All-on-4种植固定义齿不同侧方咬合方式应力分布的有限元分析

doi:10.13591/j.cnki.kqyx.2025.03.004

摘要/Abstract

摘要：

目的分析不同侧方咬合方式对All-on-4种植固定义齿应力分布的影响。方法建立All-on-4种植固定义齿的模型,通过改变加载方式模拟侧方平衡𬌗、组牙功能𬌗和尖牙保护𬌗。选取的加载力大小为垂直向200 N、水平向30 N。结果模拟平衡𬌗模型各部分的最大应力值最小,尖牙保护𬌗模型各部分的最大应力值最大,组牙功能𬌗模型各部分的最大应力值较平衡𬌗略大,比尖牙保护𬌗明显减小。结论 All-on-4支持的种植全口义齿的最终修复中侧方咬合可选择组牙功能𬌗。

关键词: All-on-4, 咬合接触, 组牙功能𬌗, 尖牙保护𬌗, 有限元分析

Abstract:

Objective To analyze the effect of different lateral occlusion patterns on the stress distribution of All-on-4 implanted fixed dentures. Methods A model of All-on-4 implant fixed denture was established, and lateral balanced occlusion, group functional occlusion, and canine protection occlusion was simulated by changing the loading method. The selected loading force was 200 N vertically and 30 N horizontally. Results The maximum stress values of each part of the simulated balanced occlusion model were the smallest, while the maximum stress values of each part of the canine protection model were the largest. The maximum stress values of each part of the group functional occlusion model were slightly larger than those of the balanced occlusion model, but significantly smaller than those of the canine protection model. Conclusion Group function occlusion could be selected for the lateral occlusion in the final restoration of All-on-4 implant prosthesis.

Key words: All-on-4, occlusion, group function occlusion, canine protected occlusion, finite element analysis

中图分类号:

R783.4

吴正敏, 张勇, 杨瑛, 张方明. All-on-4种植固定义齿不同侧方咬合方式应力分布的有限元分析[J]. 口腔医学, 2025, 45(3): 180-184.

WU Zhengmin, ZHANG Yong, YANG Ying, ZHANG Fangming. Analysis of stress distribution in different lateral occlusion patterns of All-on-4 fixed denture: A three-dimensional finite element study[J]. Stomatology, 2025, 45(3): 180-184.

图/表 9

表1

图1

图2

图3

图4

表2

图5

图6

图7

参考文献 22

[1]	Maló P, Rangert B, Nobre M. “All-on-Four” immediate-function concept with Brånemark System implants for completely edentulous mandibles: A retrospective clinical study[J]. Clin Implant Dent Relat Res, 2003, 5(Suppl 1): 2-9.
[2]	张海萍, 许天民, 林久祥. β函数拟合正常𬌗牙弓形态的研究[J]. 口腔正畸学, 2005, 12(1): 19-23.
[3]	Takahashi T, Shimamura I, Sakurai K. Influence of number and inclination angle of implants on stress distribution in mandibular cortical bone with All-on-4 Concept[J]. J ProsthodontRes, 2010, 54(4): 179-184.
[4]	王煜婷, 张少锋, 董岩, 等. All-on-4种植体参数对周围骨应力影响的三维有限元分析[J]. 实用口腔医学杂志, 2014, 30(2): 193-197.
[5]	王惠芸. 我国人牙的测量和统计[J]. 中华口腔科杂志, 1959, 7(3): 149-155.
[6]	皮昕. 口腔解剖生理学[M]. 6版. 北京: 人民卫生出版社,2007:288-289.
[7]	温颖, 郑东翔, 张振庭, 等. 全口无牙颌应用种植固定修复后的咬合力分布研究[J]. 北京口腔医学, 2008, 16(6):325-328.
[8]	王琰玲. 自然牙列下颌侧方咬合运动中𬌗接触特征的研究[D]. 南京: 南京医科大学, 2008.
[9]	Türker N, Büyükkaplan US, Sadowsky SJ, et al. Finite element stress analysis of applied forces to implants and supporting tissues using the “all-on-four” concept with different occlusal schemes[J]. J Prosthodont, 2019, 28(2): 185-194.
[10]	Gomes LCL, Pierre FZ, Tribst JPM, et al. Occlusal scheme effect on the biomechanical response of full-arch dental prosthesis supported by titanium implants: A systematic review[J]. Metals, 2021,11:1574.
[11]	庞丽娇, 杨海萍, 胡婷姿, 等. All-on-4种植固定修复的咬合设计[J]. 口腔医学, 2021, 41(8): 765-768.
[12]	张雪洋, 黄雁红, 陈沛, 等. 无牙颌种植义齿的咬合设计[J]. 华西口腔医学杂志, 2018, 36(1): 1-3.
[13]	刘诗瑶, 晏奇, 施斌. 无牙颌种植固定义齿设计的研究进展[J]. 口腔疾病防治, 2022, 30(7): 511-516. doi: 10.12016/j.issn.2096-1456.2022.07.008
[14]	Kim Y, Oh TJ, Misch CE, et al. Occlusal considerations in implant therapy: Clinical guidelines with biomechanical rationale[J]. Clin Oral Implants Res, 2005, 16(1): 26-35.
[15]	Abduo J, Tennant M. Impact of lateral occlusion schemes: A systematic review[J]. J Prosthet Dent, 2015, 114(2): 193-204. doi: 10.1016/j.prosdent.2014.04.032 pmid: 25957242
[16]	Miralles R. Canine-guide occlusion and group function occlusion are equally acceptable when restoring the dentition[J]. J Evidence Based Dent Pract, 2016,16:41-43.
[17]	Türker N, Alkiş HT, Sadowsky SJ, et al. Effects of occlusal scheme on all-on-four abutments, screws, and prostheses: A three-dimensional finite element study[J]. J Oral Implantol, 2021, 47(1): 18-24.
[18]	Greco GD, Jansen WC, Landre Junior J, et al. Biomechanical analysis of the stresses generated by different disocclusion patterns in an implant-supported mandibular complete denture[J]. J Appl Oral Sci, 2009, 17(5): 515-520. doi: S1678-77572009000500029 pmid: 19936535
[19]	Gutiérrez MF, Miralles R, Fuentes A, et al. The effect of tooth clenching and grinding on anterior temporalis electromyographic activity in healthy subjects[J]. Cranio, 2010, 28(1): 43-49. pmid: 20158008
[20]	Apicella A, Masi E, Nicolais L, et al. A finite-element model study of occlusal schemes in full-arch implant restoration[J]. J Mater Sci Mater Med, 1998, 9(4): 191-196.
[21]	王佐林, 范震. 无牙颌种植修复设计[J]. 口腔颌面外科杂志, 2013, 23(1): 1-7.
[22]	李晓茜, 马晓妮, 徐欣. 无牙颌种植固定修复的咬合分析[J]. 华西口腔医学杂志, 2018, 36(6): 628-632.

材料	弹性模量/GPa	泊松比
皮质骨	13.40	0.30
松质骨	1.37	0.30
修复体支架、种植体及基台	110.00	0.33
复合树脂	7.50	0.30

工况	种植体	基台	皮质骨	松质骨	钛支架	树脂面
工况L1	21.188	14.932	6.959	0.813	6.592	6.759
工况L2	29.762	20.162	9.386	1.085	8.908	9.049
工况L3	46.713	23.502	12.596	1.637	16.462	23.252