圆柱种植体直径和长度的双因素分析

Diameter and length double objectives robust analysis of cylinder dental implant

目的应用Ansys DesignXplorer模块,进行圆柱形种植体直径和长度的双目标稳健分析,为临床选择和设计种植体提供理论依据。方法建立包含圆柱状种植体的颌骨骨块三维有限元模型,设定种植体的直径(D)为2.5～5.0mm,种植体长度(L)为6.0～16.0mm,观察D和L变化对颌骨Von Mises应力峰值的影响,同时进行颌骨VonMises应力峰值对变量的敏感度分析。结果在一个变量取中间值时,垂直向加载情况下,随着D的增加,皮、松质骨的EQV应力峰值分别降低了44.66%和51.45%,随着L的增加,皮、松质骨的EQV应力峰值分别降低45.97%和52.15%;颊舌向加载情况下,随着D的增加,皮、松质骨的EQV应力峰值分别降低71.32%和58.50%,随着L的增加,皮、松质骨的EQV应力峰值分别降低21.66%和37.75%。在两种加载情况下,当D>3.7mm且L>10.0mm时,颌骨的EQV应力峰值对D和L的响应曲线曲率位于-1和0之间;变量D比L对颌骨的EQV应力峰值的影响更明显。结论种植体直径的增大有利于改善颊舌向力的力学分布,长度的增大有利于改善垂直向力的力学分布;临床选择种植体时,只要骨量允许,种植体直径应不小于3.7mm,长度应不小于10.0mm;相对于长度而言,应更重视圆柱形种植体直径的选择和设计,而改善颌骨的宽度比改善颌骨的高度在缓和颌骨的应力分布中可能更有意义。

Objective To determine the jaw bone stress variation affected by cylinder implant diameter and length simultaneously in Ansys DesignXplorer module. Methods Finite element model of segment mandible with a cylinder implant was created. The range of the implant diameter （D） and length （L） were set from 2.5 mm to 5.0 mm and from 6.0 mm to 16.0 mm respectively. The maximum Von Mises stresses in jaw bone and sensitivity to D and L were evaluated. Results Under axial （buccolingual） load, when one variable equaled to median, the amplification of maximum Von Mises stresses in cortical bone and cancellous bone were 44.66% （71.32%） and 51.45% （58.50%） respectively with the D increasing. The amplification of maximum Von Mises stresses in cortical bone and cancellous bone were 45.97%（21.66%） and 52.15%（37.75%） respectively with the L increasing. When D exceeded 3.7 mm and L exceeded 10.0 mm, the response curve curvatures of maximum Von Mises stresses to L and D in jaw bone ranged from -1 to 0. And the variation of the maximum Von Mises stresses in jaw bone was more sensitive to D than to L. Conclusion Stresses in jaw bone under buccolingual and axial load are apt to be affected by implant diameter and length respectively. And to a cylinder implant, the diameter exceeds 3.7 mm and length exceeds 10.0 mm are optimal selections. Diameter should pay more attention to than to length for cylinder implant. Expanding the width of the jaw bone is more important than expanding the height of the jaw bone in clinical experience.