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目的:利用有限元法,分析不同种植体数目及附着体类型,对下颌窄径种植覆盖义齿颌骨内应力分布的影响。方法:采集患者下颌骨及其所佩戴覆盖义齿的CT数据,利用逆向工程技术构建包含下颌皮质骨、松质骨、附着体(杆卡附着体B;球帽附着体R;磁性附着体M)及覆盖义齿的完整下颌窄径种植覆盖义齿的三维有限元模型,通过对上述不同部件接触关系的定义,模拟右侧后牙垂直咬合作用下,不同植体数目及附着体类型对下颌窄径种植覆盖义齿颌骨内应力分布的影响。结果:偶数枚植体设计,植体周围应力峰值明显低于奇数枚植体设计;杆卡附着体植体周围应力峰值较低,球帽附着体其次,磁性附着体最高;杆卡附着体随着植体数目的增多,植体周围应力峰值降低;磁性附着体随着植体数目的增多,植体周围应力峰值反而增高。结论:植体数目和附着体类型对于颌骨内的应力分布均有显著影响;建议临床优先选用偶数枚植体的杆卡附着体设计;其次建议使用两植体球帽附着体设计。
OBJECTIVE: To analyze the effect of different implants and attachment types on the stress distribution in mandible with mandibular narrow diameter implant overdenture using finite element method. Methods: The CT data of the mandible and overdenture of the patient were collected. The mandibular cortical bone, cancellous bone, attachment (rod attachment B, ball cap attachment R, magnetic attachment M) And three-dimensional finite element model of intact mandibular narrow diameter implant overdentures with overdenture. Through the definition of the contact relationships of the above components, simulating the effect of vertical occlusion of right posterior teeth, the number of different implants and the type of attachment on mandibular narrow-width implant Effect of mandibular internal stress distribution in overdenture. Results: The design of even-numbered implants and stress peaks around implants were significantly lower than those of odd-numbered implants. The stress peaks around the implants of rod-shaped implants were lower than that of the cap-cap implants, followed by the magnetic attachments The number of implants increased and the stress peak around the implants decreased. The number of magnetic implants increased with the number of implants and the stress peaks around the implants increased. CONCLUSION: The number of implants and the type of attachment have a significant effect on the stress distribution in the jaw. It is recommended that the design of the pole-plate attachment of even-numbered implants should be given priority in clinical practice.