Efficacy of a posterior implant support for extra shortened dental arches: a biomechanical model analysis
Efficacy of a posterior implant support for extra shortened dental arches: a biomechanical model analysis
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DOI：
10.1111/j.1365-2842.2005.01478.x
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发表时间：
2005-09-01
影响因子：
2.9
通讯作者：
Tsutsumi, S
中科院分区：
文献类型：
--
作者：
Maeda, Y;Sogo, M;Tsutsumi, S
本研究的目的是测试利用远中游离端义齿基托下的种植体为极短牙弓(ESDA)建立稳定的咬合支持的效果。作者建立了ESDA的二维有限元模型，其中只保留了较低的前牙。后牙合支持采用固定义齿+骨集成型义齿(IFPD)、固定悬臂式义齿(CFPD)或可摘局部义齿(IRPD+RPD)。以齿状下颌骨模型为对照。当施加模拟咬合力的肌肉载体时，比较不同构型下颞骨表面区的应力水平，以评价建立咬合支撑的效果。在ESDA的情况下，颞骨的应力增加最大，其次是RPD。当种植体放置在磨牙区时，IFPD的应力增加最小，IRPD次之。IRPD的应力增加约为RPD的20%-45%。我们的结果表明，IFPD提供了最有利和最稳定的咬合支持，然而，带有单个后部种植体的IRPD也提供了稳定的咬合支持，同时降低了颞下颌关节的应力水平。
The purpose of this study was to test the efficacy of utilizing implants underneath distal free-end denture bases to establish a stable occlusal support for extreme shortened dental arches (ESDA). The authors constructed a two-dimensional finite element model of the ESDA where only lower anterior teeth remain. Posterior occlusal support was provided by a fixed partial denture with an osseointegrated implant (IFPD), fixed cantilever partial denture (CFPD), or a removable partial denture with or without an implant underneath (IRPD and RPD). A dentate mandible model was the control. When muscle vectors simulating clenching force were applied, stress levels on the temporal bone surface area under each configuration were compared, to evaluate the efficacy in establishing the occlusal support. The largest stress increase in temporal bone was found in the ESDA situation followed by the RPD. The least amount of stress increase was found with the IFPD followed by IRPD when the implant was placed in the molar region. The stress increase with IRPD was about 20-45% of the amount with RPD. Our results suggest that IFPD provides most favourable and stable occlusal support, however, IRPD with a single posterior implant also provide stable occlusal support with reducing the stress levels in the temporomandibular joint.