双皮层骨种植影响牙种植体稳定性的有限元固有频率研究

目的 用有限元方法研究双皮层骨种植对牙种植体初期稳定性的影响。方法 建立牙种植体和局部下颌骨块三维有限元模型,利用ABAQUS有限元软件,分析双皮层骨种植对种植体颊舌向和轴向一阶振动固有频率的影响。结果 双皮层骨种植可明显提高种植体颊舌向和轴向振动的固有频率值,且随着种植体穿颊侧皮质骨厚度的增加,固有频率值逐渐增加。结论 双皮层骨种植可明显增加种植体颊舌向和轴向的初期稳定性。     

密质骨厚度影响牙种植体稳定性的有限元固有频率分析

目的：用有限元方法研究密质骨厚度对牙种植体初期稳定性的影响。方法：建立牙种植体、局部下颌骨块三维有限元模型,利用ABAQUS有限元软件,分析不同密质骨厚度对种植体颊舌向、轴向一阶振动固有频率的影响。结果：随着密质骨厚度由缺如逐渐增加至3．0mm,种植体颊舌向、轴向振动的固有频率值均逐渐增加,其中颊舌向固有频率最大增幅达97．61％,而轴向固有频率最大值仅增加了11．06％。结论：种植体周密质骨厚度主要增加了种植体颊舌向稳定性,而对种植体轴向稳定性的增加有限。     

圆柱状、根端带缝及膨胀式种植体在骨质疏松状态时生物力学比较的三维有限元分析

目的:比较圆柱状、根端带缝与膨胀式种植体在骨质疏松条件时功能状态下的生物力学效果。方法:分别建立包含柱状、根端带缝和膨胀式种植体的骨质疏松颌骨骨块三维有限元模型。对种植体轴向和颊舌向分别施加100 N和30 N的力,评估皮质骨和松质骨的最大应力和种植体-基台复合体的最大位移。结果:与圆柱状种植体相比,根端带缝种植体使皮质骨在轴向和颊舌向加载下应力峰值分别增加了3.62%和7.49%,膨胀式种植体则使其降低了11.3%和9.60%;对于在松质骨,带缝种植体使其应力峰值分别增加了37.8%和65.0%,而膨胀式种植体使其增加了107%和89.2%;轴向加载时带缝种植体和膨胀式种植体的种植体-基台复合体的最大位移分别增加了1.12%和减少了0.60%,在颊舌向加载时,最大位移分别增加了6.37%和7.04%。结论:在骨质疏松状态下,皮质骨的应力对种植体外形变化更敏感;膨胀式种植体表现出比圆柱状种植体和带缝种植体更好的应力分布和更低的应力值。     

种植体长度对即刻负载种植体骨界面生物力学分布的影响

目的:建立包含不同长度标准直径种植体的下颌骨三维有限元模型,分析不同长度种植体对即刻负载种植体骨界面应力应变分布的影响.方法:采用薄层CT扫描下颌骨和自主开发的USIS软件建立直径4.1mm不同长度螺纹种植体即刻负载的三维有限元模型,用ANSYS软件分析长度分别为6、8、10、12、14mm的种植体,在垂直和颊舌向45o加载150N力时种植体骨界面的von Mises应力、应变值.结果:随着种植体长度的增加,种植体骨界面的应力和应变值均呈下降趋势.种植体骨界面应力值在长度从6mm增加到8mm时下降最明显,尤其是颊舌向加载时;而种植体长度从8mm增加到10mm及从10mm增加到12mm和从12mm增加到14mm时,骨界面应力值下降并不很明显.种植体骨界面应变值也是在长度从6mm增加到8mm及8mm增加到10mm时下降最明显.结论:种植体长度的增加能降低骨界面应力和应变值,呈负相关关系;但只在长度从6mm增加到8mm时应力值降低才较明显.这提示临床上尽量不要采用长度为6mm的种植体,并应适当地选择足够长度的种植体.     

种植体长度对天然牙-种植体联合修复体应力影响的研究

目的:建立天然牙-种植体联合支持固定桥的三维有限元模型.探讨不同种植体长度对天然牙-种植体联合支持固定桥的修复体上部结构、天然牙等应力分布的影响.方法:对模型施加200N垂直向集中的力和200N颊舌向集中的力,运用CT扫描、三维有限元分析方法等手段,对比观察不同长度的种植体对天然牙及其修复体上部结构应力分布的影响.结果...     

