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首页> 外文期刊>The Journal of Prosthetic Dentistry >Influence of implant framework and mandibular flexure on the strain distribution on a Kennedy class II mandible restored with a long-span implant fixed restoration: A pilot study
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Influence of implant framework and mandibular flexure on the strain distribution on a Kennedy class II mandible restored with a long-span implant fixed restoration: A pilot study

机译：种植体框架和下颌弯曲对肯尼迪II级下颌骨修复大跨度种植体固定修复的应变分布的影响：一项初步研究

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Statement of problem The human mandible flexes during different jaw movements. Mandibular flexure is known to be restricted when natural dentition is restored with long-span fixed prostheses, but its effect on implant-supported fixed prostheses is unknown. Restriction of mandibular movement by implant-supported fixed prostheses may lead to excess strain accumulation, which could affect the outcome of implant treatment. Purpose The purpose of this study was to investigate the influence of mandibular flexure on the implant bone interface by measuring the strain distribution in the body of the mandible at the periimplant level and at the implant framework level during the unilateral loading of a long-span implant-supported fixed prosthesis. Material and methods A partially edentulous mandible model with the mandibular left premolars and molars missing was fabricated in epoxy resin. Two implants were placed in the edentulous area, one in the position of the first premolar and one in the position of the second molar. Strain gauges were cemented at the implant bone interface parallel to each implant on the body of the mandible and on the framework. Three screw-retained, 3 × 3-mm bar-shaped frameworks were cast from cobalt-chromium alloy. The fit of these frameworks was deemed clinically acceptable with a routine clinical assessment technique. The mandible model was suspended by elastic cords to a universal testing machine. A 50-N load cell was placed on the occlusal surface of the right first molar. The mandible model was then loaded to 50 N on the working side first without any framework and then a second time with the framework in place. Information from the strain gauges were collected with a computer for analysis. Results When the mandible model was loaded without the implant framework, the buccal aspect of the body of the mandible experienced mainly compression, whereas the lingual aspect was mainly in tension on the working side under unilateral loading. At the implant-bone interface, compression strain was detected on the mesial aspect of the mesial implant. When frameworks were placed and a unilateral load applied, compression was detected on the mesial and buccal aspect of the mesial implant with all 3 frameworks. The amount of strain recorded was higher than that recorded without any framework in place. Conclusions Mandibular flexure occurred during unilateral loading. The amount of strain transmitted to the implants increased with the screw-retained fixed-implant frameworks in place. The amount of strain introduced by mandibular flexure under unilateral loading may not be enough to stimulate bone remodeling; however, the accumulative strain generated by mandibular flexure under cyclic loading and its relationship with bone remodeling is unclear.
机译：问题陈述人类下颌在下颌运动期间会弯曲。当使用大跨度固定假体恢复自然齿列时，已知下颌弯曲会受到限制，但其对植入物支撑的固定假体的作用尚不清楚。植入物支撑的固定假体限制下颌运动可能导致过多的应变积累，这可能会影响植入物治疗的结果。目的本研究的目的是通过在大跨度种植体的单侧加载过程中测量下颌骨在种植体周围水平和种植体框架水平上的应变分布来研究下颌弯曲对种植体骨界面的影响。支持的固定假体。材料和方法在环氧树脂中制作了一部分缺牙的下颌骨模型，其中缺少下颌左前磨牙和磨牙。在无牙区域放置两个植入物，一个位于第一前磨牙的位置，另一个位于第二磨牙的位置。将应变仪固结在与下颌骨主体和框架上的每个植入物平行的植入物骨界面处。用钴铬合金铸造三个螺丝固定的3×3毫米棒状框架。通过常规的临床评估技术，这些框架的适合性在临床上被认为是可以接受的。下颌模型通过弹性线悬挂在通用测试机上。将50 N的称重传感器放置在右第一磨牙的咬合面上。然后将下颌模型在没有任何框架的情况下首先在工作侧加载到50 N，然后在框架就位的情况下再次加载。用计算机收集来自应变仪的信息以进行分析。结果当下颌骨模型在没有植入物框架的情况下加载时，下颌骨的颊侧主要受到压缩，而舌侧则在单侧加载下主要承受工作侧的张力。在植入物-骨界面处，在内侧植入物的内侧部分检测到压缩应变。当放置框架并施加了单侧载荷时，在所有3个框架的情况下，均检测到了种植体近中和颊侧的压迫。记录的应变量高于未安装任何框架的应变量。结论下颌弯曲发生在单侧负荷过程中。螺钉固定的固定植入物框架安装到位后，传递到植入物的应变量增加了。下颌弯曲在单侧负荷下引入的应变量可能不足以刺激骨骼重塑;然而，下颌弯曲在循环载荷下产生的累积应变及其与骨重塑的关系尚不清楚。

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