本文主要是利用三維動態彈塑性有限元素模型來模擬分析人工牙根之鑽孔流程造成齒槽骨之溫升情形，探討不同人工牙根鑽孔參數對齒槽骨溫升之影響。本文所探討之鑽孔參數則分為兩大部分，分別為鑽頭設計參數及手術流程參數。在鑽頭設計參數部分，利用田口品質設計方法獲得鑽頭設計最佳化之參數組合。手術流程參數部分，針對Straumann標準鑽孔流程進行分析，並探討修改Straumann標準鑽孔流程之可行性。分析結果顯示，在固定進刀速率下，影響齒槽骨溫升之重要因子為螺旋角、鑽槽寬比、鑽頭直徑、鑽頭間隙角、鑽頂角，其中以螺旋角影響最大。分析結果也顯示，在Straumann標準流程中，造成齒槽骨最大溫升為無預鑽機制之鑽頭直徑D=2.2 mm之鑽孔。此外，研究結果也指出，可透過手術流程參數的變化，達到手術簡化及減少手術風險之效果。本文之分析結果可提供人工牙根廠商及臨床醫師，於鑽頭設計及鑽孔手術時之參考。

In this thesis, the effects of dental implant drilling parameters on the temperature rise of alveolar bone are investigated using a three-dimensional elastic-plastic dynamic finite element model. The parameters discussed are the geometrical parameters of drill bit and procedure parameters of surgery. In the analysis of geometrical parameters of drill bit, the Taguchi method is used to obtain the optimum parameters. In the analysis of procedure parameters of surgery, the Straumann standard drilling procedures are investigated and the possibility to modify the Straumann standard drilling procedures is also studied. The results indicate that for a constant feed rate, the helix angle, the specific heat of material, the flute/land ratio, the diameter and the point angle of drill are the key parameters affecting the bone temperature rise. Among these parameters, the helix angle affects most significantly. The results also show that, in Straumann standard drilling procedure, the maximum bone temperature rise occurs when a 2.2 mm-diameter drill bit is used with no pre-drilling.
In addition, the results also indicate that the modification of surgical process can simplify the surgery and reduce the risk. The research results can provide a basis for the design of drill bit to the dental implant manufacturer and the improvement of surgical operations to the dentist.

目 錄
摘要....................................... ......I
Abstract.........................................II
謝誌........................................... .IV
目錄 ............................................VI
表目錄...........................................IX
圖目錄...........................................XI
第1章 緒論 1
1.1前言 1
1.2文獻回顧 2
1.3組織與章節 5
第2章 問題背景與研究方法 6
2.1齒槽骨上溫度變化之影響 6
2.2鑽孔過程產生溫升之行為 8
2.3鑽頭設計參數 10
2.4植牙手術流程 13
2.5田口法 15
第3章 人工牙根鑽孔溫升之實驗量測 19
3.1實驗設備 19
3.2實驗步驟 25
第4章 人工牙根鑽孔之有限元素分析 31
4.1有限元素模型 31
4.2材料性質與邊界條件 35
4.3人工牙根鑽孔參數 37
4.4有限元素模型驗證 38
第5章 結果與討論 40
5.1齒槽骨上最高溫度發生位置及時間 40
5.2 鑽頭設計參數對齒槽骨溫升之影響 46
5.2.1 定義問題 46
5.2.2 選擇控制因子和相關水準 46
5.2.3 選擇適用直交表 46
5.2.4 執行分析並收集結果 48
5.2.5依品質特性計算的各分析結果之S/N比及 51
5.2.6各因子對於S/N比與 之影響 53
5.2.7 決定控制因子的最佳水準組合 57
5.2.8 確認最佳化參數並進行分析 60
5.3 手術流程參數對齒槽骨溫升之影響 62
5.3.1 Straumann標準鑽孔流程所造成之溫升情形 62
5.3.2 修改Straumann標準鑽孔流程所造成之溫升情形 77
第6章 結論 90
參考文獻 92
作者簡介 96