跨下牙槽神经种植相关解剖结构的影像学测量及分析研究

目的 通过锥形束CT影像数据测量下颌第二磨牙处下颌神经管位置,分析跨下牙槽神经种植术的理论植入范围,为临床上使用该方法解决下颌后牙区种植骨量不足问题提供理论依据。方法 选取80例下颌第二磨牙缺失且缺牙区垂直骨高度<9 mm的患者CBCT图像,测量该处下颌神经管到颊侧骨皮质、舌侧骨皮质、牙槽嵴顶距离,并模拟跨下牙槽神经种植,测量种植体颊舌向倾斜的角度范围。结果 下颌第二磨牙处下颌神经管到颊侧骨皮质、舌侧骨皮质、牙槽嵴顶的距离分别是(6.913±1.222)、(2.859±0.891)、(7.991±0.783)mm,下颌神经管到颊侧骨皮质距离明显大于到舌侧骨皮质距离。75%的患者可行跨下牙槽神经种植术,模拟植入种植体颊舌向倾斜最小角度为19.360°±7.086°,最大角度为39.462°±6.924°。结论 下颌第二磨牙处下颌神经管明显偏向舌侧,保障了颊侧足够的骨量,多数下颌第二磨牙处无法垂直植入短种植体的患者仍可通过跨下牙槽神经种植术植入常规长度种植体。     

牙槽突骨挤压扩张同期种植的临床观测

目的：观测牙槽突骨挤压扩张同期种植的方法处理骨宽度不足病例的近期临床效果。方法：对56名牙槽突颊舌向骨宽度不足的患者行牙槽突骨挤压扩张同期种植的方法,植入ITI种植体61颗。术后3个月行上部冠修复。在术后即刻,术后3个月,6个月,12个月行临床检查和X线检查,观测种植体临床存活率和种植体颈部边缘骨的变化。结果：使用该方法的种植体存留率为100%,经X线检查种植体颈部边缘骨水平无明显吸收。结论：运用牙槽突骨挤压扩张同期种植的方法处理牙槽突颊舌向骨宽度不足的病例,操作简单,手术创伤小,近期可以取得较理想的临床效果,远期效果有待进一步观测。     

动态载荷下不同骨质对天然牙-种植体联合修复应力分布的影响

目的 利用有限元方法探索下颌后牙区天然牙-种植体联合修复在不同骨质内的应力分布情况,以评定出适宜行联合修复所需的骨质类型。方法 采用三维有限元分析法,分别对骨质为Ⅰ、Ⅱ、Ⅲ、Ⅳ类颌骨类型中的天然牙-种植体联合修复体施加动态载荷,并对各界面所承受的Von Mises应力进行分析。结果 皮质骨所受最大Von Mises应力值从Ⅰ类骨到Ⅳ类骨逐渐增大,最大等效应力分别为89.229、91.860、125.840、158.420 MPa。松质骨所受最大Von Mises应力值从Ⅰ类骨到Ⅳ类骨均逐渐减小,最大等效应力分别为58.584、43.645、21.688、18.249 MPa。在同一类模型中,松质骨和皮质骨的最大Von Mises应力值均为舌颊向加载>颊舌向加载>垂直向加载。结论 骨质的类型对修复体周围骨的应力分布有重要的影响,Ⅰ、Ⅱ类骨较Ⅲ、Ⅳ类骨更适合行种植体-天然牙联合修复。     

种植体直径和长度在Ⅳ类骨质中的优化选择

目的:应用Ansys DesignXplorer模块,进行圆柱形种植体直径和长度同时连续变化时对Ⅳ类骨质的颌骨应力影响的分析。方法:建立了包含圆柱状种植体的下颌骨Ⅳ类骨质的骨块三维有限元模型,设定种植体直径(D)变化范围为3.0～5.0mm,种植体长度(L)变化范围为6.0～16.0mm,观察D和L变化对颌骨Von Mises应力峰值的影响。同时进行颌骨Von Mises应力峰值对变量的敏感度分析。结果:随着D和L的增加,垂直向加载时,皮质骨、松质骨的EQV应力峰值分别降低了63.9%和87.9%,颊舌向加载时,皮质骨、松质骨的EQV应力峰值分别降低了76.2%和92.7%;当D>4.0mmL>11.0mm时,应力峰值的响应曲线的切斜率位于-1～0之间;在垂直向加载和颊舌向加载时,变量L和D分别对皮质骨的EQV应力峰值的影响更明显。结论:颊舌向力的力学分布更易受种植体参数影响;松质骨的应力更易受种植体参数影响;种植体直径增加更有利于改善颌骨颊舌向加载下的应力分布,种植体长度的增加更有利于改善皮质骨垂直加载下的应力分布。从生物力学角度而言,对于Ⅳ类骨质在临床上选择种植体时,种植体的直径应≥4.0mm,种植体的长度应≥11.0mm。     

