Dab tsi yog Morse Taper?
Dec 21, 2023
Dab tsi yog Morse Taper?
Unraveling the Mystery of Morse Taper: Kev Tshawb Fawb Zoo Tshaj Plaws rau hauv Ntiaj Teb Kev Kho Hniav Kev Sib Txuas.
Kaum Ob Hlis 21, 2023
Tshawb nrhiav lub ntiaj teb txaus nyiam ntawm Morse Taper, lub tswv yim tshwj xeeb engineering uas ua lub luag haujlwm tseem ceeb hauv kev cog hniav. Unravel cov paub tsis meej tom qab Morse Taper qhov tseem ceeb hauv kev kho mob ntawm qhov ncauj thiab yuav ua li cas nws hloov pauv kev sib txuas ntawm kev cog thiab abutments. Koom nrog peb ntawm kev taug kev los tshawb txog cov thev naus laus zis thev naus laus zis tsim lub neej yav tom ntej ntawm kev kho hniav implantology!
Cov hniav cog hniav ua lub luag haujlwm tseem ceeb hauv kev kho cov hniav thiab kev puas tsuaj, dav siv hauv kev kho hniav kho hniav. Raws li kev cog qoob loo siv tshuab ua ntau dua, kev sib txuas ntawm kev cog thiab abutments tau txais kev saib xyuas ntau ntxiv los ntawm cov kws tshaj lij thiab cov kws tshawb fawb vim nws qhov cuam tshuam ntev rau kev cog qoob loo. Implant-abutment kev sib txuas poob rau hauv ob pawg: kev sib txuas sab nraud thiab kev sib txuas sab hauv. Kev sib txuas sab nraud suav nrog kev cog ntoo lub dav hlau sab saud 1-2 hli sab nraud, txuas nrog qhov sib thooj concave ntawm lub abutment lub dav hlau qis. Internal kev twb kev txuas, ntawm qhov tod tes, nta lub implant lub sab sauv dav hlau recessing nyob rau hauv, txuas nrog lub abutment lub sab dav hlau sab nraud protruding feem. Kev sib txuas sab nraud suav nrog hexagon, octagon, thiab cogwheel kev sib txuas, thaum kev sib txuas sab hauv suav nrog hexagon, octagon, cogwheel, thiab taper kev sib txuas, nrog Morse taper kev sib txuas, tseem hu ua Morse Taper, tau txais kev saib xyuas tseem ceeb hauv kev kho hniav niaj hnub.
1. Morse Taper Connection Structure:
Morse Taper qauv, tsim los ntawm American engineer Stephen A. Morse nyob rau hauv 1864, muaj ib lub khob hliav qab (hu ua txiv neej taper) haum rau lwm qhov sib txuam hollow cone (xws li poj niam taper), ob qho tib si sib koom taper cov ces kaum. Nyob rau hauv kev cog lus-abutment kev sib txuas siv Morse Taper, sab hauv junctions tsim los ntawm ob lub conical lug, nrog rau cov txiv neej taper nyob rau ntawm abutment kev twb kev txuas nto thiab tus poj niam taper ntawm lub cog kev twb kev txuas nto. Cov qauv conical no, nrog rau qhov sib luag-ntsib sib koom ua ke, nthuav qhia tus kheej-xauv tus yam ntxwv, tsim kom muaj kev sib txhuam loj heev los pab kom ruaj khov. Cov txheej txheem cog qoob loo uas muaj cov qauv Morse Taper suav nrog Bicon® (1.5 degree), Ankylos® (5.7 degree), ITI® (6 degree ~ 8 degree), thiab Astra Tech® (11 degree), nrog Bicon® thiab Ankylos® sawv cev zoo. -paub ntshiab Morse Taper txuas cog cog.
Bicon® (Bicon, USA) cog cog muaj 1.5 degree taper, tso siab rau ntawm Morse Taper qauv rau kev ruaj ntseg yam tsis muaj kev pab ntawm cov ntsia hlau, ua rau lawv siv dav hauv kev kho mob, tshwj xeeb tshaj yog rau kev cog qoob loo luv luv. Thaum lub sij hawm soj ntsuam cov txheej txheem cog, Bicon® implant abutments yog zaum los ntawm tapping, tso siab rau tag nrho cov kev sib txhuam rog ntawm qhov chaw sib txuas rau stabilization, tshem tawm kev txhawj xeeb txog cov ntsia hlau loosening los yog breakage. Txawm li cas los xij, Bicon® abutments tsis muaj cov cim qhia rau qhov chaw zaum. Hauv kev xyaum kho mob, cov txheej txheem sib luag X-rays tuaj yeem ua haujlwm los ntes periapical X-rays ntawm kev cog qoob loo los txiav txim siab qhov chaw zaum ntawm Morse Taper kev sib txuas implant abutment los ntawm kev ntsuam xyuas qhov muaj cov duab ntxoov ntxoo qis ntawm qhov abutment thiab cog.
