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研究生：	張閔傑 Chang, Min-Chieh
論文名稱：	下顎甘迺迪第二類部分缺牙之選擇性雷射熔融鈦六鋁四釩支架的生物力學評估與抗菌塗層開發研究 Biomechanical Evaluation and Antimicrobial Coating Development of SLM-fabricated Ti-6Al-4V Frameworks in Mandibular Kennedy Class II Partial Edentulism
指導教授：	吳炳慶 Wu, Ping-Ching
學位類別：	博士 Doctor
系所名稱：	工學院 - 生物醫學工程學系 Department of BioMedical Engineering
論文出版年：	2026
畢業學年度：	114
語文別：	英文
論文頁數：	220
中文關鍵詞：	生物力學、鈦六鋁四釩、選擇性雷射熔融、可撤式局部義齒、有限元素分析、鈰離子、多醣包覆複合物、TSPBA-PVA塗層
外文關鍵詞：	Biomechanics, Ti-6Al-4V, Selective laser melting, Denture, Partial, Removable, Finite element analysis, Cerium ions, PLEC, TSPBA-PVA coating
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背景與目的：選擇性雷射熔融鈦六鋁四釩合金（Ti-6Al-4V, Ti64）可撤式局部義齒（removable partial denture, RPD）支架可作為鈷鉻合金（cobalt–chromium, CoCr）支架之替代方案，但其生物力學優化與抗菌表面之整合研究仍有限。本研究評估不同Ti64支架設計之生物力學效應，並開發適用於Ti64表面的抗菌塗層。
材料與方法：建立下顎甘迺迪第二類有限元素模型，比較一組CoCr支架與十六組具有不同卡環設計、舌側對抗構造及大連接體尺寸之Ti64支架於垂直與斜向受力下的生物力學表現。以有限元素分析評估應力分布與支持組織反應，並透過體外機械測試與數位影像相關法進行驗證。以鈰離子或多醣包覆複合物（polysaccharide-linked encapsulated complex, PLEC）處理之Ti64試片，透過菌落形成單位計數初步評估其對大腸桿菌（Escherichia coli, ATCC 8739；BCRC 11634）之抗菌效果。其後，以N¹-(4-硼酸基苄基)-N³-(4-硼酸基苯基)-N¹,N¹,N³,N³-四甲基丙烷-1,3-二銨（TSPBA）與聚乙烯醇（polyvinyl alcohol, PVA）製備鈰離子及PLEC負載塗層，並以掃描式電子顯微鏡觀察表面形態、NIH/3T3纖維母細胞進行萃取液體外細胞毒性試驗，以及抑菌圈試驗評估擴散相關抗菌行為。
結果：相較於CoCr，Ti64支架整體應力降低21%–43%。垂直受力下，牙周韌帶與支架應力分別最高降低40%及32%–46%。斜向受力下，大連接體應力降低約17%，而直接固位體、游離端黏膜及直接支台齒牙周韌帶應力分別增加約3%、13%及6%。支架應力重新分配主要受卡環與舌側對抗構造之交互作用影響，而增加大連接體剛性可穩定支架應力分布，並主要影響支持組織反應。鈰離子及PLEC處理試片均呈現濃度依賴性抗菌效果，分別自185 ppm與0.125%開始呈現抗菌活性。Ce-570與PLEC-0.5的菌量降低最明顯，而氧化鈰奈米粒子的效果有限。掃描式電子顯微鏡觀察顯示Ti64表面形成膜狀TSPBA–PVA塗層覆蓋。未添加抗菌劑之TSPBA–PVA塗層於測試條件下未呈現細胞毒性反應，導入抗菌劑後，細胞毒性則受抗菌劑種類與濃度影響。鈰離子塗層萃取液的非細胞毒性範圍較PLEC塗層廣。鈰離子與PLEC初步候選濃度區間分別為185–570 ppm與0.125%–0.25%。抑菌圈試驗中，鈰離子塗層未形成可偵測之抑菌圈，而PLEC塗層呈現濃度及時間依賴性之抑菌圈擴張。氯己定（chlorhexidine, CHX）塗層的早期反應較快，PLEC-0.25於48小時內與CHX大致相當，而PLEC-0.5於48小時的抑菌圈大於CHX。
結論：選擇性雷射熔融Ti64 RPD支架可透過應力重新分配改善整體載荷分布，其生物力學表現受材料性質、卡環設計、舌側對抗構造及大連接體剛性共同影響。TSPBA–PVA可作為抗菌功能化之塗層平台。鈰離子與PLEC均呈現濃度依賴性抗菌效果，但僅PLEC負載塗層呈現可偵測之時間依賴性抑菌圈擴張。

Background/purpose: Selective laser melting (SLM)-fabricated Ti-6Al-4V (Ti64) removable partial denture (RPD) frameworks offer an alternative to cast cobalt–chromium (CoCr) frameworks, but combined biomechanical optimization and antimicrobial surface functionalization remain underexplored. This dissertation evaluated the biomechanical effects of Ti64 framework design and developed antimicrobial coatings for Ti64 surfaces.