天然牙-游离端种植牙联合支持固定桥的应力分布

目的 :揭示天然牙—种植体联合支持固定桥不同桥长度的设计时应力分布特点 ,为临床优化设计提供实验力学依据。方法 :采用三维有限元的方法研究三种长度桥体的天然牙—游离端种植牙联合支持固定桥的应力分布。结果 :天然牙—种植牙固定桥应力集中于基牙的颈部 ;种植体颈部骨组织的应力大于天然牙颈部骨组织的应力 ;集中垂直载荷时种植体颈部骨的应力分布较均匀 ;集中斜向载荷时种植体的颊舌侧骨组织有明显的应力集中区 ,并且桥体跨度增加 ,种植体周骨的最大应力值增加 ,天然牙周骨的应力值无显著变化。结论 :天然牙—种植体固定桥受集中斜向载荷易导致种植牙周骨损伤 ,尤其桥体长度增加时应减小侧向力并增加基牙数量     

Influence of implant length and bicortical anchorage on implant stress distribution

Background: Short implants present superior failure rates for everybody. Purpose: The aim of this theoretic study was to assess to what extent implant length and bicortical anchorage affect the way stress is transferred to implant components, the implant proper, and the surrounding bone. Materials and Methods: Stress analysis was performed using finite element analysis. A three‐dimensional linear elastic model was generated. All implants modeled were of the same diameter (3.75 mm) but varied in length, at 6, 7, 8, 9, 10, 11, and 12 mm (Branemark System®, Nobel Biocare AB, Gothenburg, Sweden). Each implant was modeled with a titanium abutment screw and abutment, a gold cylinder and prosthetic screw, and a ceramic crown. The implants were seated in a supporting bone structure consisting of cortical and cancellous bone. An occlusal load of 100 N was applied at a 30° angle to the buccolingual plane. Results: With the selected model and bone properties, the coronal cortical anchorage was dominating, and the bone stress concentrated to that area. Conclusions: The maximum bone stress was virtually constant, independent of implant length and bicortical anchorage. The maximum implant stress, however, increased somewhat with implant length and bicortical anchorage.     

Effects of lateral cortical anchorage on the primary stability of implants subjected to controlled loads: an in vitro study

Our aim was to evaluate the effects of lateral cortical anchorage on the primary stability of implants subjected to immediate loading. Implants were placed into bovine bones with monocortical anchorage (implant placed through the cortical bone of the crest) and bicortical anchorage (the crest cortical bone plus one cortical bone on the lateral side). Loads of 25N and 50N were applied to the implants in different cycles. The implant stability quotient (ISQ) was measured before and after the cyclic loadings. Under 25N load there was no difference in ISQ between 1800 cyclic loading and preloading, but the values decreased significantly after 3600 cyclic loading in both groups (p<0.05). Under a 50N load the ISQ value after 1800 and 3600 cyclic loading decreased in the monocortical group (p<0.05), but there was no difference between 1800 cyclic loading and preloading in the bicortical group, and the ISQ in the bicortical group was higher than in the monocortical group after 1800 cyclic loading (p<0.05). Our results suggest that the stability of implants with bicortical anchorage decreased more slowly under higher loads.     

Influence of bicortical or monocortical anchorage on maxillary implant stability: a 15-year retrospective study of Brånemark System implants

The present study evaluated implant survival and marginal bone loss in maxillae over a 15-year follow-up period as a function of either monocortical or bicortical implant anchorage. Of 207 standard Br?nemark implants (10 mm in length) followed, 110 implants were judged to be monocortically anchored and 97 as bicortically anchored. The bicortically anchored implants failed nearly 4 times more often than the monocortical ones. Implant fractures accounted for over 80% of the observed failures and were found to affect the bicortical group almost 3 times more often. As tentative explanations, induction of increased stress and bending forces resulting from possible prosthetic misfit, presence of unfavorable arch relationships, or high occlusal tables in combination with bicortically anchored implants have been suggested, all indicating an overambitious fixation of the bicortical anchorage. Total marginal bone loss was low over the 15-year period and close to identical for the 2 groups, suggesting that the mode of cortical anchorage did not have any clinically significant influence on marginal bone remodeling.     

