All-on-Four hibrid protezler için farklı tekniklerle üretilen PEEK altyapının mekanik dayanım ve stres analizlerinin karşılaştırılması
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Amaç: Alt çene modeli üzerine "All-on-Four" konseptine uygun olarak milling ve enjeksiyon yöntemleriyle hazırlanan PEEK altyapıların mekanik ve stres analizleri arasında fark olup olmadığının karşılaştırılmalı olarak incelenmesidir. Yöntem: Mekanik dayanım testi ve sonlu elemanlar analiziyle PEEK materyalinin farklı üretim teknikleri karşılaştırılmıştır. Dört nokta eğme testi uygulanan materyaller için 3mmx4mmx45mm (ISO14704:2016) boyutunda prizmatik örnekler üretilmiştir. %95 güven aralığında güç analizine göre her gruptaki örnek sayısı 22 olarak belirlenmiştir. Milling ve enjeksiyon yöntemleri kullanılarak PEEK örnekler üretilmiştir. Kontrol grubu olarak CAD-CAM ile hazırlanan titanyum örnekler kullanılmıştır. Tüm örneklere 5°C/55°C'lik 5.000 termal döngü ile yaşlandırma (ISO/TS11405:2003) uygulanmıştır. Stres analizi için "Sonlu Eleman Analizi" yöntemi kullanılarak alt çene modellemesi oluşturulmuştur. Alt çene modelinde "All-on-Four" konseptine uygun olarak ön bölgeye paralel 2, arka bölgeye açılı 2 implant yerleştirilmiştir. İmplant yerleşimine uygun olarak hazırlanan hibrid protez altyapı tasarımı her 3 grup için oluşturulmuştur. PEEK materyalinin farklı üretim tekniklerine ait fiziksel ve mekanik özellikleri literatürde belirtilmediğinden bu özellikleri belirleyip Sonlu Elemanlar analizine veri girişinde kullanabilmek amacıyla iki üretim tekniği için Çekme Testi uygulanmıştır (ISO527-2:1996). İki üretim tekniği için 8 örnek hazırlanmıştır. Mekanik testlerden elde edilen bulgular sonlu elemanlar analizi veri girişinde kullanılıp, istatistiksel olarak değerlendirilmiştir (SPSS 25, IBM, Amerika). Sonlu elemanlar analiziyle; vertikal ve oblik yönlerde bilateral 150 N kuvvet uygulanmıştır. Kemikte oluşan streslerin değerlendirilmesi için maksimum ve minimum principal stresler, implant ve protetik bileşenler için von Mises stres değerleri her grup için ayrı olarak ölçülmüştür. Bulgular: Dört nokta eğme testinden elde edilen verilere göre maksimum kuvvet, maksimum kuvvetteki deplasman, maksimum eğilme gerinimi, maksimum eğilme gerilimi, elastisite modülü, eğilme sertliği, maksimum kuvvetteki gerinim enerjisi ortalama ve standart sapma değerleri için sırasıyla enjeksiyon PEEK 423,39±79,85, 6,73±0,87, 0,05±0,007, 352,83±66,54, 3116,76±653,62, 28050,9±5882,62, 4,53±1,4, milling PEEK 488,632±70,57, 5,78±1,01, 0,04±0,008, 407,19±58,81, 4584,39±933,48, 41259,55±8401,34, 4,66±1,19 ve milling titanyum 2650,28±349,12, 8,54±1,44, 06±0,01, 2208,57±290,94, 126999,3±17484,86, 1142993,74±157363,75, 19,3±2,62 olarak ölçülmüştür. Elastistisite modülü ve eğilme sertliği kriterlerinde enjeksiyon ve milling PEEK grupları arasında istatistiksel olarak anlamlı fark vardır (p<0,05). Diğer kriterlerde Enjeksiyon ve milling PEEK grupları arasında istatistiksel olarak anlamlı fark yoktur (p>0,05). Tüm kriterlerde titanyum grubuyla enjeksiyon ve milling PEEK grupları arasında istatistiksel olarak anlamlı fark vardır (p<0,05). Çekme testinde değerlendirilen kriterler arasında istatistiksel olarak anlamlı fark yoktur (p>0,05). Sonlu eleman analizi bulguları değerlendirildiğinde vertikal yüklemede stres değerleri kemik, implant, abutment, protetik vidalarda enjeksiyon PEEK > milling PEEK > milling titanyum şeklinde sıralanırken altyapılarda milling titanyum > milling PEEK > enjeksiyon PEEK şeklinde sıralanmıştır. Oblik yüklemede stres değerleri kemik, implant, abutment, protetik vidalar ve altyapılarda enjeksiyon PEEK > milling PEEK > milling titanyum şeklinde sıralanmıştır. Sonuç: Enjeksiyon PEEK örnekler daha esnek davranış göstermiştir ve elastisite modülü daha düşüktür. Vertikal yüklemede altyapının elastisite modülünün düşmesi altyapı içerisindeki stresleri azaltırken, peri-implant kemik, implantlar, abutmentlar ve protetik vidalardaki stresi artırmıştır.Oblik yüklemede altyapının elastisite modülünün düşmesi tüm yapılarda stresi artırmıştır.Vertikal ve oblik yüklemede enjeksiyon ve milling PEEK altyapılar sınır akma dayanımlarını aşmıştır. All-on-Four protezler tasarlanırken titanyum gibi rijit altyapıların kullanılması ile gelen kuvvetler protezi destekleyen implantlara daha iyi dağıtılabilir