Materials and methods: A mandibular Kennedy Class II finite element model was used to compare one CoCr framework with sixteen Ti64 designs varying in clasp configuration, lingual reciprocal assembly (LRA), and major connector dimensions under vertical and oblique loading. Stress distributions and supporting tissue responses were evaluated using finite element analysis, with partial validation by in vitro mechanical testing and digital image correlation. Ti64 specimens treated with cerium ions or polysaccharide-linked encapsulated complex (PLEC) were initially screened against Escherichia coli (E. coli, ATCC 8739; BCRC 11634) by viable colony counting. Cerium ion- and PLEC-loaded coatings based on N¹-(4-boronobenzyl)-N³-(4-boronophenyl)-N¹,N¹,N³,N³-tetramethylpropane-1,3-diaminium (TSPBA) and polyvinyl alcohol (PVA) were evaluated by scanning electron microscopy (SEM), extract-based in vitro cytotoxicity testing using NIH/3T3 fibroblasts, and diffusion-related antimicrobial behavior by disc diffusion testing.
Results: Compared with CoCr, Ti64 reduced overall framework stress by 21%–43%. Under vertical loading, periodontal ligament (PDL) and framework stresses decreased by up to 40% and 32%–46%, respectively. Under oblique loading, major connector stress decreased by approximately 17%, whereas direct retainer, distal-extension mucosal, and direct-abutment PDL stresses increased by approximately 3%, 13%, and 6%, respectively. Framework stress redistribution was mainly governed by clasp–LRA interaction, whereas increasing major connector rigidity generally stabilized the stress distribution and primarily influenced supporting-tissue responses. Cerium ion- and PLEC-treated specimens showed concentration-dependent antibacterial effects, with activity evident at 185 ppm and 0.125%, respectively. Ce-570 and PLEC-0.5 produced the greatest bacterial reductions, whereas cerium oxide nanoparticles showed limited effects. SEM showed film-like TSPBA–PVA coating coverage on the Ti64 surfaces. TSPBA–PVA-only coatings were non-cytotoxic under the tested conditions, while cytotoxicity after antimicrobial incorporation depended on agent type and concentration. Provisional candidate concentration ranges were 185–570 ppm for cerium ions and 0.125%–0.25% for PLEC. Ce ion-loaded coatings produced no detectable inhibition zones, whereas PLEC-loaded coatings showed concentration- and time-dependent inhibition-zone expansion. The CHX-loaded coating showed a faster initial response, whereas PLEC-loaded coatings responded more slowly. PLEC-0.25 produced an inhibition-zone response generally comparable to CHX over 48 h, while PLEC-0.5 ultimately exceeded CHX at 48 h.
Conclusion: SLM Ti64 RPD frameworks improved overall load distribution through stress redistribution governed by material properties, clasp configuration, LRA incorporation, and major connector rigidity. TSPBA–PVA provided a feasible antimicrobial coating platform. Cerium ions and PLEC both showed concentration-dependent antibacterial activity, but only PLEC-loaded coatings exhibited detectable time-dependent inhibition-zone expansion.

