| Objective: This study was conducted to systematicly review the clinical studies of using porous tantalum trabecular metal(PTTM)- enhanced titanium dental implants,(Ta-based Trabecular MetalTM Material TMT, Parsippany, NJ), combined with the three-dimensional finite element biomechanical analysis, and evaluate the clinical efficiency of its new three-dimensional structure and tantalum's excellent properties to explore its application value in the area of oral implant provide the theoretical basis in clinical practice. Methods:1. Nine electronic databases and relevant periodicals were searched for the appropriate study records without any restrictions on time, region and country. Screened papers based on inclusion/exclusion criteria and extracted relevant data, then incorporated qualified studies after risk assessments and made systematic reviews. 2. Established the solid model of approximate “trabecular metal” dental implant, regular titanium dental implant, mandible and abutment with the software “mimics16.0?CATIA?Hypermesh”, and then placed the two kinds of implants into three different types of bone qualities in mandible(?????) independently and assembled abutment. Load of 100 N was applied on the center of the abutment at a 45°angle to the vertical axis of the implants under the simulation of the implant in the bone block constraints. Stress and strain data was analyzed with software MSC Patran and MSC Nastran, and collected representative Von Mises stresses as well as analyzed the variation of stress in each situation. Results: 1. Of the 1,246 potentially qualified records, 17 were incorporated into the study by screening the titles and abstracts. After analyzing the full texts of these 17 records and making quality assessments. 7 studies involving 394 patients and 487 PTTMs- were identified, on which 221 patients and 244 PTTMs- were focused. The survival rate, mean marginal bone loss, initial and secondary stability, early and immediate loading(?6–8 weeks), and complications were chosen as indices by which to study clinical efficiency. 2. Six 3D finite element model representing PTTM and titanium dental implants under three types of bone quality(?????)in a portion of mandible at the first molar region was developed. Then drew stress line chart and stress distribution nephogram, and statistical analysis suggest that there is a significant difference of the average and maximum von Mises between PTTM and TI groups under three types of bone quality Conclusion: 1. PTTM dental implant can be widely used in patients with dentition defect and deletion whose survival rate of implant or early load is up to 96.23% with no series complications and the mean marginal bone loss was less than 0.43 mm. Preliminary data showed no statistically significant differences between conventional titanium and PTTMs although it suggests higher initial and secondary stability and better capability for immediate and early loading under limited clinical control and follow-up. 2. It considers that in this Three-dimensional Finite Element Analysis:(1) In experimental group and control group, the Von Mises were both focused on the interface of the jointing area of the abutment,implant and cortical bone,and trabecular bone were minimum.(2)As the bone density lowered,the average and maximum Von Mises increased for both of PTTM and TI dental implants,and the average and maximum Von Mises of PTTM dental implant are smaller than that of Titanium. |
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