參考文獻
1. Alberktsson, T., Branemark, P. I., Hansson, H. A. and Lindstrom, J., 1981, “Osteointegrated titanium implants: requirements for ensuring a longlasting, direct bone-to-implant anchorage in man,” Acta Orthopedica Scandinavica, Vol. 52, pp. 155-170.
2. Eriksson, R.A., and Alberksson, T., 1983, “Temperature thereshold levels for heat induced bone tissue injury: a vital microscopic study in rabbit,” Journal of Prosthetic Dentistry, Vol. 50, pp. 101-107.
3. Cotisch, E. R., Youngblood, P. J. and Walden, J. M., 1964, “A study of the effects of high-speed rotatory instruments on bone repair in dogs,” Journal of Oral Surgery, Vol. 17, pp. 563-571.
4. Matthews, L. S. and Hirsch, C., 1972, “Temperatures measured in human cortical bone when drilling,” Journal of Bone & Joint Surgery, Vol. 54, pp. 297-308.
5. Krause, W. R., Bradbury, D. W., Kelly, J. E. and Lunceford, E. M., 1982, “Temperature elevation in orthopedic cutting operations,” Journal of Biomechanical Engineering, Vol. 15, pp. 267-275.
6. Watanabe, F., Tawada, Y., Komatsu, S. and Hata, Y., 1992, “Heat distribution in bone during preparation of implant sites: Heat analysis by real-time thermography,” The International Journal of Oral & Maxillofacial Implants, Vol. 7, pp. 212-219.
7. Brisman, D. L., 1996, “The effect of speed, pressure, and time on bone temperature during the drilling of implant sites,” The International Journal of Oral & Maxillofacial Implants, Vol. 11, pp. 35-37.
8. Benington, I.C., Biagioni, P. A., Crossey, P. J., Hussey, D. L., Sheridan, S. and Lamey, P. J., 1996, “Temperature changes in bovine mandibular bone during implant site preparation: An assessment using infrared thermography,” Journal of Dentistry, Vol. 24, pp. 263-267.
9. Cordioli, G. and Majzoub, Z., 1997, “Heat generation during implant site preparation: An in vitro study,” The International Journal of Oral & Maxillofacial Implants, Vol. 12, pp. 186-193.
10. Tehemar, S., 1999, “Factors Affecting Heat Generation During Implant Site Preparation: A Review of Biologic Observations and Future Considerations,” The International Journal of Oral & Maxillofacial Implants, Vol. 14, pp. 127-136.
11. Sharawy, M., Misch, C. E., Weller, N. and Tehemar, S., 2002, “Heat Generation During Implant Drilling:The Significance of Motor Speed,” Journal of Oral and Maxillofacial Surgery, Vol. 60, pp. 1160-1169.
12. Sean, R. H. and David, F., 2003, “Drilling in Bone:Modeling heat generation and temperature distribution,” Journal of Biomechanical Engineering, Vol. 125, pp. 305-314.
13. Ercoli, C., Paul, D., Lee, H. J. and Mark, E., 2004, “The Influence of Drill Wear on Cutting Efficiency and Heat Production During Osteotomy Preparation for Dental Implants: A Study of Drill Durability,” The International Journal of Oral & Maxillofacial Implants, Vol. 19, pp. 335-349.
14. Guillermo, E., Daniel, L., Peter, E., Edwin, A.and Michael B., 2006, “Heat Production by 3 Implant Drill Systems After Repeated Drilling and Sterilization,” Journal of Oral and Maxillofacial Surgery, Vol. 64, pp. 265-269.
15. Taguchi, G., Chowdhury, S. and Wu, Y., 2005, Taguch’s Quality Engineering Handbook, John Wiley, USA.
16. Shetty, V. and Bertolami, C. N., 1992, “The physiology of wound healing,” in Principles of Oral and Maxillofacial Surgery, pp. 3-18, JB Lippincott, Philadelphia..
17. Weiss, C. M., 1986, “Tissue integration of dental osseous implants: Description and comparative analysis of the fibro-osseous integration and osseous integration systems,” Journal of Oral Implantology, Vol. 12, pp. 169-214.
18. Ludewig, R., 1972,Temperaturmessungen beim Knochensagen , Thesis, Univ of Gissen, Gissen.
19. Rhinelander, F., Nelson, C. L., Stewart, R. D. and Stewart, C. L., 1979, “Experimental reaming of the proximal femur and acrylic cement implantation. Vascular and histologic effects,” Clinical Orthopaedics and Related Research, Vol. 141, pp. 74-89.
20. Eriksson, R. A., Albrektsson, T., Grane, B. and McQueen, D., 1982, “Thermal injury to bone. A vital microscopic description of heat effects,” International Journal of Oral Surgery, Vol. 1, pp. 115-121.
21. Eriksson, R.A. and Albrektsson, T., 1984, “The effect of heat on bone regeneration: An experimental study in rabbit using the bone growth chamber,” Journal of Oral and Maxillofacial Surgery, Vol. 42, pp. 705-711.
22. Mauch, M., Currey, J. D. and Sedman, A. J., 1992, “ Creep fracture in bones with different stiffness,” Journal of Biomechanics, Vol. 25, pp. 11-16.
23. Rimnac, C. M., Pekto, A. A., Santner, T. J. and Wright, T. M., 1993, “The effect of temperature, stress and microstructure on the creep of compact bovine bone,” Journal of Biomechanics, Vol. 26, pp. 219-228.
24. 趙芝眉，湯銘權，2002， 金屬切削原理，成陽出版社，台北，第133-135頁。
25. 傅光華，1982，切削刀具學，高立圖書，台北，第15-37頁。
26. http://www.straumann.com, Accessed 01 June 2009.
27. http://www.matweb.com, Accessed 01 June 2009.
28. 蘇朝墩，2002，品質工程，中華民國品質學會，台北。
29. http://www.sawbones.com, Accessed 01 June 2009.
30. Chen, C. S. and Lee, W. D., 2007, “Analysis and Optimum Design of Sheet Metal Parts Subjected To Pure Torsional Loading,” Journal of technology, Vol. 22, No.4, pp. 291-297.
31. 李輝煌，2000，田口方法-品質設計的原理與實務，高立圖書，台北，第73-280頁。
32. 傅光華，1982，切削刀具學，高立圖書，台北，第275-285頁。
33. Mellal, A., Wiskot, H. W., Botsis, J., Scherrer, S. S. and Belser, U. C., 2004, “Stimulating effect of implant loading on surrounding bone : Comparison of three numerical models and validation by in vivo data,” Clinical Oral Implants Research, Vol. 15, pp. 239-2418.