摘要
目的 采用数值模拟方法研究冲击力及咬合力作用下种植体周围不同密度骨的损伤特征。方法 建立种植体及不同密度骨的微观结构有限元模型,对种植体先后施加冲击力和咬合力,编写程序结合应力极限失效值对骨内应力进行判断,测算骨单元的破坏失效数量,评估骨冲击损伤及咬合损伤的损伤程度。结果 不同密度的骨在冲击力作用后未发生皮质骨损伤。损伤主要集中在种植体底端骨小梁部位,随着密度的降低,损伤加剧。骨组织损伤单元数量随着骨密度的降低而增多。在冲击损伤基础上施加咬合力,骨组织发生了继发损伤。种植体与皮质骨结合界面处出现破坏,导致种植体移位,进而发生种植体周围骨小梁断裂加重。咬合造成的损伤随着骨密度的降低而加重。结论 冲击损伤与咬合损伤程度与骨密度相关,损伤随着密度的降低而加重。皮质骨的保护作用十分重要。咬合力的加载使骨组织损伤加剧,皮质骨损伤后种植体出现移位现象。临床诊疗中应对冲击损伤患者结合病史进行全面的检查和评估,损伤后要降低其承担的咬合力,必要时拆除修复体待其重新形成骨结合后再行修复。
Objective To investigate the damage characteristics of peri-implant bones with varying densities under impact and occlusal forces using numerical simulation.Methods A finite element model of the microstructure of an implant and bones with different densities was established.Impact and occlusal forces were applied sequentially to the implant.A user material subroutine was created for failure judgment using stress-based failure criteria,enabling the analysis of bone damage caused by impact and occlusal forces.Results No cortical bone damage was observed in bones of varying densities under impact force.Damage primarily occurred in the trabecular bone at the base of the implant,with the extent of damage worsening as bone density decreased.Additionally,the number of failed bone elements generated by the damage increased with reduced bone density.Bone tissues with pre-existing impact damage sustained secondary damage when subjected to occlusal force:the bonding interface between the implant and cortical bone was damaged,leading to implant displacement and fracture of peri-implant trabecular bone.The damage caused by occlusal force also worsened as bone density decreased.Conclusions The degree of damage from impact and occlusal forces is correlated with bone density,with damage worsening as bone density decreases.This underscores the protective role of cortical bone.The application of occlusal force exacerbates bone tissue damage,leading to implant displacement when the cortical bone is damaged.In clinical practice,patients with a history of impact damage should undergo thorough examination and evaluation.The occlusal force borne by damaged bones should be reduced;if necessary,the implant should be removed and reinserted after re-establishment of osseointegration.
作者
马新扬
刁晓鸥
侯兵
张欣玥
曾辉
MA Xinyang;DIAO Xiaoou;HOU Bing;ZHANG Xinyue;ZENG Hui(College of Stomatology,Xi’an Medical University,Xi’an 710021,China;College of Stomatology,the Air Force Military Medical University,Xi’an 710032,China;School of Aeronautics,Northwestern Polytechnical University,Xi’an 710072,China;Aviation Key Laboratory of Science and Technology on Structures Impact Dynamics,Aircraft Strength Research Institute of China,Xi’an 710065,China)
出处
《医用生物力学》
北大核心
2025年第4期872-877,共6页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(11672327)
陕西省科技厅重点研发计划一般项目(2024SF-YBXM-270)
西安医学院博士科研启动基金(2023BS37)。
关键词
冲击力
冲击损伤
咬合力
种植体
骨损伤
骨密度
impact force
impact damage
occlusal force
implant
bone damage
bone density
