摘要：
BACKGROUND: Single tooth loss at posterior mandibular area is difficult to complete regularly axial implantation under limited conditions. Concerning this problem, some scholars employ the skill of tilted implantation with abutment angulations to restore it. However, the security study of this design has been limited until now. OBJECTIVE: To provide theoretical evidence for tilted implantation in the posterior mandibular area, and to make a biomechanical analysis on bone-implant interface after titled implantation under the same dynamic force stress. METHODS: First, restoration models of implant crown at different tilting angles in posterior mandibular area were built and optimized using the software CBCT and DICOM. Then dynamic force stress was applied in chewing cycles of the crown model. Finally, the stress-strain analysis of bone-implant interface was made by utilizing the three-dimensional finite element software Ansys. RESULTS AND CONCLUSION: (1) When the dental implant in the axis implantation was tilted to the lingual side at 5° or 10°, the maximum stress and strain values at the bone interface were 53.8 MPa and 2 671, respectively, under three loading conditions: the force during the chewing cycle was given vertical to the implant, toward the lingual side from the buccal side at 45° with the long axis of the tooth, and toward the buccal side from the lingual side at 45° with the long axis of the tooth. (2) When the implant inclined to the lingual side at a 15° angle, the rear edge of the implant was close to the interface between the cortical and cancellous bone, and the stress and strain values were bigger than those at any other implantation angle. (3) When the implant inclined to the lingual side at a 20° angle, the rear edge of the implant was beyond the interface between the cortical and cancellous bone, and contacted with the cortical bone that provided a support for the rear part of the implant. The stress and strain values on the bone interface were both reduced. The stress was concentrated in the cortex around the neck of the implant, and reduced a lot in the cancellous bone. The maximum strain value appeared at the contact site between the bone interface and the implant neck or rear part. It is concluded that in posterior mandibular area, the dental implant can be implanted at a < 10° linguoclination angle.%背景:因下颌后牙单颗牙缺失受条件所限,常规轴向种植难以实现.针对此问题,有学者采用倾斜种植技术结合角度基台进行修复,但对于倾斜种植用于后牙区及倾斜种植角度设计的安全性目前相关研究有限.目的:对下颌后牙区进行不同角度的偏舌侧倾斜种植修复,分析在相同动态载荷下种植修复后的骨界面生物力学.方法:借助于锥形束 CT、DICOM 等多种软件联合应用,建立下颌后牙区舌向不同倾斜角度的种植体冠修复模型,冠优化设计,对冠模拟磨牙咀嚼周期施加动态载荷,运用三维有限元软件Ansys对各界面的应变、应力进行分析.结果与结论:①在轴向种植和种植体偏舌侧倾斜5°、10°时,在咀嚼周期的垂直向、颊偏舌与轴呈45°、舌偏颊与轴成45° 3种受力状态下,骨界面应力最大值为53.8 MPa,应变最大值为2671微应变;②当种植体偏舌侧倾斜15°时,此模型种植体尾部边缘接近皮质骨与松质骨交界处,骨界面在各个受力状态下产生的应力、应变均明显大于其余种植角度;③当种植体偏舌侧倾斜20°时,种植体尾部边缘已越过皮质骨与松质骨交界处,与皮质骨发生接触,由皮质骨对种植体尾部形成支撑,骨界面应变、应力较小.并且,此研究应力集中的部位均在种植体颈部周围的骨皮质内,而松质骨内的应力值较小,应变最大值可出现在骨界面与种植体颈部或尾部接触部位;④通过此模型分析研究,可以在下颌后牙区行10°以内的偏舌侧倾斜种植,并且倾斜种植应避免使种植体尾部边缘位于皮质骨与松质骨交界处.