摘要     I 
ABSTRACT      III
ACKNOWLEDGEMENT    V
CONTENTS    VII
LIST OF FIGURES    XIV
LIST OF TABLES    XIX
NOMENCLATURE    XXI
CHAPTER 1 INTRODUCTION	1
1.	RESEARCH BACKGROUND	1
1.1.	The demographic transition toward a super-aged society	1
1.2.	Epidemiology of partial edentulism and the persistent need for       removable partial dentures	2
2.	CLINICAL CHALLENGES AND COMPLICATIONS OF  CONVENTIONAL REMOVABLE PARTIAL DENTURES	3
2.1.	Limitations of removable partial denture frameworks fabricated by the       conventional lost-wax casting technique	4
2.2.	Biomechanical mechanism–related complications and fatigue failure	5
2.3.	Microbiologically mediated complications affecting oral supporting       tissues	6
3.	DEVELOPMENT OF MODERN REMOVABLE PARTIAL DENTURE   TECHNOLOGIES	7
3.1.	Emergence of additive manufacturing in removable partial denture      fabrication	7
3.2.	Advantages of SLM for the fabrication of removable partial denture       frameworks	8
3.3.	Accuracy of digitally fabricated removable partial denture frameworks:      evolution of evidence across three periods	9
3.4.	Manufacturing maturity and the shift toward performance optimization   12
3.5.	Initial surface roughness of SLM-fabricated removable partial denture        frameworks	14
3.6.	Effects of polishing on surface roughness and material loss	15
3.7.	Current limitations and the need for antimicrobial coatings	18
4.	IMPORTANCE OF ANTIMICROBIAL PROPERTIES IN  REMOVABLE PARTIAL DENTURES	18
4.1.	Mechanisms of biofilm formation and resistance	19
4.2.	Limitations of conventional bioinert materials	19
4.3.	Emerging antimicrobial strategies in biomedical engineering	20
4.4.	Opportunities and challenges for next-generation removable partial      denture frameworks	20
5.	SUMMARY OF THE INTRODUCTION	21
CHAPTER 2 LITERATURE REVIEW	23
1	PRINCIPAL STRESS CONCENTRATION REGIONS IN FREE-END  SADDLE REMOVABLE PARTIAL DENTURES	24
2	PATIENT-RELATED VARIABLES GOVERNING BIOMECHANICAL  BEHAVIOR AND STRESS DISTRIBUTION IN FREE-END SADDLE REMOVABLE PARTIAL DENTURES	26
2.1.	Mucosal resilience and residual ridge morphology	27
2.2.	Occlusal force and antagonistic dentition	28
2.3.	Periodontal status and support	29
2.4.	Summary of patient-related biomechanical determinants	31
3	DESIGN-RELATED VARIABLES GOVERNING BIOMECHANICAL  BEHAVIOR AND STRESS DISTRIBUTION IN FREE-END SADDLE REMOVABLE PARTIAL DENTURES	33
3.1.	Effects of different removable partial denture design philosophies	33
3.2.	Biomechanical considerations in abutment selection	36
3.3.	Biomechanical influence of rest configuration and spatial positioning       	37
3.4.	Biomechanical influence of clasp configuration and morphology	40
3.5.	Influence of major connector design on stress distribution and      prosthesis deflection	44
4	MATERIAL-RELATED VARIABLES GOVERNING  BIOMECHANICAL BEHAVIOR AND STRESS DISTRIBUTION IN FREE-END SADDLE REMOVABLE PARTIAL DENTURES	46
4.1.	The rigidity-flexibility trade-off	47
4.2.	Comparative analysis of esthetic and flexible polymers	48
4.3.	Current research gaps: Titanium and selective laser melting technology     	51
5	MODELING ASSUMPTIONS AND PARAMETERIZATION IN    FINITE ELEMENT ANALYSES OF FREE-END SADDLE REMOVABLE PARTIAL DENTURES	52
5.1.	Geometric, material, and boundary modeling assumptions	53
5.2.	Loading protocol definitions	54
5.3.	Summary of modeling assumptions and parameterization	56
5.4.	Extended validation rationale incorporating digital image correlation	58
6	ANTIMICROBIAL CHALLENGES IN REMOVABLE PARTIAL  DENTURES	61
6.1.	Biofilm related biological complications in removable partial denture       wearers	62
6.2.	Materials and design features of removable partial dentures that        promote biofilm retention	63
6.3.	Current antimicrobial strategies for dental materials and limitations in       the context of removable partial dentures	64
6.4.	Cerium-based antimicrobial and redox-active materials	69
6.5.	Natural bioactive alternatives: Polysaccharide-linked encapsulated       complex	71
