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目的:建立下颌种植覆盖义齿三维有限元模型,研究咬合力作用下种植体数目与位置分布对牙槽骨组织应力分布的影响因素。方法:临床采集患者下颌骨及其原有义齿CT数据,使用逆向工程软件建立种植体数目与位置不同的下颌种植覆盖义齿实体模型。通过Abaqus有限元软件分析咬合力作用下种植体数目与位置分布对种植体周围以及下颌后端牙槽骨应力变化的影响。结果:在咬合力作用下,下颌骨Mises应力主要分布在种植体周围骨组织,种植体远中颈部呈现应力集中,下颌后端区域应力较小且分布均匀。随着种植体数目的增加,后端种植体周围骨应力上升,远端牙槽骨应力降低。当牙弓前、后端种植体距离增加时,种植体周围骨应力增大,远端牙槽骨应力降低。结论:采用2植体支持的下颌种植覆盖义齿种植体周围骨吸收风险较小,但远端牙槽嵴骨吸收风险增大。4植体义齿所承受的咬合力主要由植体承担,修复时应注意前后植体的距离和咬合力在义齿上的合理分布。
OBJECTIVE: To establish a three-dimensional finite element model of mandibular implant overdenture to study the influencing factors on the stress distribution of alveolar bone under the occlusal force. Methods: The CT data of mandible and its original denture were collected clinically. Reverse engineering software was used to establish solid model of mandibular implant overdenture with different number and position of implants. Abaqus finite element software was used to analyze the influence of the number and location of the implants on the changes of stress in the alveolar bone around the implant and the mandible. Results: Under occlusal stress, the mandibular Mises stress mainly distributed in the bone tissue around the implant. The distal and middle cervical part of the implant showed stress concentration and the stress in the posterior mandibular region was smaller and distributed evenly. As the number of implants increased, bone stress around the posterior implant increased and the distal alveolar bone decreased in stress. When the dental arch anterior and posterior implant distance increases, the bone around the implant stress increases, distal alveolar bone stress decreased. CONCLUSIONS: There is a lower risk of bone resorption around mandibular implant overdenture implant supported by 2 implant, but the risk of distal alveolar bone resorption is increased. 4 implant prosthesis bear the bite force mainly by the implant, repair should pay attention to the distance before and after the implant and occlusal force in the rational distribution of the denture.