Biomechanical characteristics of maxillary anterior incisor, conventional immediate implantation and socket shield technique — A finite element analysis and case report

IF 2 3区 医学 Q2 ANATOMY & MORPHOLOGY Annals of Anatomy-Anatomischer Anzeiger Pub Date : 2024-08-02 DOI:10.1016/j.aanat.2024.152313
Zhangyan Ye , Mingquan Yu , Yanwu Ji , Shengrui Jia , Xiaomin Xu , Huiyu Yao , Xiaowen Hua , Zhongqiang Feng , Guangwei Shangguan , Jun Zhang , Xuekun Hou , Xi Ding
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Abstract

Background

To prevent the absorption and collapse of the labial bone plate of the anterior teeth, immediate implantation and socket shield technique have been increasingly applied to anterior dental aesthetic implant restoration.

Objective

To provide a biomechanical basis for implant restoration of maxillary anterior teeth, finite element analysis was used to investigate the stress peak and distribution in different anatomical sites of natural teeth, conventional immediate implantation and socket shield technique.

Methods

Three maxillary finite element models were established, including a maxillary incisor as a natural tooth, a conventional immediate implantation and a socket shield technique. A mechanical load of 100 N was applied to simulate and analyze the biomechanical behavior of the root, periodontal ligament (PDL), implant and surrounding bone interface.

Results

The stress distribution of the natural tooth was relatively uniform under load. The maximum von Mises stress of the root, periodontal ligament, cortical bone and cancellous bone were 20.14 MPa, 2.473 MPa, 19.48 MPa and 5.068 MPa, respectively. When the conventional immediate implantation was loaded, the stress was mainly concentrated around the neck of implant. Maximum stress on the surface of the implant was 102 MPa, the cortical bone was 16.13 MPa, and the cancellous bone was 18.29 MPa. When the implantation with socket shield technique was loaded, the stress distribution of the implant was similar to that of immediate implantation. Maximum stress on the surface of the implant was 100.5 MPa, the cortical bone was 23.11 MPa, the cancellous bone was 21.66 MPa, the remaining tooth fragment was 29.42 MPa and the periodontal ligament of the tooth fragment was 1.131 MPa.

Conclusions

1. Under static loading, both socket shield technology and conventional immediate implantation can support the esthetic restoration of anterior teeth biomechanically. 2.Under short-term follow-up, both immediate implant and socket shield technology achieved satisfactory clinical results, including bone healing and patient satisfaction. 3.The stress distribution is mainly located on the buccal bone surface of the implant and is associated with resorption of the buccal bone plate after implant replacement in both socket shield technology and conventional immediate implantation. 4.The presence of retained root fragment had an impact on the bone graft gap. In immediate implantation, the peak stress was located in the cortical bone near the implant position, while in socket shield technology, the peak stress was at the neck of the cortical bone corresponding to the retained root fragment.

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上颌前切牙的生物力学特征、传统即刻种植技术和牙槽屏蔽技术--有限元分析和病例报告。
背景:为防止前牙唇侧骨板的吸收和塌陷,即刻种植和牙槽屏蔽技术已越来越多地应用于前牙美学种植修复:为了给上颌前牙种植修复提供生物力学依据,我们采用有限元分析方法研究了天然牙、传统即刻种植和牙槽屏蔽技术在不同解剖部位的应力峰值和分布情况:建立了三个上颌有限元模型,包括作为天然牙的上颌门牙、传统即刻种植体和牙槽屏蔽技术。方法:建立三个上颌有限元模型,包括作为天然牙的上颌切牙、传统即刻种植体和牙槽屏蔽技术,施加 100N 的机械负荷,模拟和分析牙根、牙周韧带(PDL)、种植体和周围骨界面的生物力学行为:结果:天然牙在负荷下的应力分布相对均匀。牙根、牙周韧带、皮质骨和松质骨的最大 von Mises 应力分别为 20.14MPa、2.473MPa、19.48MPa 和 5.068MPa。传统即刻种植体加载时,应力主要集中在种植体颈部周围。种植体表面的最大应力为 102MPa,皮质骨为 16.13MPa,松质骨为 18.29MPa。当使用套筒盾牌技术加载种植体时,种植体的应力分布与即刻种植相似。种植体表面的最大应力为 100.5MPa,皮质骨为 23.11MPa,松质骨为 21.66MPa,剩余牙片为 29.42MPa,牙片的牙周韧带为 1.131MPa:1.结论:1.在静态负荷下,牙槽窝屏蔽技术和传统的即刻种植技术都能为前牙的美学修复提供生物力学支持。2.在短期随访中,即刻种植和牙槽盾技术都取得了令人满意的临床效果,包括骨愈合和患者满意度。3.应力分布主要位于种植体的颊骨表面,与种植体植入后颊骨板的吸收有关。4.残根的存在对植骨间隙有影响。在即刻种植中,峰值应力位于种植体位置附近的皮质骨中,而在套筒屏蔽技术中,峰值应力位于与保留的牙根碎片相对应的皮质骨颈部。
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来源期刊
Annals of Anatomy-Anatomischer Anzeiger
Annals of Anatomy-Anatomischer Anzeiger 医学-解剖学与形态学
CiteScore
4.40
自引率
22.70%
发文量
137
审稿时长
33 days
期刊介绍: Annals of Anatomy publish peer reviewed original articles as well as brief review articles. The journal is open to original papers covering a link between anatomy and areas such as •molecular biology, •cell biology •reproductive biology •immunobiology •developmental biology, neurobiology •embryology as well as •neuroanatomy •neuroimmunology •clinical anatomy •comparative anatomy •modern imaging techniques •evolution, and especially also •aging
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