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首页> 外文期刊>The Journal of Prosthetic Dentistry >The influence of cantilever length and implant inclination on stress distribution in maxillary implant-supported fixed dentures.
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The influence of cantilever length and implant inclination on stress distribution in maxillary implant-supported fixed dentures.

机译：悬臂长度和种植体倾斜度对上颌种植体支持的固定义齿中应力分布的影响。

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STATEMENT OF PROBLEM: The benefits and limitations of jaw treatments with tilted versus vertical implants, as well as prosthesis design with and without posterior cantilevers, have been extensively discussed. However, biomechanical advantages associated with cantilevers in fixed dentures (FDs) and tilted implants in the maxillae are less well documented. PURPOSE: The purpose of this study was to compare and analyze, via 3-dimensional (3-D) finite element analysis, stresses transmitted to tilted versus vertical implants and the surrounding periimplant bone in the maxillae. MATERIAL AND METHODS: A 3-D edentulous maxillary model was created using customized computer software (FEMAP 8.3). Four implants were virtually placed in the premaxilla and splinted with an FD. Keeping the prosthesis length constant, 4 different configurations were evaluated with the distal implants inclined 0, 15, 30, and 45 degrees; cantilever extensions were 13, 9, 5, and 0 mm, respectively. A vertical load (150 N) was applied to the distal portion of the posterior cantilevers. Von Mises' stress values transmitted to periimplant bone and at the metal framework of FDs on implants were evaluated in cancellous and cortical bone. RESULTS: The maximum stresses recorded in periimplant bone for the vertical implants were 75.0 MPa (distal implants), 35.0 MPa (mesial implants), and 95.0 MPa for the metal frameworks. Tilted distal implants, with consequent reduction of the posterior cantilevers, resulted in decreased stress values for all of the variables: -12.9%, -18.3%, and -11.5% for the 15-degree configuration; -47.5%, -52.6%, and -31.3% for the 30-degree configuration; and -73.5%, -77.7%, and -85.6% for the 45-degree configuration CONCLUSIONS: Finite element analysis data regarding rehabilitation of atrophic maxillae revealed that tilted distal implants, rigidly splinted with an FD, decrease stress in the periimplant bone and frameworks. This treatment modality seems to be a valid therapeutic alternative to conventional maxillary fixed complete prostheses supported by vertical dental implants with posterior cantilevers.
机译：问题陈述：倾斜和垂直植入物的颌骨治疗的优点和局限性，以及带有或不带有后悬臂的假体设计已被广泛讨论。但是，与固定义齿（FD）中的悬臂和上颌骨中的倾斜植入物相关的生物力学优势却鲜为人知。目的：本研究的目的是通过3维（3-D）有限元分析来比较和分析传递至倾斜种植体和垂直种植体以及上颌骨周围种植体周围骨的应力。材料和方法：使用定制的计算机软件（FEMAP 8.3）创建3D无牙上颌模型。将四个植入物虚拟放置在前颌骨中，并用FD夹板。在保持假体长度不变的情况下，对远端植入物倾斜0、15、30和45度进行了4种不同的配置评估。悬臂延伸分别为13、9、5和0毫米。向后悬臂的远端部分施加垂直负载（150 N）。在松质骨和皮质骨中评估了冯·米塞斯（Von Mises）传递至植入物周围骨以及植入物FD的金属框架的应力值。结果：垂直植入物在植入物周围骨中记录的最大应力为75.0 MPa（远端植入物），35.0 MPa（局部植入物）和金属框架的95.0 MPa。倾斜的远端植入物，从而减少了后悬臂，导致所有变量的应力值降低：15度配置为-12.9％，-18.3％和-11.5％;对于30度配置，分别为-47.5％，-52.6％和-31.3％;结论：45度构型的结果为-73.5％，-77.7％和-85.6％结论：关于萎缩性上颌骨康复的有限元分析数据表明，倾斜的远端植入物（牢固地固定有FD）可以降低植入物周围骨和框架的应力。这种治疗方式似乎是替代传统的上颌固定完整假体的有效治疗方法，该假体由带有后悬臂的垂直牙科植入物支撑。

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