All-ON-4® ve trefoil™ implant tedavi protokollerinin karşılaştırmalı biyomekanik analizi
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Tarih
2021
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İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Çalışmanın amacı; tam dişsiz mandibulada All-on-4 tedavi sistemi, Trefoil tedavi konsepti ve 5 implant destekli hibrit protezin immediat yüklenerek uygulanan oblik kuvvet altında kemik, implant, implant komponentleri ve protezde oluşturduğu streslerin sonlu elemanlar stres analizi ile değerlendirilmesidir. Materyal ve Metod: Bilgisayar ortamında tam dişsiz posterior atrofik mandibula modeli oluşturuldu. All-on-4 ve 5 implant destekli modeller için mental foramenler arasına yerleştirilen 5.0 mm çapta, 11.5 mm uzunlukta NobelParallel™ Conical Connection implantlar kullanıldı. All-on-4 tedavi sisteminde posterior bölgede 30° açılı multi-unit abutmentlar kullanıldı. Trefoil tedavi sisteminde ise 5.0 mm çapta, 11.5 mm uzunlukta Trefoil implantlar kullanıldı. Trefoil model için prefabrik titanyum bar modellenip alt yapı olarak uygulandı ve tüm modellere immediat akrilik hibrit protez uygulandı. Çiğneme kuvvetlerini taklit etmesi amacıyla birinci molar dişin distal triangular bölgesinde belirlenen 1.5 mm'lik alana 100 N'luk oblik kuvvet uygulanarak implant, implantı çevreleyen kemik, implant komponentleri ve protezde oluşan stres değerleri ve dağılımları sonlu elemanlar stres analizi kullanılarak karşılaştırıldı. Bulgular: Modellerde kortikal ve spongioz kemikte en yüksek basma ve çekme stres değerleri All-on-4 modelde posterior implantta gözlendi. En yüksek von Mises stres değerleri implantlarda All-on-4 modelde posterior implantta, abutment vidalarında ve protezde ise Trefoil modelde gözlendi. Sonuç: All-on-4 tedavi protokolünde kemik, implant ve abutment komplikasyon görülme riski, Trefoil tedavi protokolünde ise protez ve abutment vida komplikasyon görülme riski daha fazladır. Anahtar kelimeler: All-on-4, trefoil, immediat yükleme, sonlu elemanlar stres analizi.
Objective: The objective is to evaluate the stresses on bone, implant, implant components, and the prosthesis under an oblique force applied by immediate loading of All-on-4 system, the Trefoil concept, and 5-implant-supported treatment allowing hybrid prostheses in edentulous mandible, using finite element stress analysis. Material and Method: A fully edentulous atrophic mandible model was formed digitally. For All-on-4 and 5-implant-supported models, 11.5-mm long implants having a diameter of 5.0-mm placed between mental foramina were used, with 30°-angle multi-unit abutments in the posterior region. In the Trefoil system, 11.5-mm long Trefoil implants having a diameter of 5.0-mm were used. For the Trefoil model, a prefabricated titanium bar was modeled and applied as the infrastructure, and an immediate acrylic hybrid prosthesis was applied to all models. Applying 100-N oblique force to a 1.5-mm area in the distal triangular region of the first molar tooth to mimic chewing forces, the stress values and distributions in the implant, the bone, implant components, and the prosthesis were compared using finite element stress analysis. Results: The highest compressive and tensile stress values in the cortical and spongious bone were observed in the posterior implant in the All-on-4 model. The highest von Mises stress values were observed in the posterior implant in the All-on-4 model, and in abutment screws and protheses in the Trefoil model. Conclusion: The risk of bone, implant, and abutment complications is higher in the All-on-4 treatment protocol, and the risk of the prosthesis and abutment-screw complications is higher in the Trefoil treatment protocol. Key Words: All-on-4, trefoil, immediate loading, finite element stress analysis.
Objective: The objective is to evaluate the stresses on bone, implant, implant components, and the prosthesis under an oblique force applied by immediate loading of All-on-4 system, the Trefoil concept, and 5-implant-supported treatment allowing hybrid prostheses in edentulous mandible, using finite element stress analysis. Material and Method: A fully edentulous atrophic mandible model was formed digitally. For All-on-4 and 5-implant-supported models, 11.5-mm long implants having a diameter of 5.0-mm placed between mental foramina were used, with 30°-angle multi-unit abutments in the posterior region. In the Trefoil system, 11.5-mm long Trefoil implants having a diameter of 5.0-mm were used. For the Trefoil model, a prefabricated titanium bar was modeled and applied as the infrastructure, and an immediate acrylic hybrid prosthesis was applied to all models. Applying 100-N oblique force to a 1.5-mm area in the distal triangular region of the first molar tooth to mimic chewing forces, the stress values and distributions in the implant, the bone, implant components, and the prosthesis were compared using finite element stress analysis. Results: The highest compressive and tensile stress values in the cortical and spongious bone were observed in the posterior implant in the All-on-4 model. The highest von Mises stress values were observed in the posterior implant in the All-on-4 model, and in abutment screws and protheses in the Trefoil model. Conclusion: The risk of bone, implant, and abutment complications is higher in the All-on-4 treatment protocol, and the risk of the prosthesis and abutment-screw complications is higher in the Trefoil treatment protocol. Key Words: All-on-4, trefoil, immediate loading, finite element stress analysis.
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BAKİ, N. (2021). All-ON-4® ve trefoil™ implant tedavi protokollerinin karşılaştırmalı biyomekanik analizi,İnönü Üniversitesi / Diş Hekimliği Fakültesi / Protetik Diş Tedavisi Ana Bilim Dalı.
