美学区种植义齿与天然邻牙在不同咬合关系中的三维有限元分析

doi:10.13591/j.cnki.kqyx.2025.12.003

摘要/Abstract

摘要：

目的探讨美学区种植义齿的植入对天然邻牙生物力学行为的影响,为减少美学区种植修复后邻接触丧失的发生提供参考依据。方法建立上颌美学区天然牙列三维实体模型为对照组(A组),包含右上中切牙种植修复义齿及天然邻牙在内的混合牙列三维实体模型为实验组(B组),利用有限元软件计算对刃牙合、正常牙合、深覆牙合三种咬合关系下两组模型在位移方向和大小上的差异。结果在同一咬合关系中,天然牙的生理动度明显大于种植牙;B组天然邻牙总位移的幅度均大于A组同位牙总位移的幅度;在不同咬合关系中,A组右上侧切牙向远中产生位移,左上中切牙向近中产生位移;B组右上侧切牙和左上中切牙均向远中产生位移;在咬合力的作用下,B组种植义齿与相邻天然牙之间产生的间隙均大于A组右上中切牙与相邻牙之间的间隙。结论在咬合力的作用下,种植义齿的植入增加了天然邻牙总位移的幅度,且会影响天然邻牙位移的方向,使天然邻牙有朝着远离种植义齿的方向移动的趋势。咬合因素是影响种植修复后邻接关系的关键因素。

关键词: 美学区, 种植义齿, 邻接触丧失, 有限元

Abstract:

Objective To investigate the biomechanical effects of implant-supported prostheses on natural adjacent teeth in the aesthetic zone and provide a reference for reducing the occurrence of proximal contact loss after implant restoration in the aesthetic zone. Methods A three-dimensional finite element model of the maxillary aesthetic zone with natural dentition was established as the control group (Group A), and a mixed dentition model including an implant-supported prosthesis at the right maxillary central incisor and its adjacent teeth was established as the experimental group (Group B). Finite element analysis software was used to calculate the differences in displacement direction and magnitude between the two groups under three different occlusal relationships. Results Under the same occlusal relationship, the physiological mobility of natural teeth was significantly greater than that of implant-supported prostheses. The total displacement of the natural adjacent teeth in Group B was greater than that of the corresponding teeth in Group A. Under different occlusal relationships, the right maxillary lateral incisor in Group A exhibited distal displacement, while the left maxillary central incisor exhibited mesial displacement. In Group B, both the right maxillary lateral incisor and the left maxillary central incisor exhibited distal displacement. Under occlusal loading, the gaps between the implant-supported prosthesis and the adjacent natural teeth in Group B were larger than the gaps between the right maxillary central incisor and its adjacent teeth in Group A. Conclusion Under the influence of occlusal forces, the implantation of the implant-supported prosthesis increases the total displacement amplitude of the natural adjacent teeth and affects the direction of their displacement, causing the natural teeth to tend to move away from the implant prosthesis. Occlusal factors are key determinants affecting the proximal contact relationship after implant restoration.

Key words: aesthetic zone, dental implant, proximal contact loss, finite element analysis

中图分类号:

R783.4

钱翌, 杨益, 毕效铭, 徐纪雅, 王志芳, 王月秋, 刘梅. 美学区种植义齿与天然邻牙在不同咬合关系中的三维有限元分析[J]. 口腔医学, 2025, 45(12): 895-900.

QIAN Yi, YANG Yi, BI Xiaoming, XU Jiya, WANG Zhifang, WANG Yueqiu, LIU Mei. Three-dimensional finite element analysis of implant-supported prostheses and natural adjacent teeth in the aesthetic zone under different occlusal relationships[J]. Stomatology, 2025, 45(12): 895-900.

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材料	弹性模量/MPa	泊松比
皮质骨	1.37×10⁴	0.30
松质骨	1.37×10³	0.30
牙体组织	1.86×10⁴	0.31
牙周膜	68.90	0.45
种植体(钛)	1.10×10⁵	0.35
基台(钛)	1.10×10⁵	0.35
氧化锆全瓷冠	2.10×10⁵	0.27
螺丝(钛)	1.10×10⁵	0.35
粘接层(玻璃离子水门汀)	1.59×10⁴	0.33

咬合状态	A模型			B模型
咬合状态	右上侧切牙	右上中切牙	左上中切牙	右上侧切牙	种植义齿	左上中切牙
对刃牙合	35.18	63.56	66.78	35.96	34.81	69.87
正常牙合	87.99	102.07	109.17	93.56	58.06	111.52
深覆牙合	63.61	74.73	81.49	72.67	48.35	89.93

模型	邻接点		对刃牙合				正常牙合				深覆牙合
模型	邻接点		X轴		Y轴		X轴		Y轴		X轴		Y轴
A模型	右上侧切牙近中面邻接点	-13.61		-80.81		-11.66		-202.34		-15.38		-126.00
	右上中切牙远中面邻接点	-7.15		-93.48		-7.95		-225.19		-7.71		-110.03
	右上中切牙近中面邻接点	-8.93		-129.13		-9.04		-248.36		-9.47		-128.25
	左上中切牙近中面邻接点	-4.50		-119.61		-2.38		-230.53		-4.42		-139.15
B模型	右上侧切牙近中面邻接点	-18.16		-84.67		-40.63		-245.07		-26.77		-173.36
	种植义齿远中面邻接点	-5.73		-99.30		-6.10		-201.26		-4.85		-139.78
	种植义齿近中面邻接点	-7.67		-134.32		-8.01		-245.49		-6.36		-170.41
	左上中切牙近中面邻接点	4.71		-145.13		9.73		-276.17		14.36		-206.41

咬合关系	模型	右上中切牙/种植义齿与右上侧切牙间的间隙		右上中切牙/种植义齿与左上中切牙间的间隙
咬合关系	模型	X轴	Y轴	X轴	Y轴
对刃牙合	A	6.46	12.67	4.43	9.52
	B	12.43	14.63	12.38	10.81
正常牙合	A	3.71	22.85	6.66	17.83
	B	34.53	43.81	17.74	30.69
深覆牙合	A	7.67	15.97	5.05	10.90
	B	21.92	33.58	20.72	36.00