臺灣博碩士論文加值系統

伴隨著醫療科技的日新月異以及臨床醫學與日俱進，使得近幾年愈來愈多的缺牙患者選擇人工植牙的方式來治癒缺牙症狀，植牙手術的成功關鍵在於牙植體術後之穩定性與骨整合的情況。而過往的研究多半著重於優化牙植體之設計與改變植體表面材料性質達到提升骨整合之功效。經由相關臨床文獻可得知，植牙手術之預成形鑽孔過程具有影響牙植體術後之骨整合效應。然而，在植牙手術過程中，幾乎少不了使用鑽頭器械來進行切削或鑽孔之行為，也代表著牙植體鑽頭是手術中最不可或缺的工具之一。因此，本研究透過具破壞準則之動態有限元素分析法(finite element method,FEM)與鑽孔力學試驗探討預成形鑽孔過程之力學行為，並且比較不同幾何外型的牙植體鑽頭與轉速對於切削扭值與切削反作用力值以及齒槽骨應變能之影響。
研究過程中選用直徑2.0mm的Nobel Biocare人工牙植體鑽頭作為更改鑽頭幾何外型與鑽孔試驗之樣本。首先，分別使用800rpm、1200rpm、1600rpm、2000rpm四種不同的切削轉速進行預成形鑽孔，並將分析之結果與鑽孔試驗相互驗證，確認有限元素模擬之可行性與可信度。接著，再使用有限元素分析探討牙植體鑽頭其鑽頂角(75°、90°、118°)、螺旋角(13°、23°、33°)、螺旋槽數目(雙螺旋槽、三螺旋槽式)的變化對於切削扭矩值與切削反作用力之影響。
有限元素分析結果顯示，鑽頭轉速增加時，其切削反作用力值有下降之趨勢，反之，切削扭矩值具遞增之現象，並與實際鑽孔試驗的趨勢相符。然而，當鑽頂角為75°時，能最有效降低預成形鑽孔過程中對於齒槽骨所產生的應變能；當螺旋槽數目由雙槽式增加至三槽式時，具有減少切削反作用力之效果；當螺旋角增加時，切削扭矩值與齒槽骨之應變能皆有降低之現象，若不考慮排屑過程之影響，螺旋角為23°、33°較適合應用於臨床手術器械之設計，此資訊可以提供研發新型牙植體鑽頭之參考依據。

The technologies of Medical treatment and clinical surgery have been highly developed in recent years. So, there are more and more patients with missing teeth choose dental implant as their medical treatment. The Key point of executing a successful dental implant surgery is the stability of implant and the compatibility with surrounding osseous structures. Much research has been carried out recently on the optimal design of implant structure and the physical properties on the implant surface in order to enhance the effectiveness of osseointegration. As we know from the literature of clinical surgery, the pre-formed drilling process in implant surgery has a great impact on the osseointegration following insertion. But the dental implant surgery always encounters the preparation process: cutting and drilling, it indicates that the implant drill is considered the most crucial tool in the surgery. In this study, we investigated the influence on the strain energy, drilling torque and drilling reaction force in the alveolar bone under different geometrical shapes of implant drill and spindle speeds.
The experiments were performed with a 2.0mm diameter Nobel Biocare artificial implant drill as our base model of each drilling experimental-set. First, we executed the pre-formed drilling process under four different drilling speeds, 800rpm, 1200rpm, 1600rpm and 2000rpm, respectively. And then, we compared the analytical result with the drilling experiment results to validate the feasibility and reliability of the simulation. After that, finite element analyses were performed on the dental implant drills with three different geometric features, point angle (75°, 90°, 118°), helix angle (13°, 23°, 33°) and dill flute (2-flutes and 3-flutes) to investigate the influence of each experimental-set on the drilling torque and drilling reaction force.
The results of finite element analyses showed that the drilling reaction force decreased and the drilling torque raised gradually when the speed of drill bit raised. So, the results matched well with the results from the drilling experiments. Furthermore, when the point angle is 75°, it can reduce the strain energy generated by the pre-formed drilling process in the alveolar bone effectively. As the drill flute number is 3-flutes, it can reduce the drilling reaction force. The drilling torque and the strain energy in the alveolar bone declined when larger helix angle was used. Without consideration of the influence of bone chip removal, the helix angles of 23°and 33°are more suitable in clinical surgery tool design. In this study, we provided a set of more optimal design parameters for the design of new implant drills.

中文摘要 i
ABSTRACT iii
誌謝 v
表目錄 ix
圖目錄 x
第一章 緒論 1
1.1前言 1
1.2研究背景與文獻回顧 2
1.2.1 牙植體鑽頭 2
1.2.2鑽頭幾何外型參數 3
1.2.3有限元素分析之相關研究 10
1.2.4預成形鑽孔與骨頭組織 13
1.2.5文獻總結 16
1.3 研究目的與動機 16
第二章 基礎理論 17
2.1牙齒結構與牙周組織 17
2.2牙植體鑽頭 20
2.3術前規畫與手術過程 21
2.4骨整合定義 22
2.5破壞理論 22
第三章 材料與方法 24
3.1 研究流程 24
3.2 研究材料與儀器 25
3.2.1 牙植體鑽頭 25
3.2.2 人造假骨試片 26
3.2.3 精密動態鑽孔裝置 27
3.2.4圓鋸切割機 28
3.3 研究方法 29
3.3.1 鑽孔試驗設計 29
3.3.2 有限元素模型建立 32
3.3.3 材料參數設定 35
3.3.4有限元素分析 37
第四章 結果 39
4.1預成形鑽孔力學試驗 39
4.1.1牙植體鑽頭之切削扭矩值 39
4.1.2牙植體鑽頭之切削反作用力值 40
4.2有限元素分析 40
4.2.1預成形鑽孔轉速之影響 41
4.2.2牙植體鑽頭之幾何外型之影響 43
4.3有限元素分析與鑽孔試驗之比較 53
4.3.1牙植體鑽頭之切削反作用力 53
4.3.2牙植體鑽頭之切削扭矩值 55
第五章 討論 58
5.1牙植體鑽頭幾何外型之影響 58
5.1.1鑽頂角對於切削行為之影響 58
5.1.2螺旋角對於切削行為之影響 59
5.1.3螺旋槽數目對於切削行為之影響 60
5.2鑽頭轉速於切削行為之影響 60
5.3研究限制與誤差原因 61
第六章 結論 63
參考文獻 64

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