【作者】 张爱玲；

【导师】 樊瑜波；

【作者基本信息】 四川大学 ， 固体力学， 2006， 硕士

【摘要】 牙列末端游离缺损，特别是多个后牙的缺失修复，在口腔修复界一直是个难题。由于精密附着体义齿的固位力、稳定性、审美性好，异物性小等特点，在牙列缺损修复中，是一种较为理想的修复方式。而在治疗过程中，基牙的选择对该修复方法的治疗效果有很重要的影响。目前基牙数目的选择及牙周吸收的底线一直是个有争议的问题。盲目追求多基牙，需磨除更多的牙体组织，对活髓牙可能带来牙髓激惹问题和费用增加等问题。因此，探索最佳的治疗方法对临床治疗具有一定的指导意义。 精密附着体修复后，基牙及其牙周组织的应力大小及分布可以反映修复情况。研究基牙牙周组织的应力大小和分布情况，对于合理的选择基牙有重要意义。本文首先建立了包括下颌骨和切牙、尖牙、前磨牙的双侧游离末端牙列缺失的三维有限元模型，在此基础上建立了基牙牙周组织完好和基牙牙周组织吸收的不同基牙数目的三维有限元模型。将义齿基托与缺牙区牙槽骨考虑成接触，利用ANSYS软件，对以上模型进行有限元分析。具体而言，本文包括以下三部分论文：1．分析精密附着体修复后对基牙及其牙周组织会产生何种影响。结果表明精密附着体修复后，基牙及基牙根周牙槽骨的von Mises应力值较修复前无论舌侧、颊侧都有了明显增加，应力集中范围增大；牙列缺失部位的应力值也有所增加。2．比较不同基牙数目时，基牙及其牙周组织的应力分布。结果表明，双基牙较单基牙修复远中基牙牙周组织及基托下牙槽骨应力值减小。三基牙较双基牙修复，远中基牙牙周膜应力增加，牙槽骨及基托下牙槽骨应力值减小，但变化不明显。综合考虑本文认为：在牙周组织健全的条件下，双基牙修复比较理想，应尽量避免三基牙。3．分析牙周组织吸收时基牙及其牙周组织的应力。结果表明，如果两颗基牙的牙周组织吸均超过1／3，双基牙修复会使远中基牙牙更多还原

【Abstract】 The distal-extension edentulous dentition, especially used to repaire more than one back-tooth, has long been a difficulty in the field of stomatological repairing. As the removable partial denture with the precision attachment has the advantages of having great retention, high stabilities and better looking with little foreign effects, it is a comparatively ideal. In the course of treating, the choice of the abutment has great influence on the therapeutic effect of repairing method. These are still disputable on the choice and number of abutments and the bottom line of the periodontal absorbability. Pursuing the way of using more abutments blindly, more tooth tissue must be abraded away, which may cause gum imitations to the living marrow tooth and also increases expense. So, explore the best therapeutic method has guiding significance onto the clinical practice. After the repairing of precision attachment, studies on the pressures and its distribution on the abutments and periodontal tissues could reveal the state of repairing. Also, the pressures and its distribution on the abutments and periodontal tissues have great significance on the sound choice of abutments.A 3D finite element model of bilateral distal-extension edentulous dentition, which includes mandible, incisors, canines, premolars is set up in this thesis. Based on this, a 3D finite element model on the periodontal tissues’ intactness and absorbability of different numbers of abutments is also set up. Then, presuming that the denture and edentulous alveolar bone are in contact, using the software ANSYS, analyses on those models are done. To be detailed, there are three chapters: 1. What influences the precision attachment repairing has on abutment and periodontal tissues更多还原