种植体修复上部义齿不同面形态设计的三维有限元分析

牙种植体及其上部结构三维有限元模型的建立戴东晓;李伟;于静;赵暖;翟秀英;侯晓薇【摘要】目的探讨建立牙种植体及其上部结构、下颌骨骨块的三维有限元模型的方法.方法使用Pro/ENGINEER wildfire( Pro/E )2.0软件建立包含牙种植体及其上部结构、下颌骨骨块三维实体模型,导入Ansyswork-bench 10.0有限元分析软件,进行单元划分及初始应力的验证分析,建立三维有限元模型.结果本研究建立了含有上部结构的牙种植体及下颌骨骨块三维有限元模型,牙种植体及其上部结构的大小、形态及尺寸与实体情况完全一致,应力分析与以往报道的三维有限元模型的研究结果亦相一致.结论应用pro/E 2.0软件的自适应功能可建立牙种植体及其上部结构的三维有限元模型,为后期力学分析提供准确、灵活、快速的平台.%Objective To explore the use of adaptive function of Pro/E software to establish the three-dimensional finite element model for dental implants, and its upper structure and jaw bones. Methods Pro/E software was used to establish the three-dimensional solid model including the dental implants and the upper structure, the mandible bone, then into ansyswork-benchl0. 0 finite element analysis software, make the unit division, verify the initial stress analysis, and finally to establish the finite element model. Results This study established the three-dimensional finite element model which was made up of dental implants, its upper structure and jaw bones. The size and shape of dental implants and its upper structure were totally consistent with the entity situation. The result of stress analysis was also consistent with the previously reported findings of three-dimensional finite element model. Conclusion Application ofadaptive function of pro/E software can create the implant and the three-dimensional finite element model, of its superstructure thus providing an accurate, flexible and fast platform for its post-mechanical analysis.【期刊名称】《临床误诊误治》【年(卷),期】2012(025)004【总页数】3页(P79-81)【关键词】牙种植体;三维有限元;牙模型;软件设计【作者】戴东晓;李伟;于静;赵暖;翟秀英;侯晓薇【作者单位】050051石家庄,石家庄市第二医院口腔科;050051石家庄,石家庄市第二医院心胸外科;050051石家庄,石家庄市第二医院口腔科;050051石家庄,石家庄市第二医院口腔科;050051石家庄,石家庄市第二医院口腔科;050051石家庄,河北医科大学第三医院口腔科【正文语种】中文【中图分类】R782有限元计算分析方法是生物力学研究的首选方法，建立准确快速的模型是有限元分析的基础。

·25JOURNAL OF RARE AND UNCOMMON DISEASES, JUN. 2023,Vol.30, No.6, Total No.167【第一作者】刘子嫣，女，研究生，主要研究方向：口腔医学。

E-mail：****************【通讯作者】刘子嫣·论著·不同开髓方法下上中切牙贴面修复的三维有限元分析*刘子嫣* 杨春桃 王　倩 徐　丽 林　杭泉州医学高等专科学校 (福建 泉州 362000)【摘要】目的 应用三维有限元分析法分析上颌中切牙在不同开髓方法下贴面修复对牙体组织应力分布的影响。

方法 建构上颌中切牙进行三维实体模型，依据开髓方式的与贴面修复方式的不同分别建立四组实验模型，A组为传统开髓对接型瓷贴面，B组为传统开髓包饶型瓷贴面，C组为微创开髓对接型瓷贴面，D组为微创开髓包饶型瓷贴面。

加载力为静态力，施力方向和牙体长轴相交呈45°，设定载荷大小为100N，于腭侧中1/3和切1/3相交处施力，分析指标是von Mises应力、最大主应力。

结果 (1)应力峰值：通过von Mises应力和最大主应力的数据呈现，传统开髓对接型(A组)呈现出最高的应力峰值，微创开髓对接型(C组)呈现出最低的应力峰值。

(2)应力分布：相比A组，C组的应力分布情况优于A组，应力向根尖更广区域分散；相比B组，D组的应力分布情况优于与B组，应力向根尖更广区域分散；对比最大主应力与von Mises应力的应力峰值数据，A组峰值数值高于B组；D组峰值数值稍高于C组；A组和B组在应力分布情况上差异不明显；C组和D组在应力分布情况上差异不明显。