Ankylos® (Dentsply Sirona, Lub teb chaws Yelemees) cov tshuab muaj 5.7 degree taper, sib txuas cov qauv Morse Taper nrog cov ntsia hlau kho. Nyob rau hauv kev kho mob, ib tug torque wrench yog siv los zawm lub hauv paus ntsia hlau, ruaj lub abutment rau lub cog, uas ua rau ntau dua nyob rau hauv lub sij hawm retention.
2. Cov yam ntxwv ntawm Morse Taper Txuas:
(1) Kev ruaj ntseg siab:
Kev ruaj ntseg ntawm kev cog hniav yog qhov tseem ceeb tshaj plaws uas cuam tshuam rau lawv lub sijhawm khaws cia ntev. Hauv ntau qhov xwm txheej, kev sib txuas thiab kev ruaj ntseg ntawm kev cog thiab abutments koom nrog kev siv lub hauv paus ntsia hlau. Lub torque siv rau lub hauv paus ntsia hlau no txiav txim siab qhov preload ntawm qhov cog-abutment interface. Qhov no preload, ua ke nrog kev tiv thaiv ntawm kev cog hniav-abutment kev twb kev txuas nto qauv, collectively influences stability ntawm cov hniav implants. Yog li ntawd, torque plays lub luag haujlwm tseem ceeb hauv kev tswj xyuas qhov nruj ntawm qhov cog-abutment interface. Tsim nyog torque tuaj yeem txo cov ntsia hlau loosening thiab marginal qhib. Lub zog sab nraud ntau dhau ntawm qhov cog, tshaj qhov preload thiab kev sib txhuam ntawm qhov chaw sib txuas, tuaj yeem ua rau lub zog poob, ua rau cov ntsia hlau loosening lossis txawm tawg, cuam tshuam rau kev cog qoob loo. Morse Taper kev twb kev txuas, nrog nws cov conical txuam nto tsim ib tug self-locking nyhuv, muab siab stability.
Mangano et al. tau ua ib qho kev tshawb nrhiav tom qab ntawm 178 Morse Taper kev cog lus cog rau hauv 49 tus neeg mob nyob rau lub sijhawm 10 txog 20 xyoo. Cov txiaj ntsig tau pom qhov muaj sia nyob (10 xyoo thiab siab dua) ntawm 97.2%, ze ze rau qhov tshaj tawm 10-xyoo muaj sia nyob tus nqi rau kev cog qoob loo (96.7%). Kev tshawb fawb los ntawm Feitosa et al. Muab piv Morse Taper, sab nraud hexagon, thiab sab hauv hexagon txuas implants nyob rau hauv tib qhov ntxig torque pom tias Morse Taper kev twb kev txuas implants nthuav tawm ntau dua pib tshem tawm torque thiab tsawg dua torque poob tom qab kev qaug zog piv rau sab nraud hexagon thiab sab hauv hexagon cog cog. Yog li ntawd, Morse Taper kev twb kev txuas implants pom zoo stability dua hexagon txuas implants.
(2) Zoo heev haum:
Micro-gap ntawm qhov cog-abutment kev sib txuas interface tuaj yeem cuam tshuam lub foob thiab ua haujlwm ua cov ntsiab lus tsis zoo rau microbial ntxeem tau. Microbial tsub zuj zuj tuaj yeem ua rau cov pob txha pob txha puas tsuaj, cuam tshuam rau osseointegration, thiab ua rau muaj teeb meem loj xws li peri-implantitis, uas yuav ua rau kev cog hniav tsis ua haujlwm. Cov kev tshawb fawb tau pom tias tsis hais hom kev sib txuas, ob-thooj kev cog hniav pom muaj qee qhov kab mob sib kis ntawm qhov chaw cog-abutment txuas. Txawm li cas los xij, cov qauv sib txawv ntawm kev cog-abutment kev sib txuas interfaces tuaj yeem cuam tshuam rau lawv qhov haum. Morse Taper kev twb kev txuas implants qhia ib tug meej kom zoo dua nyob rau hauv cov nqe lus ntawm haum ntawm lub cog-abutment kev twb kev txuas.
