cancellous bone are continuous, uniform, isotropic the elastic material, the material, The deformation is an elastic small deformation. 3.2 The solid modeling uses the computer technology to establish a three-dimensional model of the jaw and the micro-implant according to the actual size to form the assembly. .3 Mesh division Using the computer technology, the three-dimensional model is introduced to the finite element modeling software Hyperwor1 1.0 H Mesh refinement of the model in the yermesh module. 3.4 Component connections import the finite element mesh model into the Abaqus6.10 and set up each part of the corresponding contact surface. The results of the calculation take advantage of the Hypershade rks 11.0 The Hyperview module looks at the calculation results and collects the Von-Mises stress values and the displacement values for each group. The stress distribution and the strain law of the micro-implant-bone interface and the micro-implant were established. Results:1 The micro-implant-jaw model with different healing time was established, the geometric similarity and the biomechanical similarity were good, and the mechanical operation requirement was satisfied. The stress and displacement distribution of the implant: The Von-Mises stress of the micro-implant in all working conditions is mainly distributed in the area in which the bone is in contact with the cortical bone; the displacement is mainly concentrated in the outer part of the bone, and the intra-osseous part is mainly concentrated in the area in contact with the cortical bone. The stress of the micro-implant-bone interface and displacement distribution: the stress distribution of the Von-Mises stress in all working conditions in the jaw is mainly concentrated in the cortical bone, the stress is rapidly attenuated in the range of the cortical bone, and the stress in the range of the cancellous bone is small; and the EL group and the DL In the group, the displacement is more concentrated in the cortical bone, and is rapidly reduced in the cancellous bone; in the IL group, the displacement peak is distributed in the cortical bone area, but the change of the displacement is within the whole jaw the wave is presented with the apex value of the wave occurring at the edge of each thread. The healing time is for the micro-implant-bone The effect of interface stress and displacement is that the stress and displacement peaks of the IL group have higher stress and displacement peak value, and the stress and displacement peaks of the EL group and the DL group are the same. The effect of the implant-bone interface stress: the stress peak of the IL1-IL3 group was positively correlated with the stress of the micro-implant-bone interface and the same amount of interference No, no, no, no. Loading, loading of 1N or 2N force values, and no change in the stress peak. This indicates that at the initial stage of implant implantation, the microspecies The stress of the bone-bone interface is basically provided by the mechanical block force of the micro-implant and the bone, and the orthodontic loading on the bone-bone interface is applied to the bone. There was no obvious effect on the interface. Conclusion:1 micro-implant -The stress distribution of the bone interface is mainly concentrated in the cortical bone. the stress in the implant range is small; at the initial stage of the implant implantation, the microspecies The stress of the bone-bone interface is basically provided by the mechanical block force of the micro-implant and the bone, and the stress of the bone-bone interface is 1-2N Orthodontic loading has no significant effect on the bone interface.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R783.6
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