Purpose: To comparatively examine whether there is a difference between the mechanical and stress analyzes of PEEK frameworks prepared by milling and injection methods in accordance with the "All-on-Four" concept on the mandible model. Method: Different production techniques of PEEK material were compared by mechanical strength test and finite element analysis. Prismatic samples of 3mmx4mmx45mm (ISO14704:2016) size were produced for the materials that were subjected to the four-point bending test. The number of samples in each group was determined as 22 according to the power analysis at the 95% confidence interval. PEEK samples were produced using milling and injection methods. Titanium samples prepared with CAD-CAM were used as control group. All samples were aged with 5,000 thermal cycles of 5°C/55°C (ISO/TS11405:2003). For stress analysis, mandible modeling was created using the "Finite Element Analysis" method. In the lower jaw model, 2 implants were placed parallel to the anterior region and 2 angled implants were placed in the posterior region in accordance with the "All-on-Four" concept. The hybrid prosthesis framework design prepared in accordance with the implant placement was created for all 3 groups. Since the physical and mechanical properties of PEEK material for different production techniques are not specified in the literature, Tensile Test (ISO527-2:1996) was applied for two production techniques to determine these properties and use them in data entry into Finite Element analysis. Eight samples were prepared for the two production techniques. Findings from mechanical tests were used in finite element analysis data entry and statistically evaluated (SPSS 25, IBM, USA). With finite element analysis; A force of 150 N was applied bilaterally in the vertical and oblique directions. Maximum and minimum principal stresses were measured to evaluate the stresses in the bone, von Mises stress values for implant and prosthetic components were measured separately for each group. Results: According to the data obtained from the four-point bending test, for maximum force, displacement at maximum force, maximum bending strain, maximum bending stress, modulus of elasticity, flexural stiffness, strain energy at maximum force mean and standard deviation values respectively measured as; Injection PEEK 423.39±79.85, 6.73±0.87, 0.05±0.007, 352.83±66.54, 3116.76±653.62, 28050.9±5882.62, 4.53±1.4, milling PEEK 488.632±70.57, 5.78±1.01, 0.04±0.008, 407.19±58.81, 4584.39±933.48, 41259.55±8401.34, 4.66±1.19 and milling titanium 2650.28±349.12, 8.54±1.44, 06±0.01, 2208.57±290.94, 126999.3±17484.86, 1142993.74±157363.75 , 19.3±2.62. There was a statistically significant difference between injection and milling PEEK groups in terms of modulus of elasticity and bending stiffness (p<0.05). There was no statistically significant difference between the injection and milling PEEK groups in other criteria (p>0.05). There was a statistically significant difference between the titanium group and the injection and milling PEEK groups in all criteria (p<0.05). There was no statistically significant difference between the criteria evaluated in the tensile test (p>0.05). When the finite element analysis findings were evaluated, the stress values in vertical loading were listed as injection PEEK > milling PEEK > milling titanium in bone, implant, abutment and prosthetic screws while milling titanium > milling PEEK > injection PEEK in frameworks. The stress values in oblique loading are listed as injection PEEK > milling PEEK > milling titanium in bone, implant, abutment, prosthetic screws and frameworks. Conclusion: Injection PEEK specimens showed more flexible behavior and had a lower modulus of elasticity. While the decrease in the elasticity module of the framework in vertical loading decreased the stresses in the framework, it increased the stress in the peri-implant bone, implants, abutments and prosthetic screws. The decrease in the elasticity module of the framework in oblique loading increased the stress in all structures. Injection and milling in the vertical and oblique loading PEEK frameworks exceeded the limit yield strengths. When designing All-on-Four prostheses, the forces that come with the use of rigid frameworks such as titanium can be better distributed to the implants supporting the prosthesis.