Influence of cortical bone anchorage on the primary stability of dental implants

Purpose

This retrospective chart review study assessed patient records to determine implant insertion torque (IT) and implant stability quotient (ISQ) values during implant placement to evaluate the correlation with cortical bone anchorage (mono- or bicortical).

Methods

Primary stability data (IT during implant placement surgery and ISQ values immediately after implant placement) and cone beam computed tomography of 33 patients (165 implants) were assessed. Patients were divided into the following groups: G1, implants with apical cortical bone contact; G2, implants with bicortical bone contact (apical and cervical regions); and G3, implants with cervical cortical bone contact.

Results

Sixty-eight implants were excluded due to cortical bone contact on regions other than implant apical or cervical. Ninety-seven implants were therefore assessed for this study. No implant failure was found after a mean 70.42-month follow-up time. Implants with bicortical anchorage (G2) showed higher IT (64.1 Ncm) during implant placement and higher ISQ values (76) (p?<?0.05). Monocortical implants (G1, apical, and G3, cervical) showed similar IT (G1 52.3 and G3 54.3) and ISQ values (G1 71.9 and G3 73) (p?>?0.05). No correlation (Pearson correlation coefficient) was found between the two stability measurement devices for the different cortical bone anchorages that were analyzed (G1 0.190, G2 0.039, and G3 ??0.027) (p?>?0.05).

Conclusions

Insertion torque values and implant stability quotients were influenced by cortical bone contact. No significant correlation was found between IT and ISQ values—higher insertion torque values do not necessarily lead to higher implant stability quotients.

     

Interface of unloaded titanium implants in the iliac crest, fibula, and scapula: a histomorphometric and biomechanical study in the pig

PURPOSE: Prefabrication of free vascularized fibular flaps is a 2-stage procedure for the reconstruction of maxillary and mandibular defects. The delay between prefabrication and flap transfer is 6 weeks and depends on biomechanical stability and osseointegration of the implants. The purpose of this animal study was to evaluate implant stability by measuring the removal torque values (RTVs) at 3, 6, and 12 weeks and to compare the results with interface strength of the bone-implant surface in the fibula, the scapula, and the iliac crest under unloaded conditions. MATERIALS AND METHODS: ITI implants (n = 108) with a sandblasted and acid-etched surface were placed in the fibula, the scapula, and the iliac crest of 6 Yorkshire pigs. Biomechanical, histologic, and histomorphometric results were collected at 3, 6, and 12 weeks, respectively. RESULTS: Bicortical anchored 8-mm implants in the fibula (63.7 to 101.8 Ncm) showed RTVs similar to those of monocortical anchored 12-mm implants in the scapula (62.3 to 99.7 Ncm). The RTVs of monocortical anchored 8-mm and 10-mm implants in the iliac crest (19.1 to 44.3 Ncm) and the scapula (27.2 to 55.3 Ncm) were significantly lower. The bone-to-implant contact in the fibula at 3, 6, and 12 weeks (35.2%, 44.4%, and 46.8%, respectively) was similar to that in the iliac crest (24.2%, 44.2%, and 52.5%, respectively), but significantly lower than in the scapula (63.7%, 73.8%, and 74.2%, respectively). DISCUSSION AND CONCLUSION: Bicortical anchorage determined implant stability in the fibula, whereas interfacial strength seemed to define stability in the scapula. The quality and type of bone determined the bone's response in terms of biomechanical press fit or biologic interface strength.     

Implant–Bone Interface Stress Distribution in Immediately Loaded Implants of Different Diameters: A Three-Dimensional Finite Element Analysis

Purpose: To establish a 3D finite element model of a mandible with dental implants for immediate loading and to analyze stress distribution in bone around implants of different diameters. Materials and Methods: Three mandible models, embedded with thread implants (ITI, Straumann, Switzerland) with diameters of 3.3, 4.1, and 4.8 mm, respectively, were developed using CT scanning and self‐developed Universal Surgical Integration System software. The von Mises stress and strain of the implant–bone interface were calculated with the ANSYS software when implants were loaded with 150 N vertical or buccolingual forces. Results: When the implants were loaded with vertical force, the von Mises stress concentrated on the mesial and distal surfaces of cortical bone around the neck of implants, with peak values of 25.0, 17.6 and 11.6 MPa for 3.3, 4.1, and 4.8 mm diameters, respectively, while the maximum strains (5854, 4903, 4344 μ?) were located on the buccal cancellous bone around the implant bottom and threads of implants. The stress and strain were significantly lower (p < 0.05) with the increased diameter of implant. When the implants were loaded with buccolingual force, the peak von Mises stress values occurred on the buccal surface of cortical bone around the implant neck, with values of 131.1, 78.7, and 68.1 MPa for 3.3, 4.1, and 4.8 mm diameters, respectively, while the maximum strains occurred on the buccal surface of cancellous bone adjacent to the implant neck, with peak values of 14,218, 12,706, and 11,504 μm, respectively. The stress of the 4.1‐mm diameter implants was significantly lower (p < 0.05) than those of 3.3‐mm diameter implants, but not statistically different from that of the 4.8 mm implant. Conclusions: With an increase of implant diameter, stress and strain on the implant–bone interfaces significantly decreased, especially when the diameter increased from 3.3 to 4.1 mm. It appears that dental implants of 10 mm in length for immediate loading should be at least 4.1 mm in diameter, and uniaxial loading to dental implants should be avoided or minimized.     

Two dental implants designed for immediate loading: a finite element analysis

PURPOSE: The aim of this study was to evaluate by finite element analysis the influence of the design of 3 different dental implants on micromovements, cervical shearing stress intensity, and stress distribution after occlusal loading. MATERIALS AND METHODS: The first investigated implant was a classical cylinder, the second was reinforced by 2 bicortical locking pins, and the third was an expanding dental implant. The parameters analyzed were the implant's geometry, the quality of the cancellous bone, and the orientation of occlusal loading. RESULTS: It was found that initial stability of the locking pin implant was greater than the initial stability of the other investigated implant designs, regardless of the quality of cancellous bone and orientation of occlusal loading; in low-rigidity cancellous bone, under a horizontal load (500 N), decreasing displacement compared to those of the other investigated implants was 16 microm. The apical expansion and locking pin implants exhibited favorable behavior regarding the distribution and intensity of cervical shearing stresses; in low-rigidity cancellous bone, under horizontal load, decreasing cervical stresses compared with those of the cylindric implant were 10 MPa for the apical expansion implant and 150 MPa for the locking pin implant. DISCUSSION: For the cylindric implant, stresses were concentrated in the neck region; for the apical expansion implant, stresses were evenly distributed from the neck to the apex of the implant. For the locking pin implant, stresses around the neck were moderate and appeared concentrated around the pins. CONCLUSIONS: Initial stability of the pin implant was greater than that of the expanding implant, but the expanding implant showed the most favorable stress distribution.     

Initial Stability of Two Dental Implant Systems: Influence of Buccolingual Width and Probe Orientation on Resonance Frequency Measurements

Background: Although many factors seem to have an impact on the resonance frequency (RF) values of implants, there is a lack of evidence about some other parameters, which may have an influence on implant stability. Purpose: The aims of the study were to determine whether initial stability of a dental implant differs when the buccolingual width of the bone changes, to determine whether different orientations affect the RF measurements in the RF device, and to investigate two dental implants with different morphologies with regard to their initial stability. Materials and Methods: Two implant systems (Tidal Spiral Dental Implant Systems, Huntsville, AL, USA, and MIS Seven, MIS Implants Technologies Ltd., Shlomi, Israel) with diameters of 3.75 mm and 4.2 mm and with a length of 13 mm were used. Following the insertion of implants, buccolingual thinning of the models was performed in 2‐mm increments ranging between 0 and 8 mm. Results: A statistically significant decrease for implant stability quotient (ISQ) values was noticed for both diameters and both systems for all dimensional time points of the blocks (p < .05). The second system (more number of threads) resulted with higher ISQ values for both diameters than the first system (lower number of threads) (p < .001). The orientation of the probe influenced the measurements, where a standard orientation is advisable for the magnetic RF device. Conclusion: Different implant surface geometries seem to behave in different patterns in terms of initial stability. Dimensional changes in buccolingual direction seem to have an impact on the initial stability, where wider implants also presented higher ISQ values than narrow ones.