Kev tshawb fawb los ntawm Jaworski thiab Tripodi tau lees paub tias Morse Taper kev cog cog cog pom qhov zoo tshaj plaws ntawm kev cog cog-abutment piv rau sab nraud hexagon thiab sab hauv hexagon cog cog. Kev tshawb fawb los ntawm ua Nascimento, immersing implants ntawm ntau hom kev sib txuas hauv cov qaub ncaug rau kev sim siab cycling, qhia tias Morse Taper kev txuas cog cog muaj cov kab mob tsawg tshaj plaws ntawm qhov kev sib txuas sib txuas piv rau sab nraud hexagon thiab sab hauv hexagon txuas implants.
(3) Yam tsawg kawg nkaus Peri-implant pob txha Resorption:
Peri-implant pob txha ntim, nrog rau cov pob txha qhov siab thiab tuab, cuam tshuam rau kev tuav mus ntev thiab kev zoo nkauj ntawm kev cog hniav. Tom qab implantation, pob txha resorption nyob ib ncig ntawm implants yog ib txwm muaj, thiab ntau resorption tuaj yeem ua rau muaj qhov sib sib zog nqus peri-implant hnab ris, implant loosening, lossis txawm tias cog tsis ua haujlwm. Weng et al. piv cov pob txha ntim hloov nyob rau hauv thawj 3 lub hlis tom qab implantation ntawm sab nraud hexagon thiab Morse Taper kev twb kev txuas implants nyob rau hauv ib tug tsiaj qauv, nrhiav tau hais tias Morse Taper kev twb kev txuas implants exhibited ho tsawg peri-implant pob txha resorption dua lwm hexagon txuas implants. Clinical randomized tswj kev sim los ntawm Pessoa li al. tau lees paub tias Morse Taper kev cog cog cog tau txo qis cov pob txha resorption ib xyoos tom qab cog qoob loo piv rau lwm cov hexagon txuas cog, ua raws li cov txiaj ntsig tau hais tseg.
Peri-implant pob txha ntim kuj tseem cuam tshuam rau qhov zoo nkauj ntawm kev kho kom zoo nkauj. Mangano et al. tau ua ib qho kev tshawb fawb rov qab txog tam sim thiab ncua sij hawm cog qoob loo hauv thaj av sab nrauv maxillary siv Morse Taper txuas cog cog. Lawv tau txiav txim siab tias Morse Taper txuas cog cog, txawm tias siv rau kev cog qoob loo tam sim lossis ncua sij hawm, tau pom cov qib peri-implant pob txha resorption tau zoo thiab nthuav tawm cov ntaub so ntswg zoo, ua rau muaj txiaj ntsig zoo nkauj. Txawm li cas los xij, nws yog ib qho tsim nyog sau cia tias thaum Morse Taper txuas kev cog cog qoob loo yuav muaj tsawg dua peri-implant pob txha resorption piv rau lwm cov kev sib txuas nrog kev cog qoob loo, tsis muaj qhov sib txawv tseem ceeb hauv peri-implant tsis, cov ntaub so ntswg hloov, lossis qhov siab ntawm gingival papilla nyob ib ncig ntawm qhov kawg implants. kho dua tshiab. Tsis tas li ntawd, ib pawg neeg tsawg ntawm cov ntaub ntawv tshaj tawm tias hom kev sib txuas ntawm qhov chaw cog-abutment interface tsis cuam tshuam rau peri-implant pob txha resorption. Yog li ntawd, kev kho kom zoo nkauj kho kom zoo nkauj ntawm Morse Taper kev sib txuas implants tseem xav tau mus ntevsoj ntsuam tswj kev sim rau validation.
3. Kev nce qib hauv daim ntawv thov ntawm Morse Taper Connection Implants:
Raws li tau hais ua ntej, peri-implant pob txha resorption yog ib qho kev sib tw uas tsis hais txog hom kev cog cog cog. Kev txo qis los yog tiv thaiv cov pob txha resorption nyob ib ncig ntawm qhov chaw cog qoob loo yog ib qho tseem ceeb rau kev ua kom ntseeg tau qhov kev cog qoob loo mus ntev. Ob qho tib si Morse Taper kev sib txuas thiab platform hloov cov tswv yim yog suav tias zoo hauv kev txo cov pob txha resorption. Yog li ntawd, cov ntaub ntawv tsis ntev los no qhia txog kev sib txuas ntawm Morse Taper kev sib txuas thiab lub platform hloov mus rau txo cov pob txha resorption nyob ib ncig ntawm kev cog qoob loo. Kev hloov pauv ntawm lub platform yuav tsum siv lub abutment nrog ib txoj kab uas hla me dua li txoj kab uas hla ntawm cog, tso lub abutment ntug nyob rau hauv lub platform sab saum toj ntug ntawm cov cog es tsis aligning nws nrog lub platform ntug. Cov kev tshawb fawb tau pom tias kev siv lub platform hloov thaum lub sij hawm implant restoration yuav txo tau peri-implant pob txha resorption thiab txhawb kev tsim ntawm ib tug cuff ntawm cov ntaub so ntswg nyob ib ncig ntawm lub implants, tiv thaiv cov kab mob infiltration thiab txhim kho cov txiaj ntsig mus ntev. Implant systems, xws li Ankylos® system, uas koom ua ke Morse Taper kev sib txuas nrog lub platform hloov tam sim no muaj nyob hauv khw.
