本文選題：種植體設(shè)計(jì) + 三維有限元分析��； 參考：《華南理工大學(xué)》2014年博士論文

【摘要】：牙種植體的生物力學(xué)相容性和組織相容性是實(shí)現(xiàn)義齒種植成功和長(zhǎng)期穩(wěn)定性的基礎(chǔ)。因此，牙種植體的設(shè)計(jì)過程中不僅要根據(jù)載荷條件選擇材料學(xué)性能和加工性能適配的材料，設(shè)計(jì)種植體及其基臺(tái)的形狀、長(zhǎng)度、直徑和連接方式等，同時(shí)還需要系統(tǒng)研究牙種植體表面仿生結(jié)構(gòu)的構(gòu)建及其與細(xì)胞之間的相互作用機(jī)制。本研究通過表面改性技術(shù)構(gòu)建結(jié)構(gòu)合理、力學(xué)性能優(yōu)良、具有模擬骨細(xì)胞外基質(zhì)骨架的表面微納米拓?fù)浣Y(jié)構(gòu)和骨整合性能優(yōu)異的鈣磷涂層鈦基牙種植體。通過體外仿生礦化實(shí)驗(yàn)、蛋白吸附和動(dòng)物體內(nèi)植入實(shí)驗(yàn)系統(tǒng)研究經(jīng)不同表面處理的種植體的體內(nèi)、外成骨性能，在此基礎(chǔ)上對(duì)等離子噴涂鈣磷涂層牙種植體進(jìn)行前瞻性臨床實(shí)驗(yàn)研究，為設(shè)計(jì)和制備滿足臨床應(yīng)用需求的長(zhǎng)期穩(wěn)定的新型表面改性鈦合金牙種植體提供參考。 根據(jù)機(jī)械力學(xué)、生物力學(xué)原理，結(jié)合中國(guó)人牙及頜骨的解剖特點(diǎn)，設(shè)計(jì)出面向臨床應(yīng)用的牙種植體系統(tǒng)。該牙種植體系統(tǒng)具有圓柱和螺紋兩種形態(tài)，5種直徑和5種長(zhǎng)度規(guī)格，基臺(tái)和種植體連接采用7莫氏錐度，360度旋轉(zhuǎn)定位和平臺(tái)轉(zhuǎn)移結(jié)構(gòu)�；_(tái)4、5、6、7及8錐度內(nèi)連接在35N·cm的預(yù)載力作用下,基臺(tái)與種植體之間存在冷焊現(xiàn)象，表現(xiàn)為脫位力矩大于預(yù)載力矩5%-10%，且各錐度之間無(wú)明顯差異，而超過40N·cm的力矩，將破壞界面的冷焊結(jié)合。三維有限元分析發(fā)現(xiàn)，4-8不同錐度連接的基臺(tái)在垂直和水平加載的情況下，應(yīng)力分布相似，應(yīng)力集中區(qū)均在種植體和基臺(tái)連接的頸部，且隨錐度的增大，應(yīng)力值呈線性減小。水平向加載的應(yīng)力及應(yīng)變位移均明顯高于垂直加載，說(shuō)明水平向的載荷更易對(duì)種植體結(jié)構(gòu)產(chǎn)生破壞作用；0、15和45肩臺(tái)斜面設(shè)計(jì)的種植體連接7錐度的基臺(tái)，在垂直加載和水平加載情況下，它們之間應(yīng)力分布在種植體結(jié)構(gòu)間及與周圍頜骨之間差異不大。特別的是水平加載時(shí)皮質(zhì)骨最大應(yīng)力值與垂直加載之間無(wú)明顯差異，而松質(zhì)骨內(nèi)的應(yīng)力與垂直加載相比雖有約1.5倍的增大，但位置明顯移至種植體的根部，表明平臺(tái)轉(zhuǎn)移可有效地減少種植體頸部周圍骨的應(yīng)力集中，從而減少種植體周圍骨的吸收，利于種植修復(fù)的長(zhǎng)期成功。 采用噴砂-酸蝕處理技術(shù)對(duì)鈦基種植體表面進(jìn)行處理，系統(tǒng)研究了酸的種類以及酸蝕時(shí)間對(duì)于表面微納米粗糙度、表面親疏水性、表面成分等的影響規(guī)律。通過控制酸蝕時(shí)間和酸的種類實(shí)現(xiàn)了表面微納米拓?fù)浣Y(jié)構(gòu)的調(diào)控，其中在HCl/H2SO4混合溶液中酸蝕處理的鈦基種植體樣品表面形成了具有多級(jí)尺度的拓?fù)浣Y(jié)構(gòu)，即由1～2μm的小孔組成的直徑10～20μm的腐蝕坑。這種表面微納米拓?fù)浣Y(jié)構(gòu)是晶界腐蝕與點(diǎn)蝕共同作用的結(jié)果。通過噴砂-酸蝕構(gòu)建的仿生多級(jí)拓?fù)浣Y(jié)構(gòu)可模擬細(xì)胞外基質(zhì)的物理信號(hào)刺激，促進(jìn)粘附、增殖、分化等細(xì)胞行為，有利于加速骨整合過程。 種植體的骨整合性能對(duì)其初期穩(wěn)定非常重要，本研究采用等離子噴涂技術(shù)在鈦基種植體表面構(gòu)建鈣磷生物活性涂層。系統(tǒng)研究了包括噴涂功率、粉體粒徑以及噴涂距離對(duì)涂層致密度、涂層表面形貌以及涂層中的物相組成的影響規(guī)律。結(jié)果表明：在噴涂功率30kW、噴涂距離110mm、HA粉末粒度為20～50μm時(shí)所制備的表面涂層致密度高、性能優(yōu)異。從熱力學(xué)上系統(tǒng)分析了等離子噴涂過程中可能出現(xiàn)的鈣磷鹽物相轉(zhuǎn)變過程。