結合微電腦斷層掃瞄分析與非線性有限元素法探討不同移植材料的骨密度、強度對上顎立即咬合人工植牙之生物力學影

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 牙醫學院 > 牙醫學系暨碩博士班、口腔醫學產業碩士班 > 研究計畫 > Item 310903500/12330

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题名:	結合微電腦斷層掃瞄分析與非線性有限元素法探討不同移植材料的骨密度、強度對上顎立即咬合人工植牙之生物力學影
其它题名:	Investigation of Biomechanical Effects of Various Grafted Bone Mineral Density, Bone Strength on Immediately Loaded Implant Applied with Maxillary Sinus Augmentation by Micro-CT and Non-Linear Finite Element Analyses
作者:	黃恆立(Heng-Li Huang);張志涵;陳遠謙(Yuan-Chien Chen)
贡献者:	醫學院牙醫學系
关键词:	微電腦斷層掃描;有限元素分析;移植骨;立即咬合植牙;骨應變;Micro-CT;Finite element analysis;Grafted bone;Immediately loaded implant;Bone strain
日期:	2009-07-31
上传时间:	2009-09-01 15:50:20 (UTC+8)
摘要:	上顎竇增高術與立即咬合受力之人工植牙於目前國內、外是相當熱門之治療方式，然而，截至目前為止，探討上顎竇增高術後，尤其是針對立即咬合治療之人工植牙的相關研究，仍是相當缺乏。臨床上，以不同填補材料(自體骨、異質骨或自體骨與異質骨混合)進行上顎竇增高術後，經過療預期(healing time)後之移植骨質的密度、骨小樑幾何型態、骨質強度…等是否會有所差異，甚至進一步對立即性咬合之人工植牙的初期穩定性與骨質受力造成影響，仍是一個未知但卻是重要的課題。本研究計劃以一年的時間並以兩大部份分別進行，第一部分本研究將以微米級電腦斷層掃描分析，探討不同移植材料在上顎竇增高術後，針對其移植骨的(1).骨密度、(2)骨小樑3D結構型態、(3)骨體積比、(4)骨表面積體積比、(5)骨孔洞率與(6)非等向性材料強度…等項目，進行統計分析並探討其差異。第二部分，本研究亦將建構具三維解剖幾何外型之上顎骨有限元素模型，並結合Micro-CT量測所得之非等向性材料強度的數據，以接觸界面之非線性分析的方式，分析不同移植骨之非等向性的材料強度，如何影響人工牙根與骨質之間的界面滑移量與骨質的應力分佈，以評估上顎竇增高術後，其不同移植骨對立即咬合受力人工植牙之初期人工牙根的穩定性與內部骨質力學傳遞行為，本研究計畫之結果可提供臨床醫師進行不同移植材料之上顎區植牙的術前評估與實質建議。 Immediate-load implants with maxillary sinus augmentation are becoming more and more popular in clinics nowadays. However, most studies on the maxillary sinus augmentations and immediate-load implants are still dependent on the clinical experiences rather than scientific-based data. Therefore, there is no general consensus of how a grafted bone (made of various grafted materials such as autogenous bone, xenografts or the mixture of autogenous bone and xenografts) could predominately influence the stability and bone stress distribution of an immediate-load implant. The purpose of this research is to combine the technologies of micro-computer tomography (micro-CT) analysis and three dimensional (3D) non-linear finite element simulations to investigate the effect of various grafted materials on immediate-load implant with maxillary sinus augmentation. It will furthermore provide useful clinical suggestions to the clinicians before immediate-load implant treatments are performed especially in the maxillary region. This research will be divided into two major portions to be completed within the one-year span. During the first stage, after the maturation of healing period a biopsy of grafted bone will be analyzed by the micro-CT to show the (1) 3D bone mineral density, (2) 3D structure of trabecular bone, (3) bone volume fraction, (4) Bone surface/bone volume ratio, (5) 3D porous of bone, as well as (6) anisotropic material properties. The grafted bone will be compared to ones placed with other various grafted materials in maxillary sinus. At the second stage, the 3D finite element models with an anatomic human maxillary bone and implant will be created by applying various grafted bones’ anisotropic material properties. Then the non-linear contact analysis will be carried out to analyze the implant-bone sliding distance and bone stresses value. The results of this research would provide practical information for clinicians to predict the primary implant stability and surrounding bone loss of immediate- load implant with maxillary sinus augmentation.
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