Purpose: To comparatively examine whether there is a difference between the mechanical and stress analyzes of PEEK frameworks prepared by milling and injection methods in accordance with the "All-on-Four" concept on the mandible model. Method: Different production techniques of PEEK material were compared by mechanical strength test and finite element analysis. Prismatic samples of 3mmx4mmx45mm (ISO14704:2016) size were produced for the materials that were subjected to the four-point bending test. The number of samples in each group was determined as 22 according to the power analysis at the 95% confidence interval. PEEK samples were produced using milling and injection methods. Titanium samples prepared with CAD-CAM were used as control group. All samples were aged with 5,000 thermal cycles of 5°C/55°C (ISO/TS11405:2003). For stress analysis, mandible modeling was created using the "Finite Element Analysis" method. In the lower jaw model, 2 implants were placed parallel to the anterior region and 2 angled implants were placed in the posterior region in accordance with the "All-on-Four" concept. The hybrid prosthesis framework design prepared in accordance with the implant placement was created for all 3 groups. Since the physical and mechanical properties of PEEK material for different production techniques are not specified in the literature, Tensile Test (ISO527-2:1996) was applied for two production techniques to determine these properties and use them in data entry into Finite Element analysis. Eight samples were prepared for the two production techniques. Findings from mechanical tests were used in finite element analysis data entry and statistically evaluated (SPSS 25, IBM, USA). With finite element analysis; A force of 150 N was applied bilaterally in the vertical and oblique directions. Maximum and minimum principal stresses were measured to evaluate the stresses in the bone, von Mises stress values for implant and prosthetic components were measured separately for each group. Results: According to the data obtained from the four-point bending test, for maximum force, displacement at maximum force, maximum bending strain, maximum bending stress, modulus of elasticity, flexural stiffness, strain energy at maximum force mean and standard deviation values respectively measured as; Injection PEEK 423.39±79.85, 6.73±0.87, 0.05±0.007, 352.83±66.54, 3116.76±653.62, 28050.9±5882.62, 4.53±1.4, milling PEEK 488.632±70.57, 5.78±1.01, 0.04±0.008, 407.19±58.81, 4584.39±933.48, 41259.55±8401.34, 4.66±1.19 and milling titanium 2650.28±349.12, 8.54±1.44, 06±0.01, 2208.57±290.94, 126999.3±17484.86, 1142993.74±157363.75 , 19.3±2.62. There was a statistically significant difference between injection and milling PEEK groups in terms of modulus of elasticity and bending stiffness (p<0.05). There was no statistically significant difference between the injection and milling PEEK groups in other criteria (p>0.05). There was a statistically significant difference between the titanium group and the injection and milling PEEK groups in all criteria (p<0.05). There was no statistically significant difference between the criteria evaluated in the tensile test (p>0.05). When the finite element analysis findings were evaluated, the stress values in vertical loading were listed as injection PEEK > milling PEEK > milling titanium in bone, implant, abutment and prosthetic screws while milling titanium > milling PEEK > injection PEEK in frameworks. The stress values in oblique loading are listed as injection PEEK > milling PEEK > milling titanium in bone, implant, abutment, prosthetic screws and frameworks. Conclusion: Injection PEEK specimens showed more flexible behavior and had a lower modulus of elasticity. While the decrease in the elasticity module of the framework in vertical loading decreased the stresses in the framework, it increased the stress in the peri-implant bone, implants, abutments and prosthetic screws. The decrease in the elasticity module of the framework in oblique loading increased the stress in all structures. Injection and milling in the vertical and oblique loading PEEK frameworks exceeded the limit yield strengths. When designing All-on-Four prostheses, the forces that come with the use of rigid frameworks such as titanium can be better distributed to the implants supporting the prosthesis.
Açıklama
18.04.2023 tarihine kadar kullanımı yazar tarafından kısıtlanmıştır
Anahtar Kelimeler
Diş Hekimliği, Dentistry
