Alt çene tam dişsizlik olgularında implant üstüne farklı tekniklerle uygulanan bar tutuculu overdenture tasarımlarındaki kuvvet dağılımının sayısal yöntemlerle değerlendirilmesi
Küçük Resim Yok
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızda alt çene implant üstü Hader bar tutuculu overdenture protezlerde farklı üretim teknikleri ve farklı materyaller kullanımının gerilme dağılımları üzerine etkisinin incelenmesi amaçlanmıştır. Alt çene kanin dişler bölgesine kemik seviyesinde yerleştirilen 2 implant (3,3 mm×12mm) ve Hader bar alt yapılı üç boyutlu geometrik katı model hazırlanmıştır. Geometrik katı test modelleri üç farklı bar tutucu sistemi şekilde elde edilmiştir. Model 1 ara parça kullanılmadan CNC milling yöntemiyle Ti Grade 5 materyalden, Model 2 ara parça kullanılarak Ti Grade 5 materyalden ve Model 3 ara parça kullanılarak geleneksel döküm yöntemiyle Co-Cr materyalden hazırlanan bar tutucu sistemini simüle etmektedir. Hazırlanan test modellerine 100 N ve 300 N büyüklüğünde horizontal, vertikal ve oblik yönlerde statik kuvvet uygulanmıştır. Von Mises gerilme dağılımları, minimum/maksimum asal gerilme değerlerini karşılaştırmak amacıyla ANSYS R15.0 Workbench programı kullanılmış ve sonlu elemanlar analiz yöntemi ile değerlendirilmiştir. Ayrıca, in vitro çalışmamızı desteklemek amacıyla tam dişsiz 6 hastanın 3 farklı ader bar tutucu sisteminin kullanıldığı alt çene implant üstü overdenture protezlerle tedavisi yapılmıştır. Çalışmanın sonucunda, üç farklı yönde yapılan yüklemelerde en yüksek gerilme değerleri Model 1' de gözlenmiştir. Bütün modellerde en yüksek gerilme değerlerine horizontal yükleme sonucunda rastlanılmıştır. Üç modelde de gerilmeler implantın boyun bölgesinde ve çevre kortikal kemikte yoğunlaşmıştır. Elde edilen sonuçlar doğrultusunda, ara parça kullanımının kuvvetin implant ve kemik dokuya iletimini azalttığı ve bu sayede iyi bir gerilim dağılımı sağladığı düşünülmektedir. Ayrıca, ara parça kullanılan modellerde malzeme türünün gerilme değerleri üzerinde önemli bir etkisi olmadığı tespit edilmiştir. Klinik uygulamalarda 1 yıllık periyotta yapılan kontroller sonucunda implant ve protezlerin stabilitesi ve hasta memnuniyeti açısından tatminkar sonuçlar elde edilmiştir
The purpose of this study was to evaluate effects of various fabrication techniques and materials used in implant-supported mandibular overdentures with Hader bar attachment over stress distribution. Three dimensional geometric solid models, consisting of 2 implants (3,3mm×12mm) placed at the bone level on both mandibular canine regions, supporting a Hader bar structure were prepared. Each geometric solid model was designed to represent three different bar retentive systems. Model 1 simulated a bar retentive system made from Ti Grade 5 material by CNC milling technique without using any converting adapter or multi-unit element on implants, while Model 2 simulated the same configuration, but with converting adapters on implants. Model 3 simulated a bar retentive system made from Co-Cr material, made by using conventional casting technique with converting adapters on implants. Static loads of 100 N and 300 N were applied on test models from horizontal, vertical and oblique directions. ANSYS R15.0 Workbench software was used to compare Von Mises stress distribution and minimum/maximum principal stress values, and results were evaluated by using finite element analysis method. Additionally, rehabilitation of a total of 6 edentulous patients with implant-supported manibular overdentures using three different bar retentive systems were applied in order to provide support for this in vitro study. As a result of this study, the highest stress distribution values under static loading in three different directions were obtained in Model 1. The highest stress values in all models were observed during horizontal loading. Stress were observed to intensify around neck of implants and surrounding cortical bone areas in all models. In scope of the results obtained, using converting adapters on implants has been considered to decrease transmission of forces onto implants and surrounding bone structures, thus providing a better stress distribution. It has also been observed that, type of material used for bar fabrication has no significant influence over stress values in those models where converting adapters were used. Regarding clinical applications, convincing results were obtained in terms of implants and denture stability, as well as patient satisfaction, when follow-up controls over a period of one year have been taken into consideration.
The purpose of this study was to evaluate effects of various fabrication techniques and materials used in implant-supported mandibular overdentures with Hader bar attachment over stress distribution. Three dimensional geometric solid models, consisting of 2 implants (3,3mm×12mm) placed at the bone level on both mandibular canine regions, supporting a Hader bar structure were prepared. Each geometric solid model was designed to represent three different bar retentive systems. Model 1 simulated a bar retentive system made from Ti Grade 5 material by CNC milling technique without using any converting adapter or multi-unit element on implants, while Model 2 simulated the same configuration, but with converting adapters on implants. Model 3 simulated a bar retentive system made from Co-Cr material, made by using conventional casting technique with converting adapters on implants. Static loads of 100 N and 300 N were applied on test models from horizontal, vertical and oblique directions. ANSYS R15.0 Workbench software was used to compare Von Mises stress distribution and minimum/maximum principal stress values, and results were evaluated by using finite element analysis method. Additionally, rehabilitation of a total of 6 edentulous patients with implant-supported manibular overdentures using three different bar retentive systems were applied in order to provide support for this in vitro study. As a result of this study, the highest stress distribution values under static loading in three different directions were obtained in Model 1. The highest stress values in all models were observed during horizontal loading. Stress were observed to intensify around neck of implants and surrounding cortical bone areas in all models. In scope of the results obtained, using converting adapters on implants has been considered to decrease transmission of forces onto implants and surrounding bone structures, thus providing a better stress distribution. It has also been observed that, type of material used for bar fabrication has no significant influence over stress values in those models where converting adapters were used. Regarding clinical applications, convincing results were obtained in terms of implants and denture stability, as well as patient satisfaction, when follow-up controls over a period of one year have been taken into consideration.
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry
