Üst çene tam dişsizlikte implant destekli farklı altyapı materyalleri ile rehabilite edilmiş implantüstü protezlerin biyomekanik olarak incelenmesi
Biomechanical evaluation of edentulous maxilla rehabilitated with implant-supported prostheses with different framework materials
Yazar: MİRAC BERKE TOPCU ERSÖZ
Danışman: PROF. DR. EMRE MUMCU
Eskişehir Osmangazi Üniversitesi / Diş Hekimliği Fakültesi / Protetik Diş Tedavisi Ana Bilim Dalı
Derece: Diş Hekimliği Uzmanlık, 2021
Konu: Diş Hekimliği = Dentistry
Dizin: Biyomekanik = Biomechanics ; Dental protezler = Dental prosthesis ; Dental stres analizi = Dental stress analysis ; Sonlu elemanlar stres analizi = Finite elements stress analysis ; Takma diş tabanları = Denture bases ; Çene-dişsiz = Jaw-edentulous

Özet:
Amaç:  Üst çene tam dişsizlikte uygulanan dört ve altı implant planlamalarının biyomekanik olarak, farklı materyaller ve yükleme koşulları altında sonlu elemanlar stres analizi ile değerlendirilmesi.
Gereç ve Yöntem: Bu çalışma Eskişehir Osmangazi Üniversitesi Diş Hekimliği Fakültesi, Neos Dijital Dental ve FE Teknoloji Hizmetleri İleri Mühendislik Araştırma ve Geliştirme Ltd. Şti. laboratuvarlarında gerçekleştirilmiştir. Tam dişsiz maksillada 4 ve 6 implant destekli tasarımlarına uygun olacak şekilde implantlar yerleştirilmiştir. İmplant üstü protetik altyapıda Co-Cr, Ti, ZrO2 ve PEEK altyapı materyalleri kullanılmıştır. Birinci molar diş üzerine dik ve 45° oblik olmak üzere 200 N kuvvet uygulanmıştır. Uygulanan kuvvetlerin kemik, implantlar, abutment vidasi, abutment ve protetik vida üzerinde oluşturduğu stresler değerlendirilmiştir. Çalışmamızda 3 boyutlu sonlu elemanlar analizi kullanılmış olup, lineer statik analiz uygulanmıştır. Analiz sonuçları Von Mises, Maksimum ve Minimum Asal gerilme değerleri MPa cinsinden elde edilmiştir. Kemikteki stresler asal gerilmeler cinsinden, implant parçaları ve altyapı üzerinde oluşan stresler Von Mises gerilmeleri üzerinden yorumlanmıştır.
Bulgular: Kemikte oluşan maksimum ve minimum asal gerilmeler CoCr

Abstract:
Aim: To biomechanically evaluate 4 and 6 implant plans placed for complete edentulism in the maxilla using finite element stress analysis under various materials and loading conditions.
Material and Method: This study was conducted by the Faculty of Dentistry, Eskişehir Osmangazi University, Neos Digital Dental and FE Technology Services Advanced Engineering Research and Development Ltd. Sti. laboratories. The implants were placed in the edentulous maxilla according to the 4 and 6 implant supported designs. CoCr, Ti, ZrO2 and PEEK materials were used for the prosthetic framework on the implant. A force of 200 N was applied vertically and 45° obliquely on the first molar. The stresses caused by the applied forces on the bone, implants, abutment screw, abutment and prosthetic screw were evaluated. A 3D finite element analysis was used and a linear static analysis was performed. The analysis results, Von Mises, maximum and minimum principal stress values were determined in MPa. Stresses in bone were interpreted in terms of principal stresses, and stresses on implant parts and framework were interpreted by Von Mises stresses.
Results: The maximum and minimum principal stresses in bone were determined as Co-Cr < ZrO2 < Ti < PEEK. The Von Mises stresses on the implant, abutment and prosthetic screws were determined as Co-Cr < ZrO2 < Ti < PEEK according to the materials. The Von Mises stresses formed in the framework are listed as Ti < ZrO2 < Co-Cr < PEEK except for the oblique loading condition of the 6 implant supported design. The 6 implant supported design was determined as PEEK < Ti < ZrO2 < Co-Cr under oblique loading condition. When comparing the stress accumulations for the 4 and 6 implant supported designs, it was found that the forces were higher for the 4 implant-supported designs. When the oblique and vertical loading conditions were evaluated for each design, material, and part, it was concluded that the stress from oblique loading of the system was higher.
Conclusion: When the same materials are used on 4 and 6 supported plans, the stress accumulation in the system differs when the same force is applied. The higher the modulus of elasticity of the material used as framework, the lower the stresses transferred to the bone and implant. While PEEK is the most stress-conductive material, Co-Cr and ZrO2 are the least conductive materials. Therefore, the number of implants and the mechanical properties of the infrastructure material should be considered when selecting materials for implant-supported full arch fixed prostheses.
Keywords: Biomechanics, Dental Implant, Finite Elements Analysis, Implant Supported Fixed Prosthesis