6.6.	TSPBA–PVA adhesive platform for dual antimicrobial delivery	72
7	SUMMARY OF LITERATURE AND RESEARCH GAPS	77
8	RESEARCH OBJECTIVES AND SPECIFIC AIMS	81
8.1.	Biomechanical evaluation and optimization of framework design	82
8.2.	Preliminary development and biological evaluation of antimicrobial coatings	83
CHAPTER 3 MATERIAL AND METHODS	85
1	BIOMECHANICAL EFFECTS OF TITANIUM ALLOY REMOVABLE   PARTIAL DENTURE FRAMEWORK DESIGNS FABRICATED BY SELECTIVE LASER MELTING IN MANDIBULAR KENNEDY CLASS II PARTIAL EDENTULISM: A FINITE ELEMENT STUDY	86
1.1.	Research flowchart	86
1.2.	Digital experimental model construction	87
1.3.	Experimental design and group allocation	89
1.4.	Finite element model construction	90
1.5.	Quasi-static finite element analysis	94
1.6.	Experimental assemblies output	95
1.7.	Validation using in vitro mechanical test and digital image correlation      	96
2	PRELIMINARY DEVELOPMENT AND BIOLOGICAL     EVALUATION OF ANTIMICROBIAL-LOADED TSPBA–PVA COATINGS ON SLM TI-6AL-4V SURFACES	97
2.1.	Experimental sample preparation	97
2.2.	Bacterial strains and culture conditions	98
2.3.	Preparation of antimicrobial agents for preliminary antibacterial       screening	99
2.4.	Bacterial contact and incubation	102
2.5.	Bacterial harvesting, dilution, and plating	103
2.6.	Plate colony counting and antibacterial rate calculation	104
2.7.	Preparation of antimicrobial-loaded TSPBA–PVA coating	105
2.8.	Disc-diffusion evaluation of antimicrobial-loaded coatings	106
2.9.	Extract-based in vitro cytotoxicity assay	107
2.10.	Statistical analysis	108
CHAPTER 4 RESULTS	110
1	BIOMECHANICAL EFFECTS OF TITANIUM ALLOY REMOVABLE   PARTIAL DENTURE FRAMEWORK DESIGNS FABRICATED BY SELECTIVE LASER MELTING IN MANDIBULAR KENNEDY CLASS II PARTIAL EDENTULISM: A FINITE ELEMENT STUDY	110
1.1.	Comparison of FEA-predicted and DIC-measured strain patterns	110
1.2.	Overall stress distribution and material comparison	111
1.3.	Stress distribution in framework-related regions	114
1.4.	Distal extension mucosal strain and stress	118
1.5.	Stress distribution in the periodontal ligament of tooth 44	119
2	PRELIMINARY DEVELOPMENT AND BIOLOGICAL EVALUATION  OF ANTIMICROBIAL-LOADED TSPBA–PVA COATINGS ON SLM TI-6AL-4V SURFACES	124
2.1.	Preliminary concentration-dependent antibacterial screening of cerium    ions and polysaccharide-linked encapsulated complex	124
2.2.	Morphological characterization of TSPBA–PVA coatings	129
2.3.	Extract-based in vitro cytotoxicity of antimicrobial-loaded TSPBA–     PVA coatings	131
2.4.	Diffusion-related antimicrobial behavior of TSPBA–PVA coatings	133
CHAPTER 5 DISCUSSION	140
1	BIOMECHANICAL EFFECTS OF TITANIUM ALLOY REMOVABLE    PARTIAL DENTURE FRAMEWORK DESIGNS FABRICATED BY SELECTIVE LASER MELTING IN MANDIBULAR KENNEDY CLASS II PARTIAL EDENTULISM: A FINITE ELEMENT STUDY	140
1.1.	Stress distribution and tissue response in Ti-6Al-4V and cobalt-     chromium frameworks	140
1.2.	Clasp–LRA interaction and framework stress redistribution	141
1.3.	Supporting tissue response and connector rigidity	142
1.4.	Limitations and biomechanical implications	143
2	PRELIMINARY DEVELOPMENT AND BIOLOGICAL EVALUATION    OF ANTIMICROBIAL-LOADED TSPBA–PVA COATINGS ON SLM TI-6AL-4V SURFACES	144
2.1.	Preliminary antibacterial screening of cerium ions and polysaccharide-      linked encapsulated complex	144
2.2.	Extract-based in vitro cytotoxicity of antimicrobial-loaded TSPBA–PVA coatings	147
2.3.	Diffusion-related antimicrobial behavior of TSPBA–PVA coatings	149
2.4.	Characteristics of materials	152
2.5.	Limitations	155
3	FUTURE PERSPECTIVES: TOWARD AI-ASSISTED    BIOMECHANICAL OPTIMIZATION AND MULTIFUNCTIONAL REMOVABLE PARTIAL DENTURE SYSTEMS	158
3.1.	Future biomechanical optimization and AI-assisted RPD design	158
3.2.	Antimicrobial functionalization and biological resilience	160
3.3.	Integration and translational value of multifunctional RPD systems	162
CHAPTER 6 CONCLUSION	164
REFERENCES           166
                                    

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