Gökçe SOĞANCI ÜNSAL, Güzin Neda HASANOĞLU ERBAŞAR

DİŞSİZ REZORBE MANDİBULAYA FARKLI İMPLANTLARLA YAPILAN OVERDENTURE PROTEZLERDE GERİLME ANALİZİNİN DEĞERLENDİRİLMESİ: SONLU ELEMANLAR ANALİZİ ÇALIŞMASI

AMAÇ: Bu çalışmanın amacı rezorbe mandibular kretlerde greft uygulanarak ve uygulanmadan yerleştirilen farklı boyutlardaki implantlarla desteklenmiş overdenture protezlerin biyomekanik olarak değerlendirilmesidir. GEREÇ ve YÖNTEM: Rezorbe mandibulayı taklit etmek amacıyla 2 tane 3 boyutlu mandibular model Tip II kemik özelliklerine göre oluşturuldu. 3.3×11.5 mm (dar çaplı implant) ve 2.5×13 mm (mini dental implant) olan osseointegre implantlar 3 boyutlu tarayıcı yardımıyla tarandı ve modellendi. İki adet dar çaplı implant kaninler bölgesine dik olacak şekilde yerleştirilerek Model 1 elde edildi, Dört adet mini dental implant ise ikisi lateral kesiciler bölgesine dik olarak diğer ikisi ise 1.premolar bölgesine 30° açıyla yerleştirilerek Model 2 oluşturuldu. Her bir model için overdenture tasarlandı. Vertikal olarak 150 N oklüzal kuvvet tek (soldan) ve çift taraflı olacak şekilde protezin 1.molar dişi üzerinden uygulandı ve veriler elde edildi. BULGULAR: İmplantlarda oluşan von Mises değerleri ve kortikal kemikte implant boynu etrafında meydana gelen asal gerilme sonuçları ve gerilme haritaları değerlendirildi. En yüksek von Mises değeri tek taraflı yüklemede Model 1’de yüklenen taraftaki implant çevresinde 33,64 MPa olarak belirlendi. Kortikal kemikteki maksimum asal gerilme için en yüksek değer tek taraflı yüklemede Model 2’de sol lateral kesici bölgesindeki implant çevresinde 7,75 MPa olarak bulundu. Minimum asal gerilme değeri Model 1’de tek taraflı yüklemede soldaki implantın çevresinde 6,2 MPa belirlendi. SONUÇ: Rezorbe dişsiz mandibular kretlerde greft uygulanarak yapılacak olan 2 dar çaplı implant destekli overdenture yerine greft uygulanmadan yapılacak 4 mini dental implant destekli overdenture seçeneği biyomekanik açıdan avantajlı olabilir. Bilateral dengeli oklüzyon oluşturulması da gelen kuvvet dağılımı açısından iyi bir seçenek olarak düşünülmektedir. Anahtar Kelimeler: rezorbe mandibula, dental implant, greft, sonlu elemanlar analizi STRESS EVALUATION OF OVERDENTURES SUPPORTED BY DIFFERENT IMPLANTS IN RESORBED MANDIBLE: A FEA ANALYSIS ABSTRACT AIM: The aim of this study was to compare the biomechanical behavior of overdentures retained with different implant dimensions with or without using graft in a resorbed mandible. MATERIALS and METHOD: To simulate the resorbed mandible two 3 dimensional models were created according to the Type II bone properties. 3.3×11.5 mm (narrow diameter implant) ve 2.5×13 mm (mini dental implant) implants were scanned using 3 dimensional scanner and modelled. Model 1 was created as the two narrow diameter implants were placed vertically in the canine area, 4 mini dental implants were placed as two of them in lateral incisor area vertically and the rest two implants were placed in 1.premolar region with 30° inclination to create Model 2. Overdentures were designed for each model. 150 N vertical occlusal force were applied from 1.molar tooth of overdenture, unilaterally and bilaterally and data were obtained. RESULTS: Von Mises stresses on implants and principal stresses on cortical bone around implant necks and stress patterns of models were evaluated. The highest value of von Mises stress was in the implant on the loaded side under unilateral loading in Model 1 as 33.64 MPa. Maximum principal stresses was the highest in Model 2 around cortical bone in left lateral incisor area under unilateral loading and found as 7.75 MPa. The highest value of minimum principal stress was determined 6.2 MPa around cortical bone in the left implant area under unilateral loading. CONCLUSION: In a resorbed mandible 4 mini dental implant retained overdenture choice without using graft might be preferable instead of 2 narrow implant retained overdenture using graft procedure in terms of biomechanical aspect. Bilateral balanced occlusion might be better for distribution of occlusal forces. Key Words: resorbed mandible, dental implant, graft, finite element analysis

Anahtar Kelimeler:

rezorbe mandibula, dental implant, greft

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