口腔医学研究

口腔医学研究 ›› 2022, Vol. 38 ›› Issue (9): 843-847.DOI: 10.13701/j.cnki.kqyxyj.2022.09.010

• 口腔种植学研究 • 上一篇    下一篇

基于生物力学性能分析上颌后牙区骨量不足下短种植体对种植体位移、骨组织应力和应变的影响

段咏华1*, 梅健1, 潘亮1, 刘梦石1, 郭美玲2   

  1. 1. 江西省上饶市人民医院口腔科 江西 上饶 334000;
    2. 南昌大学附属口腔医院 江西 南昌 330000
  • 收稿日期:2022-02-25 发布日期:2022-09-26
  • 通讯作者: *段咏华,E-mail:iamdoctorea@163.com
  • 作者简介:段咏华(1976~ ),女,江西玉山人,副主任医师,硕士,研究方向:口腔颌面外科。
  • 基金资助:
    江西省科学技术项目(编号:20192BBGL70019)

Effect of Short Implants on Implant Displacement, Bone Stress, and Strain Based on Biomechanical Properties.

DUAN Yonghua1*, MEI Jian1, PAN Liang1, LIU Mengshi1, GUO Meiling2.   

  1. 1. Department of Stomatology, Shangrao City People's Hospital, Shangrao 334000, China;
    2. Stomatology Hospital, Nanchang University, Nanchang 330000, China.
  • Received:2022-02-25 Published:2022-09-26

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摘要： 目的: 探讨基于生物力学性能分析上颌后牙区骨量不足下短种植体对种植体位移、骨组织应力和应变的影响。方法: 采用前瞻性试验方法,纳入2016年1月~2021年1月于我院就诊治疗的65例上颌后牙缺失患者作为研究对象,根据其种植位点骨量将其分为研究组(n=35)和对照组(n=30)。研究组轻度骨量不足患者应用短种植体,对照组骨量充足应用常规种植体。比较两组患者5年后两种植体的成功率、存留率、种植体位移、颈部边缘骨吸收量、骨组织应力和应变,统计种植体修复后并发症发生率。结果: 研究组种植体成功率和存留率均低于对照组(P＞0.05)。两组患者不同随访阶段复查颈部边缘骨吸收量结果无显著差异(P＞0.05)。短种植体模型的种植体最大位移值和骨皮质最大应力值均低于长种植体模型,骨松质最大应力值高于长种植体模型。种植体的最大移位值、骨松质最大应变值及骨皮质最大应力值均会随着牙冠减径比例的增加而减小。两组患者在随访期间修复牙冠均未出现松动、崩瓷、脱落现象;修复基台、中央螺丝未发生松动、折断;种植体颈部膜未出现红肿、种植体周围未发生骨破坏等并发症。结论: 短种植体与常规种植体疗效相当,但短种植体可在一定程度上降低上颌后牙区种植手术的困难程度,从生物力学层面来看,牙冠适当减径可促进种植体位移降低、骨组织应力值改变。

关键词: 生物力学性能, 上颌后牙区骨量不足, 短种植体, 种植体位移, 骨组织应力;应变

Abstract: Objective: To explore the effects of short implants on the displacement of implants and the stress and strain of bone tissue under insufficient bone mass in maxillary posterior region based on biomechanical analysis. Methods: A prospective trial was used. A total of 65 patients with missing maxillary posterior teeth who were admitted to our hospital from January 2016 to January 2021 were included as the research subjects. They were divided into research group (n=35) and control group (n=30) according to the bone mass at their implantation sites. Short implants were used for patients with mild osteopenia in the study group, while conventional implants were used for patients with adequate bone mass in the control group. The success rate, retention rate, implant displacement, bone resorption at the neck edge, and bone tissue stress and strain of the two implants in the two groups were compared five years later, and the incidence of complications after restoration was calculated. Results: The success rate and retention rate of implants in the study group were lower than those in the control group (P>0.05). There was no significant difference in the results of re-examination of bone resorption at the neck edge between two groups at different follow-up stages (P>0.05). The maximum displacement of the implant and the maximum stress of the cortical bone in the short implant model were lower than those in the long implant model, and the maximum stress of the cancellous bone was higher than that in the long implant model. The maximum displacement value of the implant, the maximum strain value of the cancellous bone, and the maximum stress value of the cortical bone will be decreased with the increase of the reduction ratio of the crown. The crowns of the patients in the two groups had no loose, collapse porcelain, and fall off during the follow-up period. There were no complications such as swelling of the implant neck membrane and no bone destruction around the implant. Conclusion: Short implants have the same curative effect as conventional implants, but short implants can reduce the difficulty of implant surgery in the posterior maxillary area to a certain extent. From the biomechanical point of view, proper reduction of crown diameter can promote the reduction of implant displacement and the change of stress value of bone tissue.

Key words: biomechanical properties, insufficient bone mass, short implants, implant displacement, bone tissue stress, strain