结论 从生物力学角度考虑上颌中切牙开髓建议使用微创方式；传统开髓后建议选取包饶型贴面；微创开髓后两终贴面均可选择。

【关键词】传统开髓；微创开髓；三维有限元；贴面【中图分类号】R783.3【文献标识码】A【基金项目】泉州医学高等专科学校校级课题(XJK1925B) DOI:10.3969/j.issn.1009-3257.2023.06.012Three-Dimensional Finite Element Analysis of Upper and Middle Incisor Veneer Restoration Under Different Pulp Opening Methods*Liu Zi-yan *, Yang Chun-tao, Wang Qian, Xu Li, Lin hang.Quanzhou Medical College,Quanzhou 362000, Fujian Province, Chinaabstract: objective by three-dimensional finite element method. Methods a three-dimensional corporeal model of maxillary central incisor was builded. Four groups of experimental models were established according to the discrepant methods of endodontics and veneer repair . group a was the traditional pulp open butt porcelain veneer, group B was the traditional pulp open butt porcelain veneer, group C was the minimally invasive pulp open butt porcelain veneer, and group D was the minimally invasive pulp open butt porcelain veneer . The loading force was static force, and the direction of force application intersects with the tooth axis at a 45°. The load was set as 100n, and the force was applied at the intersection of the middle 1/3 of the palatal side and the cut 1/3. The analysis indexes were von Mises stress and maximum main stress. Results (1) the maximum value stress of traditional open type pulp docking (group a) von Mises stress and the maximum main stress assumes the highest stress peak, minimally invasive open type pulp docking (group C) von Mises stress and maximum principal stress presents the minimum stress peak value. (2) Distribution of stress: match group C against group a,the stress distribution of group C is better than group a, and the tress disperses towards a wider area in the tooth root .Match group D against group B, the group D’s stress distribution was better than that of group B, and the stress dispersed to a wider area in the tooth root . The maximum value stress of group a in the maximum main stress and von Mises stress were more than those of group B. The maximum main stress and von Mises maximum value stress of group D were slightly higher than those of group C. The difference of stress distribution between group a and group B is not obvious. The difference of stress distribution between group C and group D is not obvious. Conclusion opening, it is recommended to choose the bag type veneer; Both final veneers can be selected after minimally invasive pulp opening.Keywords: Traditional Endodontics; Minimally Invasive Endodontics; Three-Dimensional Finite Element; Veneer 上颌中切牙是外伤高发的牙位，外伤后易出现牙髓或根尖周炎症，临床需要进行根管治疗。

三维有限元在桩核冠修复中的应用三维有限元法（Three-dimensional finite element method）是一种与计算机技术相结合的数值分析法。

其基本思路是将目标整体离散成有限个单元的集合体，通过对每个单元的力学分析，获得目标整体的力学性质。

它具有其他应力分析法所无可比拟的优点，作为一种理论分析方法在口腔生物力学领域得到了广泛应用。

利用三维有限元法进行力学分析，可以对较复杂的物体建模，较真实地反映口腔情况，模拟整体和局部的应力，位移值及其分布规律，并可根据需要改变受载负荷和边界条件等力学参数，在维持原几何模型不变的前提下，进行对比分析。

本文就近年来三维有限元法在牙体缺损后牙齿的桩核冠修复中的运用状况综述如下。

1 牙体缺损程度根管治疗后大面积牙体缺损的患牙通常都需要进行桩核修复，杜莉等[1]通过磨片法建立上颌第一磨牙桩核冠有限元模型，比较上颌第一磨牙4种不同程度牙体缺损桩核冠修复后的牙本质应力分布情况。

当水平向牙体剩余量大于1/2时，剩余牙体组织所受应力较大，上颌第一磨牙的腭根根分叉处是根折的危险区域。

我们在平时临床修复中尤其注意缺损量大于1/2时的牙齿。

针对于缺损较大的牙齿修复，吴张等通过UG构建出4组不同程度缺损至牙龈与牙槽骨内的残根且采用龈下桩核冠修复的模型，导入Ansys有限元分析软件中构建有限元模型，并对模型中龈下桩与牙龈和骨接触面的受力及位移进行分析。

4个实验组模型的龈下桩骨接触表面的最大位移均聚乙烯纤维树脂桩>玻璃纤维树脂桩>铸造金合金桩>铸造钛合金桩>铸造Ni-cr合金桩，但应力值相差很小。

6种不同桩修复后桩-牙本质界面应力大小的顺序为：铸造Ni-cr合金桩>铸造钛合金桩>铸造金合金桩>玻璃纤维树脂桩>聚乙烯纤维树脂桩>石英纤维桩，且应力值相差较大[7]。

Heydecke等[8]采用Meta分析回顾了1995～2000年的1773篇报道，发现铸造和预成金属桩的牙折大多位于牙根中部或根尖1/3，而与牙本质弹性模量相近的纤维桩多为牙根颈1/3处的可修复牙折。