Romanos et al. tau ua ib qho {{0}} xyoo rov qab los ntawm 634 Morse Taper kev twb kev txuas implants tsim nrog hloov platform, ua tiav qhov kev cog qoob loo zoo kawg li ntawm 98.74%. Raws li kev txheeb xyuas txawv teb chaws, caj dab pob txha resorption nyob rau hauv 1.5 mm nyob rau hauv thawj xyoo tom qab implantation yog suav tias yog ib txwm. Cov kev tshawb fawb tau pom tias Morse Taper kev txuas cog cog ua ke nrog kev hloov pauv platform pom cov pob txha resorption zoo nyob rau thawj xyoo (0.26 ~ 0.56 hli). Romanos et al. piv rau peri-implant pob txha tej yam kev mob ob xyoos tom qab implantation ntawm Morse Taper kev twb kev txuas implants nrog platform switching thiab cov uas tsis muaj, nrhiav tau ho tsawg dua pob txha resorption (< 2 mm) in the Morse Taper connection implant group. These studies suggest that the combination of Morse Taper connection and platform switching has a positive effect on reducing bone resorption around implants. Regarding stress distribution, Liu et al. conducted finite element analysis on Morse Taper connection implants (Ankylos) using platform switching. The study found that stress concentrated mainly at the abutment neck and the connection between the abutment and implant for the implant itself. Around the implant, stress was distributed mainly in the cortical bone, and compared to non-Morse Taper connection implants (Anthogyr) with platform matching, Morse Taper connection implants with platform switching exhibited a more uniform stress distribution with lower stress in the peri-implant bone. However, the maximum von Mises stress values were higher in the abutment neck and the portion where the abutment was inserted into the implant. Regarding aesthetic restoration outcomes, Vinnakota et al. reported on four cases using platform switching with Morse Taper connection implants, indicating ideal aesthetic outcomes for all cases after one year, highlighting the effectiveness of Morse Taper connection and platform switching. Currently, there is a lack of long-term studies on the retention rate and long-term aesthetic outcomes of implants combining these two approaches.
Morse Taper kev twb kev txuas poob rau hauv qeb ntawm kev sib txuas nrog thiab muaj qhov zoo ntawm kev sib txuas sab nraud, xws li kev tiv thaiv rau sab nraud thiab kev sib hloov ruaj khov. Kev qaug zog txog kev ua tsis tiav feem ntau tshwm sim ntawm qhov chaw abutment thiab ntsia hlau fixation, tso cai rau abutment lossis central ntsia hlau hloov tom qab tawg. Morse Taper kev twb kev txuas implants kuj muab ib tug ntau dua gingival nyob deb, yooj yim rau tom qab-theem kho dua tshiab. Tsis tas li ntawd, piv rau cov cog cog nrog lwm hom kev sib txuas, Morse Taper kev cog cog cog muaj qhov ruaj khov dua, zoo dua rau ntawm qhov chaw sib txuas, thiab tsawg dua peri-implant pob txha resorption. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias Morse Taper kev cog cog tseem muaj qee qhov kev txwv: kev cog cog nrog lub me me taper yog qhov nyuaj los hloov; Morse Taper kev twb kev txuas implants yam tsis muaj ntsia hlau-pab fixation yog ib qho nyuaj los txiav txim seb puas zaum tag nrho, thiab txoj kev tapping tapping tej zaum yuav intolerable rau cov neeg laus cov pob txha tsis muaj zog. Ntxiv mus, ob peb Morse Taper kev twb kev txuas implants tsis tau zam tag nrho cov kab mob microbial ntawm lub cog-abutment kev twb kev txuas nto. Yog li ntawd, kev txhim kho kev kho mob ntawm Morse Taper kev twb kev txuas implants thiab harnessing lawv qhov zoo los tiv thaiv kab mob sib kis ntawm qhov kev sib txuas interface yog kev tshawb fawb yav tom ntej. Tib lub sijhawm, kev sim tshuaj mus sij hawm ntev ntxiv yog xav tau los tshawb nrhiav qhov ua tau zoo ntawm Morse Taper kev cog lus cog.