將噴砂-酸蝕處理樣品和等離子噴涂鈣磷涂層樣品浸入模擬體液6天后，均可見表面有磷灰石層沉積，利用掃描電鏡、X射線衍射、紅外光譜和能譜對(duì)表面沉積物進(jìn)行分析表明，噴砂-酸蝕鈦種植體樣品表面生成的是非晶態(tài)絨球狀磷酸鈣，而等離子噴涂種植體樣品表面在短時(shí)間內(nèi)沉積出較厚、結(jié)晶度較高的磷灰石層。此外，蛋白吸附的定性和定量分析結(jié)果表明噴砂-酸蝕以及等離子噴涂鈣磷涂層樣品表面可以顯著促進(jìn)蛋白的吸附。 對(duì)經(jīng)兩種表面處理的鈦基種植體進(jìn)行了兔腿骨內(nèi)種植實(shí)驗(yàn)。結(jié)果表明，兩種種植體都可以與骨組織發(fā)生緊密的骨性結(jié)合，顯著提高種植體與骨組織之間的結(jié)合力，促進(jìn)骨組織的形成。在此基礎(chǔ)上臨床實(shí)驗(yàn)研究表明，72個(gè)病例均無(wú)肝腎功能改變及并發(fā)癥的發(fā)生，共計(jì)植入117顆種植體3年臨床實(shí)驗(yàn)期間種植體生存率達(dá)99.2%，一期術(shù)后及二期手術(shù)檢查種植體周垂直骨喪失平均為0.07mm，，修復(fù)后1-3年全景X光片測(cè)量骨吸收平均值為0.14mm，種植體周圍指數(shù)及牙齦指數(shù)無(wú)明顯變化，表明種植體周圍軟組織健康穩(wěn)定。臨床研究表明生物功能牙種植體能與牙槽骨形成良好的骨整合，種植系統(tǒng)的結(jié)構(gòu)設(shè)計(jì)和表面構(gòu)建有利于減少種植體周骨組織的吸收，并保持種植體周軟組織的健康和軟組織的量。 本論文闡述了牙種植體發(fā)展應(yīng)用現(xiàn)狀，對(duì)種植體的臨床應(yīng)用和長(zhǎng)期成功的關(guān)鍵因素種植體表面生物功能構(gòu)建和結(jié)構(gòu)形態(tài)設(shè)計(jì)進(jìn)行了系統(tǒng)研究，經(jīng)多年研發(fā)、動(dòng)物實(shí)驗(yàn)和臨床試驗(yàn)證明生物功能牙種植體的安全性和有效性。
[Abstract]:The biomechanical compatibility and histocompatibility of dental implants are the basis for the success and long-term stability of denture implant. Therefore, the design process of dental implants is not only to choose material of material properties and processing properties according to the load conditions, but also to design the shape, length, diameter and connection mode of the implant and its base. The construction of biomimetic structure on the surface of dental implants and the interaction mechanism between the dental implants and the cells are also needed to be studied systematically. The surface modification technology is used to construct a reasonable structure with excellent mechanical properties. The surface micro and nano topology with the skeleton of the bone extracellular matrix and the implantation of calcium and phosphorus coated titanium abutments with excellent bone integration properties are cultivated. Through in vitro biomimetic mineralization experiments, protein adsorption and animal body implantation experimental system to study the internal and external osteogenesis of different surface treated implants, the plasma sprayed calcium phosphorus coated dental implant was prospectively studied in order to design and prepare a long-term stable new clinical application. The reference is provided for the dental implants of type surface modified titanium alloy.
