두 개의 임플란트를 이용한 3본 고정성 국소의치에서 가공치 위치에 따른 하악골에서의 응력 분포 및 변형에 관한 삼차원 유한요소법적 연구
The three dimensional finite element analysis of stress distribution and deformation in mandible according to the position of pontic in two implants supported three-unit fixed partial denture
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture supported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior position, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly 3035% higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were 160170% higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively 2025% higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically acceptable design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.
Abstract
Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture supported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior position, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly 3035% higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were 160170% higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively 2025% higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically acceptable design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.
참고문헌 (43)
- Branemark PI, "Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period", Scand J Plast Reconstr Surg, 16(suppl), pp.1~132 (1997)
- Skalak R, "Aspects of biomechanical considerations. In: Br?nemark PI, Zarb GA, Albrektsson T(eds). Tissue-Integrated Prostheses: Osseointegration in Clinical Dentistry", pp.117~128 (1985), Chicago : Quintessence
- Matsushita Y, "Two-dimensional FEM analysis of hydroxyapatite implants diameter effects on stress distribution", J Oral Implantol, 16, pp.6~11 (1990)
- Boggan RS, "Influence of hex geometry and prosthetic table width on static and fatigue strength of dental implants", J Prosthet Dent, pp.436~440 (1999)
- Bunski JB, "Biomechanics of osseointegration and dental prosthesis”, osseointegration in oral rehabilitation", pp.133~156 (1993), London : Quintessence publishing Co
- Weinberg LA, "The biomechanics of force distribution in implantsupported prosthesis", Int J Oral Maxillofac Implants, 8, pp.19~31 (1993)
- Sertg¨oz A, G, "Finite element analysis of the effect of cantilever and implant length on stress distribution in an implantsupported fixed prosthesis", J Prosthet Dent, 76, pp.165~ (1996)
- Adell R, "A 15 year study of osseointegrated implants in the treatment of the edentulous jaws", Int J Oral Surgery, 10, pp.387~ (1981)
- Rangert B, "Bending overload and implant fracture: a retrospective clinical analysis", Int J Oral Maxillofac Implants, 10, pp.326~ (1995)
- Balshi TJ, "An analysis and management of fractured implants", Int J Oral Maxillofac Implants, 11, pp.660~ (1996)
- Morimoto K, "An experimental study on the tissue compatibility of the titanium bladevent implant coated with HAP-alumina in the semi-functional state", J Oral Implantol, 13, pp.387~401 (1987)
- Kohal RJ, "Three dimensional computerized stress analysis of commercially pure titanium and Yttrium-partially stabilized zirconia implants", Int J Prosthodont, 15, pp.189~194 (2002)
- Borchers L, "Three-dimensional stress distribution around a dental implant at different stages of interface development", J Dent Res, 62, pp.155~159 (1983)
- Lavernia CJ, "An analysis of stress in dental implant system", J Biomech, 14, pp.555~560 (1981)
- Rieger MR, "Finite element analysis of six endosseous implants", J Prosthet Dent, 63, pp.671~676 (1990)
- Vocht JWD, "Development of a finite element model to simulate and study the biomechanics of the temporomandibular joint", pp.1~9 (1999)
- Inou N, "Functional adaptation of mandibular bone. Computational Biomechanics", pp.23~42 (1996), Tokyo: Springer-Verjag
- Misch CE, "Implant-Protected Occlusion", Pract Periodontics Aesthet Dent, 7, pp.25~ (1995)
- Hoshaw SJ, "Mechanical loading of Branemark implant affects interfacial bone remodeling and remodeling", Int J Oral Maxillofac Implants, 9, pp.345~360 (1994)
- Weinberg LA, "Biomechanical considerations when combining tooth-supported and implant-supported prostheses", Oral Surg Oral Med Oral Pathol, 78, pp.22~27 (1994)
- Soltesz U, "Principal characteristics of the stress distribution in the jaw caused by dental implants. In Biomechanics: Principles and Applications", pp.439~ (1982), Martinus-Nijhoff, The Netherlands
- Rieger MR, "A finite element surgery of eleven endosseous implants", J Prosthet Dent, 63, pp.457~465 (1990)
- Meffert R, "Implant theraphy.Proceeding of the World workshop in clinical periodontics" (1989), Chicago American Academy of periodontology
- Wang TM, "Effects of prosthesis Materials and prosthesis splinting on peri-implant bone stress Around Implants in poor-Quality : A numeric Analysis", Int J Oral Maxillofac Implants, 17, pp.231~ (2002)
- Worthington P, "Osseointegration in Dentistry, An overview .2nd. ed", pp.56~ (2003), Quintessence books, Chicago, berlin, Tokyo, Copenhagen, London, Paris, Milan, Borcelona, Istanbul, Sao Paulo, Newdelhi, Moscow, Prague, and Warsaw
- Lum LB, "Load transfer from endosteal implants to supporting bone: An analysis using statics. Part two: Axial loading", J Oral Implantol, 18, pp.349~353 (1992)
- Misch CE, "Contemporary Implant dentistry 2nd ed" (1999), Mosby
- Koeck B, "¨ber die elastishe Deformation der Unterkieferspange", Dtsch Zahna ¨rztl Z, 33, pp.254~261 (1978)
- Picton DCA, "Distortion of the jaws during biting", Arch Oral Biol, 7, pp.573~580
- Mu ¨hlemann HR, "The mechanism of tooth mobility", J Periodont, 25, pp.128~135 (1954)
- Korioth TWP, "Deformation of the human mandible during simulated tooth clenching", J Dent Res, 73, pp.56~66 (1994)
- Cruz M, "Three-dimensional finite element stress analysis of a cuneiform-geometry implant", Int J Oral Maxillofac implants, 18, pp.675~684 (2003)
- Skalak R, "Biomechanical considerations in osseointegrated prostheses", J Prosthet Dent, 49, pp.843~848 (1983)
- English G, "The cortical A-P spread", Implant Soc J, 1, pp.2~3 (1990)
- Worthington P, "The Swedish system of osseointegrated implants:problems and complications encountered during a four year trialperiod", Int J Oral Maxillofac Implants, 2, pp.77~84 (1987)
- Sones A, "Complications with osseointegrated implants", J Prosthet Dent, 62, pp.581~585 (1989)
- Akca K, "Iplikcioglu H: Finite element stress analysis of the effect of short implant usage in place of cantilever extension in mandibular posterior edentulism", J Oral Rehabilitation, 29, pp.350~356 (2002)
- Schwartzman B, "Load transfer by multiple implants under various prosthetic devices", J Dent Res, 70, pp.460~ (1991)
- White SN, "Effect of cantilever length on stress transfer by implant-supported prostheses", J Prosthet Dent, 71, pp.493~ (1994)
- Stegaroiu R, "Influence of restoration type on stress distribution in bone around implants: a three dimensionalFinite element stress analysis", Int J Oral MaxillofacImplants, 13, pp.82~ (1998)
- Kunavisarut C, "Finite element analysis ondental implant - supported prostheses without passive fit", JProsthodont, 11, pp.30~40 (2002)
- Wennstr¨om J, "Bone level change atimplant-supported fixed partial dentures with and without cantilever extension after 5 years in function", J Clin Periodontol, 31, pp.1077~1083 (2004)
- Reilly DT, "The elastic and ultimate properties of compact bone tissue", J Biomechanics, 8, pp.393~ (1975)
