TAM KONTÜR ZİRKONYA RESTORASYONLARIN FARKLI ALL ON FOUR MANDİBULAR İMPLANT MODELLERİNDE BİYOMEKANİK DAVRANIŞLARI: 3 BOYUTLU SONLU ELEMANLAR STRES ANALİZİ ÇALIŞMASI

Yıl 2020, Cilt: 30 Sayı: 3, 424 - 433, 15.07.2020

Gonca Deste Rukiye Durkan

https://doi.org/10.17567/ataunidfd.554400

Öz

Amaç: Aşırı rezorbe
mandibular tam dişsizlik; implant uygulamaları, oklüzyonun sağlanması ve hareketli
protez kullanımı yaygın gözlenen problemlerdir. Mandibular 4 implant üzerine
yapılan sabit tam ark protetik restorasyonlar alternatif bir metod
sağlamaktadır. İmplant sayısının az olması, cerrahi işlemlerin kısa sürmesi ve
sabit protez yapılması bu yöntemin özellikleridir. Bu çalışmanın amacı estetik
ve son teknoloji ürünü olan monolitik zirkonya CAD-CAM seramik materyallerin
farklı mandibuler all on four implant tasarımlarında uygulanmasının biyomekanik
özellikler bakımından değerlendirilmesidir.

Materyal ve
metod:
Katana CAD-CAM monolitik zirkonya tam ark sabit restorasyon, Biomed implant ve
abutment materyalleri kullanıldı. 4 adet mandibuler all on four implant tasarımlı
model hazırlandı. 1. model; anterior implantlar vertikal ve posterior
implantlar 15⁰ açılı, kantilever 5 mm, (Z-15,5); 2. model;
kantilever 9 mm (Z-15,9); 3. model anterior implantlar vertikal posterior
implantlar 30⁰ açılı, kantilever 5 mm (Z-30,5); 4.model; kantilever
9 mm (Z-30,9). Yükleme koşulu; 1. molar yüklemesi sağ kantilever uzantısının
merkezinden oklüzyon düzlemine 30^o açılı ve 150 N kuvvet uygulandı.
Üç boyutlu sonlu elemanlar stres analiz yöntemi ile mandibular kortikal ve spongioz
kemik, implant ve protetik restorasyonlardaki biyomekanik stres dağılımı
ölçüldü. Statik lineer analiz yapıldı.

Bulgular: Bütün
parametreler birlikte değerlendirildiği zaman CAD-CAM seramik materyal,
kantilever uzunluğu ve stres dağılımının tipleri arasında önemli bağlantılar olduğu
tespit edildi. Kantilever uzunluğu 5 mm’ den 9 mm’ ye çıktığı zaman kortikal ve
trabeküler kemikte maksimum ve minimum asal gerilme stres değerleri 15’ den 32 MPa
değerine yükseldi. Posterior
implant açılanması 15⁰’ den 30^{0 ‘}ye çıktığı zaman
implantlarda von Mises değerleri azaldı.

Sonuç: Monolitik
zirkonya restorasyon 30^o posterior implant açılanması ve 5 mm
kantilever uzantısı biyomekanik olarak kullanılabilir. Mandibuler all on four
implant destekli tam ark sabit estetik CAD-CAM restorasyonlarda biyomekanik ve
klinik açıdan kantileverin kısaltılması implant açısının arttırılması ve rijit
tek tabaka restorasyonların yapılması önerilebilir.

Anahtar
kelimeler: monolitik
zirkonya, üç boyutlu sonlu elemanlar stres analizi, all on four implant
tasarımı

  

Biomechanical behaviors of full countor
zirconia restorations on different all on four mandibular implant models: A 3
dimensional finite element stress analysis study

 

ABSTRACT

Aim: Extremely
resorbed mandibular total edentulism is most commonly seen with implant
applications, occlusion and moving prosthetic use. The fixed whole arch
prosthetic restorations on the mandibular 4 implant provide an alternative
method. The low number of implants, short duration of surgical procedures,
and fixed prosthesis are the characteristics of this method. The aim of
this study is to evaluate the application of aesthetic& state of the art
technology product of monolithic zirconia CAD-CAM ceramic materials in
different mandibular "all four implant" designs in terms of
biomechanical properties.

Material&Method: Katana
CAD-CAM monolithic zirconia full-arc fixed restoration, Biomed implant and
abutment materials were used. 4 models of mandibular "all-on-four
implants" were prepared. 1. model; anterior implants vertical and 15⁰
angled posterior implants,  cantilever 5 mm, (Z-15,5); 2. model;
cantilever 9 mm (Z-15,9), 3. model; anterior implants vertical 30⁰ angled
posterior implants, cantilever 5 mm (Z-30,5); 4. model; cantilever 9 mm
(Z-30,9). Loading condition; The 1st molar loading was applied from the
center of the right cantilever extension to the occlusion plane with an angle
of 30 degrees and a force of 150 N. Biomechanical stress distribution of
mandibular cortical and spongious bone, implant and prosthetic restorations
were measured by three dimensional finite element stress analysis method.
Static linear analysis was performed.

Results: When all
parameters were evaluated together, it was found that there were significant
connections between the types of CAD-CAM ceramic material, the length of the
cantilever and the types of stress distribution. When cantilever length
was increased from 5 mm to 9 mm, maximum and minimum principal stress values in
cortical and trabecular bone were increased from 15 to 32 MPa. When Posterior
implant angles increased from 15 to 30 degrees, the von Mises values of the
implants decreased.

Conclusion: Monolithic
zirconia restoration can be used biomechanically with 30 degree posterior
implant angle and 5 mm cantilever extension. Biomechanically shortening
cantilever, increasing implant angle and  rigid monolithic restorations
can be suggested on Mandibular "all-on-four implant" supported
full-arc fixed aesthetic CAD-CAM restorations

Key words: monolithic
zirconia, three dimensional finite element stress analysis, all on four implant
design

Anahtar Kelimeler

monolitik zirkonya, üç boyutlu sonlu elemanlar stres analizi, all on four implant tasarımı

Kaynakça

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