According to the mechanical mechanics and biomechanics principle, combined with the anatomical characteristics of the Chinese tooth and jaw, the dental implant system is designed to be applied to the clinic. The dental implant system has two forms of cylinder and thread, 5 diameters and 5 length specifications, 7 moth taper, 360 degree rotation positioning and platform transfer structure connecting the base and the implant. There is a cold welding phenomenon between the base platform and the implant under the preloading force of the base platform 4,5,6,7 and the 8 taper under the preloading force of 35N cm. It shows that the dislocation moment is greater than the preload torque 5%-10%, and there is no obvious difference between the taper degrees, and the cold welding of the interface is combined with the moment of 40N. Cm. The three dimensional finite element analysis found that the base of 4-8 different taper connection bases is found. In the case of vertical and horizontal loading, the stress distribution is similar, the stress concentration area is both in the neck of the implant and the base platform, and with the increase of the taper, the stress value decreases linearly. The stress and strain displacement of horizontal loading are obviously higher than that of the vertical loading, which indicates that the horizontal load is more vulnerable to the damage of the implant structure; 0, The 15 and 45 shoulder slope surfaces were designed to connect the base of the 7 taper. Under vertical loading and horizontal loading, the stress distribution between the implant structures and the surrounding jaws was not significant. Although the vertical loading is about 1.5 times larger, the position is obviously moved to the root of the implant. It shows that the platform transfer can effectively reduce the stress concentration around the bone around the neck of the implant, thus reducing the absorption of the bone around the implant, and is beneficial to the long-term success of the implant.
The surface of titanium based implant was treated with sand blasting and acid etching treatment. The effects of acid species and etching time on surface micro and nano roughness, surface hydrophobicity and surface composition were studied. The surface micro and nano topology was controlled by controlling the etching time and the type of acid, in which HCl/H2SO4 The surface of the titanium base implants treated with acid etching in the mixed solution formed a multi-scale topology, that is, a corrosion pit with a diameter of 10~20 micron, consisting of a small hole of 1~2 mu m. This surface micro and nano topology is the result of the interaction of grain boundary corrosion and pitting. The physical signal stimulation of extracellular matrix promotes cell adhesion, proliferation, differentiation and other cell behaviors, and accelerates the osseointegration process.
The bone integration performance of the implant is very important for its initial stability. In this study, the plasma spraying technology was used to construct calcium and phosphorus bioactive coating on the surface of titanium implants. The effects of spraying power, particle size and spray distance on the density of the coating, the surface appearance of the coating and the composition of the phase in the coating were systematically studied. The results show that the surface coating produced by spraying power 30kW, spraying distance 110mm and HA powder size of 20~50 u m has high density and excellent performance. The phase transition process of calcium phosphorus salts may appear in the process of plasma spraying. After 6 days of simulated body fluid, apatite layer was deposited on the surface, and the surface sediments were analyzed by scanning electron microscope (SEM), X ray diffraction, infrared spectrum and energy spectrum. The results showed that the surface of the sample surface of the sanding and acid etching titanium implant was amorphous calcium phosphate, and the surface of the plasma sprayed implant sample deposited in a short time. In addition, the qualitative and quantitative analysis results of protein adsorption show that the surface of sand and acid erosion and the surface of plasma sprayed calcium and phosphorus coating can significantly promote the adsorption of protein.
Two kinds of surface treated titanium implants were planted in the rabbit's leg bone planting experiment. The results showed that the two implants could combine bone tissue closely with bone tissue, significantly increase the binding force between the implant and bone tissue, and promote the formation of bone tissue. On this basis, the experimental study showed that both of the 72 cases had no liver and kidney function. The survival rate of the implant was 99.2% during the 3 year clinical trial of 117 implants. The average of the periimplant bone loss was 0.07mm after the first stage and two stage operation. The average bone absorption of the panoramic X ray after 1-3 year restoration was 0.14mm, the periimplant index and gingival index were not changed obviously. The soft tissue around the implants is healthy and stable. The clinical study shows that the biofunctional dental implant can form a good bone integration with the alveolar bone. The structural design and surface construction of the implant system are beneficial to reduce the absorption of the periimplant bone tissue and maintain the healthy and soft tissue of the soft tissue of the implant.
This paper describes the development and application status of dental implants. The clinical application of implant and the key factors for long-term success are studied systematically. After years of research and development, animal experiments and clinical trials have proved the safety and effectiveness of biological functional dental implant.
【學(xué)位授予單位】：華南理工大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2014
【分類號(hào)】：R783.6

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